Evie Summers
Choking in your sleep can be a frightening and potentially dangerous experience. It is often caused by Obstructive Sleep Apnoea (OSA), a sleep disorder where the airway becomes partially or completely blocked, leading to pauses in breathing. This causes oxygen levels to drop, triggering a brief awakening, often accompanied by choking or gasping for air. Other causes include acid reflux, postnasal drip, neurological conditions, and anatomical abnormalities. If you experience frequent choking in your sleep, it is important to consult a healthcare professional for proper evaluation and diagnosis. Treatment options may include lifestyle changes, positional therapy, medication, or surgical interventions, depending on the underlying cause.
| Characteristics | Values |
|---|---|
| Frequency | Occasional choking may be due to reflux or mucus. Regular choking may be a sign of sleep apnea. |
| Causes | Obstructive Sleep Apnoea (OSA), Gastroesophageal Reflux Disease (GERD), neurological conditions, anatomical abnormalities, stress and anxiety, and in rare cases, foreign objects. |
| Treatment | Lifestyle changes, positional therapy, medication, oral appliances, mandibular advancements, CPAP therapy, and surgical interventions. |
| Diagnosis | Home sleep test, clinical sleep test, and consultation with a healthcare professional. |
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What You'll Learn
Obstructive Sleep Apnoea (OSA)
Choking in your sleep can be a symptom of Obstructive Sleep Apnoea (OSA), a common sleep disorder. OSA occurs when the walls of the throat relax and narrow or close during sleep, causing a partial or complete blockage of the airway. This leads to repeated interruptions in breathing, resulting in fragmented and non-restorative sleep. The pattern of interruptions can repeat itself 5 to 30 times or more each hour, throughout the night.
The severity of OSA is determined by the number of breathing pauses per hour of sleep. An apnoea-hypopnea index (AHI) reading of 5 to 14 episodes per hour is considered mild, while 15 to 30 episodes per hour is moderate, and more than 30 episodes per hour is severe. OSA can significantly impact an individual's quality of life, making them very sleepy during the day and increasing the risk of developing various conditions. These include hypopnoea, a partial blockage of the airway that reduces airflow by more than 50% for at least 10 seconds, which can occur alongside apnoea in OSAHS (Obstructive Sleep Apnoea-Hypopnoea Syndrome).
OSA is associated with long-term risks such as high blood pressure, diabetes, and heart disease. It can also lead to excessive daytime sleepiness, impacting an individual's quality of life and abilities such as driving safety. Therefore, it is important to seek diagnosis and treatment for OSA to manage the condition effectively. Diagnosis can be done through a home sleep test or in-lab polysomnography (PSG), and treatment options include continuous positive airway pressure (CPAP) therapy, oral appliances, mandibular advancements, positional therapy, and, in some cases, surgery.
If you experience frequent choking in your sleep, it is recommended to seek medical advice and consider a sleep test to confirm or rule out OSA. Treating OSA can improve your sleep quality and reduce the associated risks. Additionally, lifestyle changes, such as avoiding large meals before sleep and elevating the head of your bed, can help manage OSA and its symptoms.
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Gastroesophageal Reflux Disease (GERD)
Waking up choking or gasping for air can be a symptom of a variety of conditions, one of the most common being Obstructive Sleep Apnoea (OSA). This is a sleep disorder characterised by brief interruptions in breathing during sleep, caused by a partial or complete blockage of the airway. This blockage can be caused by a collapse of the soft tissue in the throat or neck. When the airway is blocked, oxygen levels in the blood drop, causing you to wake up choking or gasping for air.
Another common cause of choking in your sleep is Gastroesophageal Reflux Disease (GERD). GERD is a chronic condition where stomach acid flows back up into the oesophagus (the tube that connects your throat to your stomach). Normally, the lower oesophageal sphincter acts as a barrier to prevent this from happening, but in people with GERD, this muscle is weak or relaxed, leading to acid reflux. This can cause irritation and swelling, resulting in symptoms like heartburn, regurgitation, and coughing or choking while sleeping. It is estimated that GERD affects around 20% of adults in the US.
GERD can be treated through lifestyle changes and medication. Lifestyle changes that can help reduce GERD symptoms include relaxation techniques such as meditation, breathing exercises, talking with a friend or therapist, reading, and getting seven to nine hours of quality sleep each night. Other changes include avoiding trigger foods, not eating right before bedtime, changing your sleep position, wearing loose-fitting clothing, quitting smoking, and maintaining a healthy weight. Medications that can help include antacids, H2 blockers, and proton pump inhibitors. In more severe cases, surgery may be required.
It is important to note that choking in your sleep can also be caused by other conditions, such as postnasal drip, heart failure, or, in rare cases, paroxysmal nocturnal dyspnoea. If you are experiencing frequent choking in your sleep, it is recommended that you seek medical advice to determine the underlying cause.
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Sleep position
If you are choking in your sleep, it is likely that something is blocking your throat or windpipe. This blockage could be caused by an object, food, or a foreign particle. In some cases, choking in your sleep could be a sign of a more serious medical condition.
If you are choking in your sleep, it is important to figure out your optimal sleep position. For some people, sleeping on their sides is more beneficial than sleeping on their backs to prevent choking. This is because when you sleep on your back, gravity can cause your tongue and the roof of your mouth to collapse into the back of your throat, blocking your airway. Sleeping on your side can prevent this.
If you are a back sleeper, you could consider the Somnibel positional sleep therapy trainer – a small vibrating device worn on the forehead. This small medical device gently vibrates when the user sleeps on their back, encouraging them to roll onto their side.
Other Causes of Sleep Choking
Other causes of choking in your sleep include:
- Gastroesophageal reflux disease (GERD), which occurs when stomach acid moves up into the oesophagus, causing irritation and swelling.
- Obstructive sleep apnoea (OSA), which occurs when the airway becomes partially or completely blocked during sleep.
- Postnasal drip, which occurs when excess mucus from your nose or sinuses drips down the back of your throat.
- High levels of stress or anxiety, which can lead to muscle tension in the throat muscles.
- Alcohol and recreational drugs, which can impair muscle function and increase the likelihood of choking.
- Anatomical issues in the throat or airway, such as enlarged tonsils or a deviated septum.
- Certain neurological conditions, such as seizures or strokes, which can affect the brain's control over the muscles involved in breathing and swallowing.
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Alcohol and drug use
Frequent choking in your sleep is a common symptom of Obstructive Sleep Apnea (OSA). OSA is a sleep disorder characterized by brief interruptions in breathing during sleep due to a partial or complete blockage of the airway. The blockage causes oxygen levels in the blood to drop, leading to choking or gasping for air as the body responds to the lack of oxygen. Lifestyle changes, CPAP therapy, and oral appliances or mouthguards can help keep the airway open and reduce the risk of choking during sleep in people with OSA.
Drug-induced sleep disorders and sleep problems associated with medication use, drug abuse, and withdrawal from drugs have also been linked to choking during sleep. Certain prescription and non-prescription drugs can cause sleep disturbances and increase the risk of choking. For example, medications with caffeine, illegal drugs such as cocaine and amphetamines, and nicotine can all disrupt sleep and contribute to sleep-related choking.
To prevent choking during sleep, it is recommended to sleep on your side, raise the head of your bed, and avoid eating late at night. These measures can help reduce the risk of acid reflux and aspiration, which are also common causes of choking during sleep.
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Neurological conditions
Choking in sleep, or sleep choking syndrome, can be caused by various factors, including neurological conditions. While obstructive sleep apnea (OSA) is the most common cause, certain neurological issues can also lead to choking episodes during sleep. These episodes can be distressing and potentially dangerous, so it is important to identify the root cause and address it.
In some cases, individuals may experience recurrent choking spells during sleep that do not respond to typical OSA treatments such as weight loss, CPAP therapy, or upper airway surgery. If gastroesophageal reflux treatments are also unsuccessful, it is important to consider alternative diagnoses, such as insular seizures. These seizures can manifest as nocturnal choking episodes with or without accompanying generalized shaking and postictal confusion.
Additionally, panic attacks, laryngospasm, and gastroesophageal reflux can be included in the differential diagnosis of nocturnal choking episodes. It is crucial to consult a healthcare professional for a comprehensive evaluation and accurate diagnosis, as treatment options will depend on the underlying cause. Positional therapy, medication, or surgical interventions may be recommended based on the specific etiology of the choking episodes.
While choking in sleep can have various causes, including neurological conditions, it is important to seek medical advice and not ignore frequent choking or gasping episodes during sleep. Home sleep tests or clinical sleep tests can help identify the underlying cause and guide appropriate treatment options.
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Frequently asked questions
Choking in your sleep can be a sign of Obstructive Sleep Apnoea (OSA), where the airway becomes partially or completely blocked, leading to pauses in breathing. This can cause you to wake up choking or gasping for air.
If you are choking in your sleep regularly, it is important to get checked out by a healthcare professional. A home sleep test can be done to quickly and accurately rule out or confirm the presence of OSA.
Treatments for choking in your sleep can include lifestyle changes, positional therapy, medication, or surgical interventions, depending on the underlying cause. Devices such as oral appliances, mouthguards, or mandibular advancements can help keep the airway open during sleep.
Causes of choking in your sleep can include acid reflux, postnasal drip, anatomical abnormalities, stress and anxiety, neurological conditions, or foreign objects in the airway.
