Causes of Sleep-Related Choking
In some instances, body position can lead to choking during sleep, particularly when lying on one’s back. In this position, the tongue, along with soft tissues and the jaw, may fall backward toward the throat, impeding airflow through the respiratory passages. Sleeping on the stomach does not significantly differ; tilting the head to one side or resting it against the pillow can also obstruct breathing.
This condition may also be observed in children, especially when they adopt uncomfortable sleeping positions or deviate from their usual habits.
Medical Causes of Sleep Choking
The sensation of choking during sleep might be linked to specific health issues, including:
Obstructive Sleep Apnea
Obstructive sleep apnea (OSA) is the most prevalent cause of choking during sleep. It occurs due to periodic relaxation of throat muscles, leading to an obstruction in the airways and a cessation of breathing for 10 seconds or more.
Individuals with obesity and excess weight are more susceptible to OSA, as accumulated fat can hinder breathing. The condition is particularly common among men, older adults, and smokers. Notable symptoms include:
- Loud snoring
- Morning headaches
- Frequent awakenings during the night, often accompanied by choking or gasping
- Difficulties concentrating during daytime
- Mood disturbances
- Sore throat or dry mouth upon waking
Gastroesophageal Reflux Disease (GERD)
Factors that help maintain the acidity of the stomach and prevent reflux into the esophagus or throat include:
- Gravity
- Saliva, which neutralizes stomach acid
- Continuous swallowing while awake reduces the risk of acid reflux
During sleep, these factors are not effective in stabilizing stomach acid, thus increasing the likelihood of acid reflux into the esophagus.
The connection between gastroesophageal reflux and choking during sleep is not entirely clear; choking may arise from reflux affecting breathing efficiency and airways, or the esophagus might be more susceptible to reflux due to sleep deprivation caused by choking. However, both conditions are influenced by similar factors, including:
- Smoking
- Alcohol consumption
- Obesity
Asthma
Asthma can exacerbate choking during sleep, and conversely, choking during sleep may worsen asthma conditions, as noted by Dr. Ronald Chervin.
Asthma can impede breathing while asleep, particularly for individuals with chronic or long-standing asthma, who appear to be at a greater risk of choking compared to others, as reported in a clinical study published in the Journal of the American Medical Association in 2015.
Heart Failure
Heart failure can result in fluid and sodium retention in the body, contributing to choking during sleep. This fluid may leak into the lungs while sleeping, causing breathlessness and choking, while the condition itself can negatively impact breathing efficiency.
Pulmonary Edema
Pulmonary edema entails fluid accumulation in the lungs, impairing breathing efficiency. Individuals may experience breathing difficulties when lying down or sleeping.
The most common cause of pulmonary edema is heart failure, which can contribute to choking during sleep, as previously mentioned.
Other Medical Conditions
In addition to the aforementioned conditions, other disorders may also lead to choking during sleep, including:
- Allergies or any health issues accompanied by nasal congestion and obstruction.
- Diseases affecting the brainstem responsible for regulating breathing, such as strokes, brain tumors, or encephalitis.
- Type 2 diabetes, with around 75% of those affected experiencing choking during sleep, primarily due to concurrent obesity.
- Chronic anxiety and stress, as well as stress-related conditions like hypertension, are also associated with sleep choking.
Choking as a Side Effect of Medications
Certain medications may induce choking during sleep by increasing the likelihood of narrowing the air passages and hindering nighttime breathing. It is essential to consult a physician regarding any concerns, rather than discontinuing medication on one’s own. Some medications that may contribute to this issue include:
- Opioid Pain Relievers: Prescribed for pain relief in severe cases, these may affect breathing during sleep. Examples include:
- Codeine
- Fentanyl
- Benzodiazepines: Often prescribed for anxiety, seizures, or as muscle relaxants, these can increase various sleep disorders, including choking during sleep. Notable examples are:
- Diazepam
- Alprazolam
- Barbiturates: These sedatives may also contribute to sleep choking. Examples include:
- Phenobarbital
- Thiopental
Tips for Preventing Sleep Choking
To reduce the risk of choking during sleep, consider the following measures:
- Avoid sleeping on your back and opt for side sleeping, utilizing appropriate pillows to minimize airway obstruction.
- Quit smoking to lower the risk of choking and alleviate other issues linked to choking, such as cardiovascular problems. Stopping smoking benefits overall health.
- Consult your doctor for personalized recommendations to reduce choking risk, particularly if you have specific health conditions, like hypertension, diabetes, or obesity, or if there is a family history of sleep choking.
- Inform your physician if you suspect that any medications you are taking could contribute to sleep choking.
- Refrain from consuming alcoholic beverages and adopt a healthy diet to maintain an optimal weight and overall physical health.
When to Seek Medical Attention for Sleep Choking
Choking during sleep should be reported to a physician. Prompt consultation is warranted if any of the following symptoms emerge:
- Sounds resembling choking or gasping during sleep.
- Persistent daytime fatigue.
- Observed episodes of breathing cessation and resumption during sleep, typically noted by others.
Summary
Causes of choking during sleep vary widely; it may result from improper sleeping positions or excess weight, or it may be associated with specific medical conditions or side effects of medications. In any case, it is advisable to consult a healthcare professional upon noticing any symptoms of choking during sleep to ensure appropriate treatment and prevent potential complications.