Choking In Sleep: Causes And Prevention Measures

Waking up choking can be a frightening and potentially dangerous experience. There are various causes, but one of the most common is obstructive sleep apnea (OSA), a sleep disorder characterised by brief interruptions in breathing during sleep. This occurs when the tongue and other tissues in the mouth fall back and block the airway when an individual lies down. Other causes include acid reflux, asthma, and panic attacks. If you are experiencing choking episodes during sleep, it is important to consult a healthcare professional for a proper evaluation and diagnosis.

Obstructive sleep apnea (OSA)

Choking in your sleep can be distressing and frightening, and a common cause for this is obstructive sleep apnea (OSA). This is a condition where your upper airway closes off as you sleep, meaning you cannot get air into your lungs and you cannot breathe. When you fall into a deep sleep, your airway closes, and you stop breathing, so your body briefly wakes you up to open the airway and restart your breathing, which might result in choking, a snort, or a gasp. This means your sleep is fragmented and of poor quality.

OSA is a common condition affecting over 1.5 million adults in the UK, and 85% of people with OSA are undiagnosed. Anyone can have OSA regardless of age or size, but it does become more common with age and if you are carrying extra weight. Risk factors for the condition include older age, being male, having a large neck circumference, a family history of sleep apnea, obesity, and certain medical conditions like hypertension.

If you experience choking in your sleep, it is important to consult a healthcare professional for a proper evaluation and diagnosis. There are various treatments for OSA, including lifestyle changes, positional therapy, medication, or surgical interventions, depending on the underlying cause. One of the most common treatments for OSA is Continuous Positive Airway Pressure (CPAP), a machine that works like a compressor to blow air into a mask that is worn over the nose and/or mouth during sleep. The flow of air acts like a splint to keep the upper airway from collapsing and prevents obstruction and apnea. Oral appliances are another treatment option, usually custom-made and fitted under the supervision of a specialized dentist or oral surgeon. These are most effective for people who have mild sleep apnea and are not overweight.

If you experience frequent choking in your sleep, it is important to seek medical advice and explore treatment options to improve your sleep quality and overall health.

Post-nasal drip

If you are experiencing post-nasal drip, there are several treatments and lifestyle changes that can help:

• Medication: Antihistamines, decongestants, and nasal steroid sprays can help clear the sinuses and improve drainage.
• Environmental changes: Keeping your bedroom dust-free, vacuuming with a HEPA filter, laundering bed sheets regularly, and using ventilation fans and dehumidifiers can reduce allergens and improve air quality.
• Sleep position: Sleeping with your head slightly elevated can help prevent mucus from pooling at the back of the throat. Using extra pillows or a wedge under the mattress can help achieve this position.
• Lifestyle changes: Staying hydrated, reducing alcohol consumption, and avoiding junk food can support overall health and reduce mucus production.

If you are experiencing frequent or severe post-nasal drip, it is important to consult a healthcare professional for proper diagnosis and treatment. An ear, nose, and throat (ENT) doctor may recommend a nasal endoscopy or imaging tests to determine the underlying cause and provide appropriate treatment options.

Alcohol and drug use

Additionally, alcohol and recreational drug use can impair muscle function, making it more difficult to clear any obstructions that may be causing choking. It is important to note that alcohol and drug use can also impact your sleep quality and increase the risk of sleep disorders. Seeking medical advice and making lifestyle changes, such as reducing alcohol intake and maintaining a healthy weight, can help address sleep-related choking issues.

Asthma

Waking up choking can be a frightening experience and can indicate an underlying issue. One possible cause is asthma, particularly if it is not well controlled with medication. People with asthma may wake up wheezing, and poor sleep may further exacerbate asthma symptoms.

If you have asthma and are experiencing nocturnal symptoms, it is important to consult a doctor, as they may recommend daily asthma medication to help relieve these symptoms. Additionally, factors such as sleep position and allergens in the bedroom can increase mucus and inflammation, further triggering asthma attacks. Therefore, it is advisable to take steps to reduce allergens in the bedroom, such as regularly cleaning bedding and ensuring good air circulation.

It is worth noting that other conditions can also cause choking during sleep, including obstructive sleep apnea (OSA), which is a common sleep-related breathing disorder. OSA occurs when the tongue and other tissues in the mouth block the airway during sleep, causing pauses in breathing. People with OSA may snore loudly, choke, or gasp for air during sleep and may experience additional symptoms such as morning headaches and excessive daytime sleepiness. If you suspect OSA, a doctor can order a sleep study for diagnosis and determine the severity of the condition.

In addition to OSA, other potential causes of choking during sleep include central sleep apnea (CSA), anxiety, panic attacks, acid reflux, and post-nasal drip. If you are experiencing regular episodes of choking in your sleep, it is important to consult a healthcare professional to determine the underlying cause and receive appropriate treatment.

GERD (Gastroesophageal Reflux Disease)

Waking up choking can be a frightening and dangerous experience. One of the most common causes is obstructive sleep apnea (OSA), a condition where the airway becomes partially or completely blocked, leading to pauses in breathing. This can cause choking, gasping, or snorting as the person wakes up briefly to resume normal breathing.

Another possible cause of choking in your sleep is Gastroesophageal Reflux Disease (GERD), a chronic digestive disorder that occurs when stomach acid flows back into the oesophagus, the tube that connects your throat to your stomach. Normally, a ring of muscles called the Lower Oesophageal Sphincter (LES) acts as a one-way valve, allowing food and liquids into the stomach and preventing stomach contents from flowing back into the oesophagus. However, in individuals with GERD, the LES may weaken or relax abnormally, leading to acid reflux. During sleep, especially when lying flat, the risk of acid reflux and aspiration (inhaling stomach contents into the airway) may increase, which can cause choking.

GERD is a common condition, affecting approximately 20% of the US population. It can be caused by various factors, including obesity, regular smoking, or exposure to second-hand smoke, pregnancy, and certain foods and drinks such as dairy, caffeine, and fried or spicy dishes. Large meals, eating too quickly, and not allowing enough time for food to digest before lying down can also trigger GERD symptoms.

If you are experiencing choking episodes during sleep due to GERD, there are several things you can do to help manage the condition and improve your sleep:

• Elevate the head of your bed or use a wedge pillow to reduce the risk of acid reflux.
• Avoid trigger foods and beverages, such as dairy, caffeine, and spicy or fried dishes, and allow several hours for food to digest before lying down.
• Eat smaller, more frequent meals during the day instead of large meals.
• Maintain a healthy weight through diet and exercise, as obesity is a major risk factor for GERD.
• Address stress and anxiety through relaxation techniques such as meditation, breathing exercises, or therapy.
• Consult a healthcare professional for medication or surgical interventions if needed.

Frequently asked questions