It is possible to die from vomiting in your sleep. While rare, this outcome occurs when the body’s natural protective reflexes are impaired.
How Vomiting in Sleep Can Be Fatal
The primary danger of vomiting during sleep is aspiration. Aspiration occurs when foreign material, such as vomit, is accidentally inhaled into the airways and lungs instead of being swallowed down the esophagus. The body normally has protective mechanisms, like the epiglottis closing off the windpipe and a strong cough reflex, to prevent this.
When consciousness is impaired, these protective reflexes can be weakened or absent, allowing vomit to enter the respiratory system. If a significant amount of vomit is aspirated, it can lead to immediate choking and obstruction of the airway, preventing oxygen from reaching the lungs. Even smaller amounts can cause severe inflammation and irritation within the lungs due to the acidic nature of stomach contents. This irritation can then lead to aspiration pneumonia, a serious lung infection. Aspiration pneumonia can be life-threatening and may result in respiratory failure if not promptly treated.
Factors Increasing the Risk
Several factors can increase a person’s risk of aspirating vomit while sleeping. An altered level of consciousness is a primary concern, often due to severe intoxication from alcohol or illicit drugs, or heavy sedation from medications. These substances can depress the central nervous system, impairing the gag reflex and the ability to clear the airway.
Risk Factors
Altered consciousness: Severe intoxication (alcohol, illicit drugs) or heavy sedation from medications can depress the central nervous system, impairing the gag reflex and the ability to clear the airway.
Neurological conditions: Stroke, seizures, head injuries, or advanced dementia can affect swallowing reflexes, tongue control, and the cough reflex, making aspiration more likely.
Medical conditions: Severe gastroesophageal reflux disease (GERD), gastroparesis (delayed stomach emptying), or intestinal obstruction can increase the likelihood of vomiting and subsequent aspiration.
Age: Infants are at higher risk due to underdeveloped reflexes, while the elderly are more susceptible due to underlying health issues, weakened reflexes, or multiple medications.
Sleep apnea: Interruptions in breathing during sleep can make individuals more prone to inhaling stomach contents.
Minimizing the Risk and When to Seek Help
To minimize the risk of aspirating vomit during sleep, several preventive measures can be taken.
Prevention
Avoid excessive alcohol consumption or sedatives before bedtime, as these impair consciousness and reflexes.
If feeling nauseous or intoxicated, sleeping on one’s side, often referred to as the recovery position, can help ensure vomit flows out of the mouth rather than into the airways.
Manage underlying medical conditions that contribute to vomiting or impaired swallowing, such as GERD.
Avoid large meals close to bedtime, aiming to finish eating at least 2-3 hours before sleeping.
Immediate medical attention is necessary if signs of aspiration or aspiration pneumonia develop after a vomiting episode. These symptoms can include persistent coughing, fever, shortness of breath, wheezing, chest pain, or coughing up foul-smelling or discolored phlegm. If someone is found unconscious after vomiting, emergency services should be contacted immediately. Seeking prompt medical evaluation can help ensure appropriate treatment, such as antibiotics for aspiration pneumonia, and address any underlying issues.