Evie Summers
Waking up gasping for air can be a frightening experience and may indicate an underlying health condition. There are several potential causes, some of which are benign, while others may be more serious. Obstructive sleep apnea (OSA) is a common cause, affecting approximately 12% of American adults, and is characterised by pauses in breathing during sleep due to airway obstruction. Other causes include post-nasal drip, acid reflux, anxiety, and nocturnal asthma. If you regularly experience this symptom or have concerns about potential causes, it is recommended to consult a doctor for proper diagnosis and treatment.
| Characteristics | Values |
|---|---|
| Frightening experience | Yes |
| Underlying causes | Sleep apnea, post-nasal drip, anxiety, nocturnal panic attacks, asthma, acid reflux, pulmonary edema, congestive heart failure, etc. |
| Treatment | CPAP machine, antianxiety medication, lifestyle changes, saline nasal sprays, antihistamines, steroid nasal spray, etc. |
| When to see a doctor | Regular occurrence, accompanied by other symptoms like chest pain, difficulty in normal breathing, etc. |
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What You'll Learn
Sleep apnea
Waking up gasping for air can be a frightening experience and can negatively impact sleep quality. Sleep apnea is one of the many causes of this occurrence. Sleep apnea is a common condition that occurs when your breathing stops and restarts many times while you sleep, which can prevent your body from getting enough oxygen. The two main types of sleep apnea are:
Obstructive Sleep Apnea (OSA)
OSA is the most common form of this nighttime breathing disorder. It occurs when the tongue and other tissues in the mouth fall backward and block the airway when sleeping. Each time this happens, breathing can stop for up to a minute or more, and it can happen hundreds of times per night. OSA develops when the airways collapse and become obstructed. People with OSA may snore loudly or wake up choking or gasping for breath. Additional symptoms include morning headaches, trouble focusing, and feeling excessively tired or irritable during the day. OSA may affect approximately 12% of American adults and is believed to be more common in people with prostates. Obesity, large tonsils, or changes in hormone levels can also increase the risk of OSA.
Central Sleep Apnea (CSA)
CSA is less common than OSA and is not caused by blocked airways. Instead, signals from the brain that normally maintain breathing during sleep malfunction, resulting in periods of little or no airflow into the lungs. CSA can be caused by certain medical conditions or drugs, as well as sleeping at high altitudes.
If you suspect that you have sleep apnea, you should consult a doctor or a sleep specialist, who may recommend a sleep study, which can be done at home or in a hospital sleep clinic. Treatment for sleep apnea may include the use of a continuous positive air pressure (CPAP) machine, lifestyle changes, or, in some cases, surgery.
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Asthma and nocturnal asthma
Waking up gasping for air can be a frightening experience. There are many reasons why someone might wake up gasping for air, including sleep-related breathing disorders, panic attacks, anxiety, acid reflux, and asthma.
Nocturnal asthma, or nighttime asthma, is a chronic lung disease that causes shortness of breath, wheezing, chest tightness, and coughing. People with nocturnal asthma experience symptoms while sleeping, which can disrupt sleep and make managing asthma more difficult. Nocturnal asthma is very serious and can be fatal. The chances of experiencing asthma symptoms are higher during sleep, and studies show that most deaths related to asthma symptoms occur at night. Nocturnal asthma can also affect children's school performance and cause parents to miss work.
The exact cause of nocturnal asthma is not completely understood, but several factors can make asthma worse at night. One factor is the daily cycle of bronchioles, the tiny branches of tubes in the lungs. Bronchioles are most constricted (or closed) around 4 a.m., leading to increased airway resistance during sleep, which can worsen asthma symptoms. Additionally, epinephrine, a hormone that helps keep airways open, is at its lowest levels around the same time, further increasing the risk of nocturnal asthma.
Other factors that can trigger nocturnal asthma include:
- Mucus from post-nasal drip
- Allergens, such as dust mites, animal dander, mold, and pollen
- Cold air or exposure to tobacco smoke
- Diet, especially the consumption of sulfites found in beer, wine, dried fruit, processed potatoes, and shrimp too close to bedtime
- Hormonal changes, such as those that occur during pregnancy
- Obesity, which may be related to excess fat around the throat and increased systemic inflammation
- Gastroesophageal reflux disease (GERD) or acid reflux
- Sleep position, as sleeping on the back can allow fluids to pool in the breathing passages
- Comorbid conditions, such as obstructive sleep apnea, allergic rhinitis, and anxiety or panic attacks
To manage nocturnal asthma, it is important to focus on good sleep habits or "sleep hygiene." This includes maintaining a consistent sleep schedule, creating a dark and quiet bedroom environment, avoiding screen time before bed, and refraining from consuming large meals, alcohol, or caffeine close to bedtime. Additionally, it is crucial to take controller medications as prescribed and keep a quick-relief inhaler at the bedside for nighttime asthma symptoms. A long-acting bronchodilator delivered via an asthma inhaler can also help prevent bronchospasm and asthma symptoms. For those with GERD and asthma, medication to reduce acid production in the stomach may be beneficial. Working with an asthma specialist to develop an Asthma Action Plan that addresses both day and night symptoms is recommended.
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Anxiety and panic attacks
Waking up gasping for air can be a frightening experience. There are many reasons why this might happen, including sleep apnea, post-nasal drip, asthma, acid reflux, and anxiety. If you are experiencing this, it is important to see a doctor to determine the root cause.
If you have anxiety, you may experience panic attacks that cause sleep disruptions if they occur at night. Nocturnal panic attacks are the nighttime version of a panic attack, characterised by a sudden onset of overwhelming fear and worry, often accompanied by physical reactions like a pounding heart, perspiration, and shortness of breath. This can leave you feeling like you've been "'jolted' awake." People who experience nocturnal panic attacks often have a history of insomnia and may have more severe breathing symptoms than those who have panic attacks during the day.
Anxiety can cause feelings of consistent or excessive worry, which can lead to panic attacks. When this happens at night, your body may believe it isn't getting enough oxygen, so your brain forces you to wake up to breathe better. This can be a frightening experience, and you may feel like you've been suffocating.
If you are experiencing nocturnal panic attacks, it is important to seek help from a healthcare provider, who can help you find the cause and offer treatments. Therapy can teach you strategies to manage triggering events and prevent attacks. Antianxiety medication can also help reduce the frequency of panic attacks.
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Acid reflux
Waking up gasping for air can be caused by several factors, one of which is acid reflux. Acid reflux, or gastroesophageal reflux disease (GERD), is a chronic disorder that affects the oesophagus. It occurs when the lower oesophageal sphincter (LES) becomes weak or relaxes abnormally, allowing stomach acid to move back up through the LES and irritate the oesophagus. This can be made worse when sleeping as lying flat does not allow gravity to help move food and acids down the oesophagus, causing the acid to pool.
People with GERD may wake up from sleep during the night with significant reflux but without symptoms. Transitions from sleep to wakefulness in the morning are also associated with significant reflux in those with GERD. Sleep, especially deep sleep, has been shown to suppress gastroesophageal reflux. However, sleep deprivation can adversely affect GERD by increasing the perception of acid in the oesophagus and potentially prolonging esophageal acid exposure.
If you experience acid reflux at night, there are several strategies you can use to manage it:
- Take over-the-counter (OTC) medications or antacids to relieve acid reflux symptoms.
- Sleep with your head and upper body elevated to prevent acid from flowing up your oesophagus.
- Eat smaller and more frequent meals throughout the day, avoiding large meals close to bedtime to reduce stomach acid.
- Stay upright after eating and avoid lying down or bending over to reduce the risk of acid creeping up your oesophagus.
- Avoid trigger foods and beverages that may cause acid reflux, such as alcohol, caffeinated drinks, spicy foods, or acidic foods.
- Reduce stress, as feeling stressed can cause the stomach to produce more acid.
If these strategies do not provide relief from your symptoms, speak with a healthcare professional. They may recommend stronger prescription medications or other treatments.
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Post-nasal drip
To treat post-nasal drip, there are several options available, including home remedies, over-the-counter medications, and prescription treatments. Home remedies include using a humidifier or inhaling steam, drinking more water, and avoiding caffeine, alcohol, and diuretics. Over-the-counter antihistamines and decongestants can help with post-nasal drip caused by sinusitis, allergies, and viral infections. Oral decongestants, such as pseudoephedrine, can also help by shrinking swollen blood vessels and tissues in the nasal and sinus passages. However, it is important to check with a doctor before taking any medications, as they can have side effects.
If over-the-counter medications are ineffective, prescription treatments may be necessary. These include nasal sprays, such as beclomethasone and ipratropium, which reduce mucus in the nose. Antibiotics may be prescribed if a bacterial infection is the cause. Additionally, a doctor may refer you to an ear, nose, and throat (ENT) specialist for further evaluation and treatment.
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Frequently asked questions
There are many reasons why someone might wake up gasping for air. Some of the most common causes are sleep apnea, acid reflux, post-nasal drip, and anxiety.
Obstructive sleep apnea (OSA) is a sleep-related breathing disorder that causes total or partial pauses in breathing during sleep. OSA occurs when the tongue and other tissues in the mouth fall back and block the airway when a person lies down.
If you wake up gasping for air infrequently, you may not require treatment. However, if it happens often, it may negatively impact your sleep quality. It is recommended that you consult a doctor, who can help you identify underlying conditions and work out a treatment plan.
Treatments for waking up gasping for air depend on the underlying cause. For sleep apnea, continuous positive airway pressure (CPAP) machines or dental devices can be used to prevent the airway from becoming blocked. For post-nasal drip, saline nasal sprays or over-the-counter medications can provide relief. For acid reflux, a combination of lifestyle changes and medications is typically recommended. For anxiety-induced hyperventilation, addressing the underlying anxiety may help reduce gasping for air.
