Choking on acid reflux while sleeping can be a startling and disorienting experience. Waking abruptly with a sensation of burning or suffocation can cause significant alarm and disrupt sleep. This event occurs when stomach contents, including acidic digestive fluids, unexpectedly enter the airway during the night. This article provides practical information to help manage and prevent such episodes.
Immediate Steps During an Episode
When you awaken choking on acid reflux, sit up immediately. This upright position uses gravity to help prevent further stomach contents from entering the airway and assists in clearing what has already come up. Maintaining a calm demeanor is beneficial for controlling breathing and initiating effective clearing actions.
Once upright, focus on clearing your airway. Forceful coughing can help expel any aspirated acid or food particles from your windpipe. You might also try swallowing repeatedly to clear the esophagus and throat. If breathing remains severely obstructed, continue to cough vigorously to dislodge the material. While these episodes are alarming, there are no reported cases of someone dying from acid reflux during sleep.
Taking small sips of water can help wash down any remaining acid in the throat and esophagus, providing relief from the burning sensation. Avoid lying back down too soon after an episode, as this can increase the risk of another reflux event. Staying upright for at least 30 to 60 minutes allows the esophagus to clear and stomach contents to settle.
Why Nocturnal Reflux Happens
Nocturnal acid reflux, which can lead to choking, often occurs due to several factors related to the body’s position and functions during sleep. When lying flat, gravity no longer assists in keeping stomach acid down, making it easier for contents to flow back into the esophagus. This differs from daytime reflux, where an upright posture naturally helps return stomach fluids.
During sleep, the muscles that typically prevent reflux, such as the lower esophageal sphincter, can relax, creating an opening for stomach acid to escape. Swallowing also becomes less frequent while asleep, which means there is less saliva produced. Saliva contains bicarbonate, a buffer that can neutralize any acid that might reflux into the esophagus.
For many, nocturnal reflux is a symptom of Gastroesophageal Reflux Disease (GERD), a chronic condition where stomach acid frequently flows back into the esophagus. Persistent nighttime symptoms, including choking, can indicate GERD. The longer acid remains in the esophagus during sleep, the greater the potential for symptoms and irritation.
Preventing Future Episodes
Preventing future episodes of nocturnal acid reflux and choking involves lifestyle adjustments and positional strategies. Elevating the head of your bed by 6 to 8 inches can significantly reduce reflux by using gravity to keep stomach contents in place. This can be achieved using a foam wedge pillow or by placing risers under the bedposts at the head of the bed.
Adjusting dietary habits is important. Avoiding trigger foods such as fatty or spicy foods, chocolate, mint, caffeinated beverages, and alcohol, especially before bedtime, can reduce acid production and reflux. Eating smaller, more frequent meals throughout the day instead of large ones can also help prevent the stomach from becoming overly full.
Aim to finish eating at least three hours before going to bed. This allows sufficient time for food digestion and stomach emptying, reducing the amount of acid available to reflux. Maintaining a moderate weight can alleviate pressure on the abdomen, which might otherwise push stomach contents upward. Wearing loose-fitting clothing, particularly around the waist, also helps to reduce this abdominal pressure.
When to Consult a Doctor
While occasional episodes of choking on acid reflux can be managed with lifestyle changes, specific situations warrant medical evaluation. If choking episodes occur frequently or become more severe, seek professional medical advice. Persistent symptoms despite consistent lifestyle modifications suggest a need for further assessment.
“Red flag” symptoms like difficulty swallowing, unexplained weight loss, or persistent chest pain should prompt immediate consultation with a healthcare provider. These symptoms could indicate more serious underlying conditions or complications related to chronic acid exposure. A doctor can diagnose the cause of your nocturnal reflux and recommend appropriate treatment options, which may include medication or other interventions.