Waking up choking on your own spit can be a startling and uncomfortable experience. This common occurrence often leaves individuals gasping for air. Understanding the underlying physiological processes and contributing factors can help demystify this phenomenon. This article explores why this happens and offers practical advice to reduce episodes.
How Swallowing Works During Sleep
The body continuously produces saliva, which is usually swallowed unconsciously. Even during sleep, the swallowing reflex remains active, though at a reduced rate. This reflex involves a complex coordination of muscles in the mouth, throat, and esophagus.
The epiglottis, a flap of cartilage at the base of the tongue, plays a role by covering the windpipe during swallowing to prevent liquids from entering the lungs. This protective mechanism normally manages saliva flow. Disruptions to this coordination or an increase in saliva volume can lead to saliva entering the airway, triggering a choking sensation.
Common Reasons for Choking
Several factors can contribute to choking on saliva during sleep. Acid reflux, also known as GERD, is a common cause. Stomach acid flows back into the esophagus and mouth, irritating the throat and potentially increasing saliva production. This irritation can make swallowing more difficult, allowing saliva to pool. Sleeping on your back can also increase the likelihood of choking because gravity does not assist in directing saliva down the throat.
Nasal congestion from allergies, colds, or sinus problems can lead to mouth breathing, which may dry out the mouth and throat, impacting normal swallowing. Some medications, such as muscle relaxants or certain antihistamines, can depress the central nervous system and relax throat muscles, impairing the swallowing reflex. Obstructive sleep apnea (OSA), where the airway repeatedly narrows or closes during sleep, is another contributor, as it can lead to brief awakenings accompanied by gasping or choking. Heavy alcohol consumption can also relax muscles, allowing saliva to pool at the back of the mouth.
Ways to Reduce Choking Episodes
Adjusting your sleep position can help reduce choking episodes. Sleeping on your side rather than your back can improve saliva flow and prevent pooling. Elevating the head of your bed by a few inches can also help keep stomach acid from flowing back into the esophagus, especially for those with acid reflux.
Managing underlying conditions such as allergies or nasal congestion through appropriate medications can alleviate symptoms that contribute to mouth breathing and impaired swallowing. Avoiding heavy meals close to bedtime, ideally within two to three hours, can lessen the chances of acid reflux. Reviewing your medications with a healthcare provider if you suspect they are contributing to the issue is also recommended. Maintaining hydration throughout the day can ensure proper throat lubrication, which supports the swallowing process.
When to Seek Medical Advice
While occasional choking on spit is common, frequent occurrences or accompanying symptoms may indicate a more serious underlying health issue. If you experience choking episodes regularly, or if they are accompanied by difficulty breathing, chest pain, a persistent cough, or signs of sleep apnea like loud snoring or pauses in breathing during sleep, seeking medical evaluation is advised.
A healthcare professional can help diagnose conditions such as acid reflux, sleep-related abnormal swallowing, or obstructive sleep apnea. They may recommend tests, such as a sleep study, to determine the cause and guide appropriate treatment, which could include lifestyle changes, medications, or devices like a CPAP machine for sleep apnea.