Waking up suddenly while asleep, feeling as though you are choking on your own spit, can be an alarming experience. This common phenomenon is often not indicative of a serious underlying condition. It typically involves a disruption of the body’s usual reflexes during sleep, where saliva or other secretions might briefly enter the airway, triggering a protective gag or cough response.
Understanding the Causes
Several physiological and environmental factors can contribute to the sensation of choking on saliva during sleep. Sleep position is a common factor, as lying on your back can allow saliva to pool at the back of the throat, potentially leading to aspiration. Gravity can cause the tongue or other soft tissues to fall backward, further complicating airflow.
Gastroesophageal Reflux Disease (GERD) is another frequent contributor. When stomach acid flows back into the esophagus, it can irritate the throat, leading to increased saliva production or a sensation of choking. This irritation can also cause coughing or a sour taste in the mouth upon waking.
Nasal congestion, often due to allergies, colds, or sinus infections, can force mouth breathing during sleep. Breathing through the mouth can lead to a dry mouth, making saliva thicker and more difficult to swallow, or it can cause post-nasal drip, where excess mucus flows down the throat and can trigger choking.
Excess saliva production can also play a role. Certain medications, dental issues like cavities or gum disease, and even specific foods can sometimes increase saliva volume, which may be harder to manage during sleep. Counterintuitively, a very dry mouth can also lead to thicker, stickier saliva that is harder to clear.
The efficiency of your swallowing reflex can be temporarily impaired during sleep. This reduced reflex control means the body is less effective at automatically clearing saliva from the throat. Sleep apnea, with its characteristic pauses in breathing, can also disrupt normal swallowing patterns and contribute to choking sensations. These breathing interruptions can cause oxygen levels to drop, prompting a sudden gasp or choke as the body attempts to reopen the airway.
Simple Steps for Prevention
Adjusting your sleep position can reduce the likelihood of choking on saliva. Sleeping on your side is recommended, as this position helps prevent saliva from pooling at the back of the throat and keeps the airway more open. Elevating the head of your bed by a few inches can also use gravity to your advantage, especially if reflux is a concern.
Managing acid reflux through lifestyle changes alleviates nighttime choking. Avoid large meals close to bedtime, waiting at least two to three hours after eating before lying down. Identifying and limiting trigger foods, such as spicy, acidic, or fatty items, makes a difference.
Addressing nasal congestion can improve nighttime breathing and reduce mouth breathing. Using saline nasal sprays, a humidifier in your bedroom, or managing allergies with appropriate medication keeps nasal passages clear. This encourages nasal breathing, which supports better saliva management.
Maintaining adequate hydration throughout the day keeps saliva at a healthy consistency, making it easier to swallow. Good oral hygiene, including regular brushing and flossing, contributes to overall mouth health and influences saliva production and quality. Limiting alcohol and caffeine intake before bed is advisable, as these can relax throat muscles or contribute to dehydration, potentially exacerbating the issue.
When Professional Help is Needed
While occasional choking on spit during sleep is harmless, certain indicators suggest consulting a healthcare professional. If these occurrences become frequent, worsen over time, or are accompanied by other concerning symptoms, medical evaluation is needed.
Accompanying symptoms that warrant attention include persistent coughing, wheezing, or shortness of breath. Chest pain or difficulty swallowing, known as dysphagia, are important red flags. If home remedies and preventative measures do not provide relief, or if you suspect an underlying medical condition, professional advice is appropriate. Concerns about undiagnosed sleep apnea, characterized by loud snoring, gasping, or pauses in breathing, or severe GERD, warrant discussion with a doctor.