Choking on drool while sleeping refers to the sudden, unsettling experience of waking up and gasping for air because saliva has entered the windpipe. This common phenomenon, though alarming, is typically not a sign of a serious health issue. It occurs when the body’s protective reflexes, which normally manage saliva, are less active during sleep.
Understanding Why It Happens
Saliva is constantly produced to lubricate the mouth, aid digestion, and protect oral tissues. During wakefulness, we unconsciously swallow saliva frequently, about once per minute. This swallowing rate significantly decreases during sleep, leading to a natural accumulation of saliva.
Several factors can contribute to this accumulation or misdirection of saliva. Sleeping position often plays a role; lying on your side or stomach allows gravity to pull saliva out of the mouth, increasing the likelihood of drooling and aspiration. Conversely, sleeping on your back can cause saliva to pool at the back of the throat. Conditions that promote mouth breathing, such as nasal congestion from allergies, colds, or sinus infections, can increase drooling as the mouth remains open.
Certain medical conditions and medications can influence saliva production or swallowing reflexes. Gastroesophageal Reflux Disease (GERD), where stomach acid flows back into the esophagus, can irritate the throat and increase saliva production. Some medications, particularly antipsychotics or those affecting the nervous system, can lead to excessive saliva production. Conditions like obstructive sleep apnea can impair swallowing reflexes and muscle control in the throat, further contributing to the issue.
Common Signs and Feelings
Choking on drool typically involves a sudden, jarring awakening. Individuals often describe gasping for air, accompanied by intense coughing as the body attempts to clear the airway. This can create panic or alarm due to the momentary inability to breathe.
Some people might feel a lump in their throat or chest, a common reaction to irritation or the effort of clearing the airway. While the immediate experience can be frightening, coughing and gasping are the body’s natural defense mechanisms working to prevent saliva from entering the lungs. Though less efficient during sleep, protective reflexes still activate to protect the airway.
Strategies to Reduce Occurrences
Adjusting your sleeping position can significantly reduce choking episodes. Sleeping on your side is often recommended to prevent saliva from pooling in the throat and allow for natural drainage. Elevating the head of your bed by a few inches, using a wedge pillow or blocks under the bedposts, can utilize gravity to keep the airway clear and minimize reflux.
Managing nasal congestion is an effective strategy. If allergies are a factor, addressing them with appropriate treatments can maintain clear nasal passages, encouraging nasal breathing rather than mouth breathing. Using a humidifier in the bedroom or taking a steamy shower before bed can thin mucus and alleviate stuffiness. Nasal strips or saline rinses may provide relief by opening nasal passages and flushing out irritants.
Addressing acid reflux can decrease nighttime choking. Avoiding large meals close to bedtime, ideally waiting three hours before lying down, allows for proper digestion. Limiting trigger foods such as acidic, fatty, spicy, or caffeinated items may help. Maintaining adequate hydration throughout the day helps keep saliva at a healthy consistency, aiding its natural clearance.
When to Consult a Doctor
While occasional choking on drool during sleep is common and generally not a concern, certain signs warrant medical evaluation. If episodes become frequent or severe, disrupting sleep regularly, professional assessment is needed. Persistent difficulty breathing beyond the initial choking sensation, or accompanying symptoms like chest pain, should prompt immediate medical attention.
Recurrent heartburn, especially if it leads to frequent nighttime awakenings, indicates acid reflux may be a significant contributing factor requiring medical management. Unexplained weight loss with choking episodes could point to an underlying condition affecting the digestive or respiratory systems. Other concerning symptoms include persistent difficulty swallowing, which might signal a muscular or neurological issue, or excessive daytime sleepiness, a symptom of conditions like obstructive sleep apnea. A healthcare provider can identify the root cause and recommend appropriate treatments.