Sleep Without Swallowing: Tips For A Restful Night

how to sleep without swallowing

Swallowing during sleep is a common occurrence, with studies showing that it happens in association with movement arousals, most frequently during the REM stage of sleep. However, for some people, swallowing while sleeping can be difficult and lead to choking. This can be caused by various factors, including acid reflux, lesions or tumors in the throat, and neurological disorders. Treatments for these issues include medication, surgery, and the use of devices such as a CPAP machine or an oral mouth guard. Sleeping with your head elevated can also help prevent choking by improving saliva flow.

Characteristics and Values

Characteristics Values
Swallowing during sleep Episodic, with long swallow-free periods
Swallowing associated with Movement arousals, most frequent during REM, 1 and 2 stages of sleep
Swallowing movement in non-REM sleep Significantly higher in the OSA group than in the control group
Treatment for swallowing difficulties Surgery, swallowing therapy, anti-inflammatory medication, steroids, muscle relaxants, medication to reduce saliva production, oral mouth guard
Prevent choking while sleeping Sleep with your head elevated, sleep on your side, avoid heavy alcohol use

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Sleep with your head elevated to prevent choking

If you're choking on your saliva while sleeping, it may be a good idea to sleep with your head elevated. This can improve saliva flow and prevent choking. You can do this by raising the head of your bed by a few inches. Just be sure to keep your head propped up so that saliva can flow down your throat.

Acid reflux can also irritate the lining of the oesophagus, making it difficult to swallow and causing saliva to pool in the back of your mouth, which may lead to choking. If you have acid reflux, you can treat it with over-the-counter or prescription antacids to reduce stomach acid.

Benign or cancerous lesions or tumours in the throat can also narrow the oesophagus, making it difficult to swallow. If you suspect this may be the case, your doctor can use an imaging test, like an MRI or CT scan, to check for lesions or tumours.

Choking on saliva can also be caused by heavy alcohol use. Alcohol is a depressant, and consuming too much can slow muscle response. If you're unconscious or incapacitated from drinking too much alcohol, saliva may pool in the back of your mouth and cause choking.

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Reduce saliva production with medication

Hypersalivation, or an excess of saliva in the mouth, can be caused by several factors, including underlying health conditions, infections, or certain medications. If you are experiencing hypersalivation, it is important to consult a doctor or medical professional for a proper diagnosis and treatment plan. Depending on the underlying cause, medication or other forms of therapy may be recommended to manage hypersalivation.

One option to reduce saliva production is oral glycopyrronium bromide. This medication helps to decrease the secretory volume of salivary glands, which can be beneficial for those with conditions affecting muscle control and swallowing. Oral motor training and therapy are also recommended to correct oral motor dysfunction and improve muscle tone, jaw stability, and swallowing function. These therapies can be time-consuming and require dedication from both the patient and caregiver.

In more severe cases of hypersalivation, surgical options are available. Surgical therapy can include the removal of salivary glands, ligation of salivary ducts, or sectioning of the nerves responsible for salivary production in the middle ear. These procedures are typically performed by otolaryngologists and carry varying levels of risk and morbidity. The most common procedure is the excision of submandibular glands, which contribute significantly to resting salivary production.

Radiation delivery to the major salivary glands has also been used to decrease saliva secretion. Single-dose radiotherapy has been found effective in reducing sialorrhea in patients with ALS, and bilateral radiation to the parotid and submandibular glands has been useful for patients with parkinsonism. However, due to the potential risk of late malignancy, radiation therapy should be carefully considered and administered judiciously.

It is important to note that the treatment for hypersalivation depends on the underlying cause, and a doctor's diagnosis is crucial for determining the most appropriate course of action.

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Avoid heavy alcohol use

Alcohol can have a detrimental impact on sleep quality and duration. While it may help some people fall asleep initially, it can cause disrupted sleep cycles, particularly REM sleep, leading to non-restorative sleep and fatigue the next day. Therefore, it is important to avoid heavy alcohol use, especially before bedtime, to improve sleep quality and overall health. Here are some strategies to help you achieve this:

Understand the Impact of Alcohol on Sleep

Recognize that alcohol can negatively affect your sleep, even if you only drink occasionally. It can disrupt your sleep cycles, interfere with your circadian rhythms, and reduce the time spent in the restorative REM stage of sleep. This can lead to feelings of insufficient rest, daytime sleepiness, and grogginess. Understanding these effects can motivate you to reduce your alcohol consumption.

Set a Sleep Schedule

Establish a consistent sleep schedule by going to bed and waking up at the same time each day. This helps to regulate your body's natural circadian rhythm and sleep cycle, promoting better sleep quality.

Create a Conducive Sleep Environment

Make your bedroom a quiet, dark, and comfortable space reserved for sleep and intimacy. Avoid using electronic devices like TVs, smartphones, or bright screens before bed, as they can interfere with your sleep. Instead, opt for soothing activities such as deep breathing or meditation to help you wind down.

Practice Good Sleep Hygiene

Good sleep hygiene involves adopting habits that promote better sleep. This includes avoiding stimulants like caffeine, especially close to bedtime, as its effects can linger and impact your sleep stages. Limit your fluid intake before bed to avoid disrupting your sleep, but stay hydrated throughout the day. Regular physical activity and a balanced diet can also positively impact your sleep quality and overall health.

Seek Professional Help if Needed

If you struggle with alcohol dependence or insomnia, consider seeking professional help. Severe alcohol withdrawal can be dangerous, so heavy drinkers should not attempt to quit without medical supervision. Detoxification and rehabilitation programs can provide the necessary support to manage withdrawal symptoms and teach you how to cope without alcohol. Additionally, cognitive-behavioral therapy for insomnia is a recommended non-pharmacological treatment for persistent sleep issues.

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Treat acid reflux to prevent choking

Acid reflux, also known as gastroesophageal reflux, is a backflow of acid from the stomach into the oesophagus. This can cause an unpleasant taste in the mouth and a burning sensation, known as heartburn. For those with gastroesophageal reflux disease (GERD), acid reflux can occur at least once a week and cause severe symptoms, interrupting sleep and causing restlessness.

There are several reasons why acid reflux occurs at night. Firstly, during the day, gravity helps to send digestive acid in the oesophagus back down into the stomach. When lying down, however, gravity no longer has this effect, and it becomes easier for reflux to occur. In addition, saliva production, which usually helps to neutralise stomach acid, is reduced during deeper stages of sleep. With less saliva and decreased swallowing during sleep, it becomes more difficult for the body to push acid reflux back into the stomach, allowing it to remain in the oesophagus and cause symptoms such as heartburn.

To prevent choking on acid reflux while sleeping, it is important to address the underlying causes of GERD, such as diet and weight, and make the necessary lifestyle changes. Here are some strategies to treat acid reflux and prevent choking while sleeping:

  • Sleep on your left side with your head and torso elevated: This position can help reduce acid reflux and GERD symptoms by keeping your head above the level of your stomach, reducing the impact of gravity and minimising the backflow of acid. Elevating your torso can be achieved by using an adjustable bed frame or a wedge pillow.
  • Avoid trigger foods and drinks: Certain foods and beverages are known to induce heartburn or reflux, including chocolate, tomatoes, spicy food, vinegar, citrus, fatty foods, carbonated drinks, coffee, and mint. Avoiding these trigger foods, especially before bedtime, can help reduce the occurrence of acid reflux.
  • Change your sleep position and wear loose-fitting clothing: Sleeping on your left side is recommended, as sleeping on your right side or back can make reflux more likely. Additionally, wearing loose-fitting clothing can help reduce pressure on the stomach and lower oesophageal sphincter, reducing the likelihood of reflux.
  • Maintain a healthy weight: Being overweight or obese can increase the pressure on the stomach and lower oesophageal sphincter, making it easier for acid to flow back up into the oesophagus. Losing weight, if recommended by a healthcare professional, can help reduce this pressure and decrease the occurrence of acid reflux.
  • Avoid eating close to bedtime: Eating a meal too close to bedtime can increase the risk of acid reflux, as it takes time for the stomach to empty. It is recommended to leave a gap of at least 3-4 hours between your last meal and bedtime to reduce the likelihood of reflux.
  • Medications: Over-the-counter or prescription antacids can help to neutralise stomach acid and relieve symptoms of heartburn and indigestion. While these medications do not address the underlying causes of acid reflux, they can provide quick relief. H2 blockers and proton pump inhibitors are other options that work by reducing the amount of stomach acid produced.

It is important to consult with a healthcare professional to determine the best treatment plan for your individual needs and to ensure that any lifestyle changes or medications are safe and appropriate for you.

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Surgery to resolve swallowing difficulties

Surgery is sometimes necessary to resolve persistent swallowing difficulties. This is usually considered when non-surgical treatments have been ineffective in treating the condition. Surgical procedures for swallowing disorders vary depending on the underlying cause.

One such procedure is vocal fold (cord) injection, which is the least invasive surgical technique. Surgeons inject the vocal cord through the mouth or skin of the neck with permanent or temporary materials to add bulk to the tissues of the vocal fold or move it closer to the middle. This method, however, is not as precise as open surgical procedures.

Laryngeal framework surgery is another option that uses an implant to either add bulk or move the vocal cord closer to the middle. Some patients may require a stitch at the joint of the vocal cord to correct its position. Although this surgery involves an incision to create a window in the larynx (voice box), the improvement is instant and reliable.

Cricopharyngeal myotomy is a surgical procedure used to treat Zenker's diverticulum, an outpouching in the throat caused by the upper esophageal sphincter failing to relax during swallowing. This procedure involves making a cut in the neck to remove or secure the pouch so that it drains into the oesophagus more effectively. During this "open approach," a cricopharyngeal myotomy is often performed, which involves cutting the cricopharyngeus muscle to allow the free passage of food.

In some cases, endoscopic surgery may be employed, which involves looking through the mouth with a telescope and dividing the common wall to separate the pouch from the oesophagus without making incisions in the neck.

Frequently asked questions

Treatments for swallowing and choking while sleeping include:

- Surgery

- Anti-inflammatory medication

- Steroids

- Muscle relaxants

- Antacids to reduce stomach acid

- Oral mouth guards

- Medication to reduce saliva production

- Antihistamines or cold medication to reduce mucus production

- Sleeping with your head elevated

Some causes of swallowing and choking while sleeping include:

- Obstructive sleep apnea

- Acid reflux

- Lesions or tumours in the throat

- Alcohol consumption

- Allergies or respiratory problems

- Parkinson's disease

Some signs that you may be experiencing swallowing and choking while sleeping include:

- Waking up gasping for air

- Choking on saliva

- Hoarse voice

- Difficulty swallowing food or medication

- Coughing

If you are experiencing swallowing and choking while sleeping, it is important to consult a doctor. They may recommend a sleep study test, an endoscopy, a special type of X-ray, or an imaging test such as an MRI or CT scan to diagnose the issue and determine the best course of treatment.

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