Waking up suddenly, gasping for air, and choking on saliva can be a disorienting and frightening experience. This article explains why individuals might choke on saliva during sleep, exploring the underlying mechanisms and contributing factors.
The Mechanics of Choking on Saliva During Sleep
Choking on saliva during sleep occurs when the body’s normal protective reflexes are temporarily disrupted. While awake, swallowing is largely conscious, but during sleep, it becomes an involuntary reflex. As sleep deepens, throat muscles, including those controlling swallowing, relax considerably. This relaxation, combined with gravity, allows saliva to pool at the back of the throat. If this accumulated saliva enters the airway instead of the esophagus, it triggers a choking sensation, causing gasping, coughing, and abrupt waking.
Underlying Reasons for Nighttime Saliva Choking
Several factors can contribute to nighttime saliva choking. Sleep position plays a role, as sleeping on one’s back can cause saliva to collect in the throat. Gravity can also cause the tongue or soft tissues to fall backward, complicating airflow and increasing the likelihood of airway obstruction.
Increased saliva production can also be a factor. Certain medications, such as those for dry mouth, can increase saliva output.
Swallowing difficulties can significantly contribute to nighttime choking. These can arise from conditions affecting the swallowing reflex or muscle coordination. When swallowing muscles weaken or do not coordinate effectively, saliva may enter the airway.
Nasal congestion or blocked airways can also alter saliva management. When nasal passages are blocked, individuals tend to breathe through their mouths. This can lead to increased saliva pooling and difficulty managing it. Excess mucus from postnasal drip can also combine with saliva, causing irritation and triggering coughing or choking, particularly when lying flat.
Acid reflux, or GERD, can significantly contribute to choking sensations at night. Stomach acid flowing back into the esophagus can irritate the throat, potentially leading to swallowing issues or increased saliva production. This irritation can worsen when lying flat, making it easier for acid and saliva to enter the airway.
When to Consult a Healthcare Professional
While occasional choking on saliva might not indicate a serious problem, frequent occurrences or accompanying symptoms warrant medical attention. Persistent or increasing severity of choking episodes should prompt a consultation. Other concerning symptoms include persistent coughing, difficulty swallowing during waking hours, or a feeling of a lump in the throat.
Additional red flags include heartburn, chest pain, or a sour taste in the mouth upon waking, which could point to underlying acid reflux. Unexplained weight loss or hoarseness also warrant medical evaluation. If choking episodes disrupt sleep, leading to excessive daytime fatigue, or if there are concerns about sleep apnea, a doctor can help identify the root cause and recommend appropriate treatment.
Practical Approaches to Minimize Nighttime Choking
Adjusting sleep position can help reduce nighttime choking. Sleeping on the side, particularly the left side, can help keep the throat open and prevent saliva from pooling. Elevating the head of the bed by 6 to 9 inches, using blocks or a wedge pillow, can also use gravity to keep airways clear and reduce reflux.
Managing nasal congestion can involve using saline sprays or rinses before bed. A humidifier in the bedroom can add moisture to the air, helping soothe irritated nasal passages and loosen mucus. Taking a warm shower before bed can also help open nasal passages through steam inhalation.
Addressing acid reflux involves avoiding late-night meals, ideally stopping food intake at least three hours before bedtime. Identifying and avoiding trigger foods like spicy, fatty, or acidic items, caffeine, and alcohol can also be helpful.
Maintaining adequate hydration throughout the day is important, as saliva helps lubricate the mouth and throat. While hydration supports saliva balance, large water intakes right before bed should be avoided. Good oral hygiene also contributes to overall oral health and saliva management. Reviewing current medications with a doctor is advisable if they are known to increase saliva production.