What Causes Choking In Sleep?

Last updated on July 4th, 2023 at 11:25 am

Why am I waking up choking?

Choking in sleep or waking up choking is a symptom of different disorders and health complications, most commonly the sleep disorder Obstructive Sleep Apnoea (OSA).

In this article, we explain all you need to know about what causes choking during sleep, potential remedies and what to do if you think you may have a sleep disorder.

What does choking in sleep feel like?

Choking in your sleep may feel like a sensation of not being able to breathe or like something is blocking your airway. You may also experience coughing, gagging or choking on saliva, and you may wake up feeling distressed or panicked. Some people may feel a choking sensation even if they do not wake up. You may experience shortness of breath and an increased heart rate.

What does it mean if you start choking in your sleep?

Choking occurs when your breathing is interrupted by a constricted or obstructed throat or windpipe caused by the relaxation of the soft tissue in the neck. As your throat collapses, air cannot reach the lungs causing you to wake up choking.

Choking in sleep, also known as sleep-related choking, can have several causes, including:

• Acid reflux: Acid reflux, also known as Gastroesophageal Reflux Disease (GERD), is a condition where stomach acid flows back into the oesophagus, causing irritation and inflammation. This can lead to symptoms such as heartburn, regurgitation, choking or coughing during sleep. Choking in sleep due to GERD can be a sign of a serious medical condition and should be evaluated by a healthcare professional.

• Obstructive Sleep Apnoea: Sleep choking syndrome, or choking in your sleep, is a warning sign that you may have Obstructive Sleep Apnoea (OSA). This occurs when the airway becomes partially or completely blocked during sleep, leading to shallow breathing or pauses in breathing and choking in sleep. Breathing pauses are referred to as Apnoea events, and as you would expect, these continuous pauses in breathing starve the brain of oxygen.

• Allergies or sinus problems: Allergies or sinus issues can cause congestion in the nose and throat, making it difficult to breathe properly during sleep and leading to choking or coughing. Different sinus-related conditions include sinusitis, post-nasal drip and nasal polyps.

• Tonsillitis: Tonsillitis is inflammation in the tonsils, which are the two lymph nodes located on either side of the back of the throat. Common symptoms of tonsillitis are sore throat, difficulty swallowing, fever, swollen glands in the neck, bad breath (halitosis) and choking in sleep. In rare cases, tonsillitis can cause choking during sleep if the tonsils become so swollen that they block the airway. However, this is not common, and most cases of tonsillitis do not lead to choking during sleep.

• Anxiety or panic attacks: Stress, anxiety, or panic attacks can cause the muscles in the throat to tighten, making it difficult to breathe properly and leading to choking or gasping during sleep. Anxiety can also cause hyperventilation, a condition where a person breathes too quickly or deeply, leading to a feeling of suffocation or choking. If you have untreated Sleep Apnoea, anxiety can worsen the condition, heightening the risk of breathing pauses and choking in sleep. Related article: How stress causes Sleep Apnoea.

• Pneumonia: Pneumonia is a lung infection caused by bacteria, viruses, or fungi. Symptoms of pneumonia include cough, fever, shortness of breath, chest pain, fatigue, and sometimes chills and sweating. While pneumonia and choking in sleep are not directly related, there is a potential connection between the two. People with Sleep Apnoea may be at a higher risk of developing pneumonia because interrupted breathing can allow bacteria to accumulate in the lungs. Additionally, people with pneumonia may be at a higher risk of choking in their sleep because of the respiratory distress caused by the infection.

• Epilepsy: Epilepsy is a neurological disorder that affects the brain’s ability to transmit electrical impulses, leading to seizures. Epilepsy seizures can cause you to wake up gasping or feeling like you are choking in sleep.

• Neuromuscular Disorders: Certain neurological conditions can affect the muscles responsible for breathing and swallowing, making people more susceptible to choking during sleep. Examples include muscular dystrophy and Amyotrophic Lateral Sclerosis (ALS).

Sleep Apnoea is the most common cause of choking in sleep. You should visit your healthcare provider or take our free online Sleep Apnoea risk test if you experience choking or gasping during sleep regularly. Leaving your condition untreated can lead to the development of other health complications.

Choking in sleep comorbidities

Obstructive Sleep Apnoea is one of the most prevalent reasons for choking or gasping in sleep. When left untreated, it is often associated with various other health conditions. Coexisting conditions associated with OSA include high blood pressure, cardiovascular disease, type 2 diabetes, obesity, Alzheimer’s and GERD. These health comorbidities can have a detrimental effect on a person’s health and well-being.

Studies show that people with GERD are more likely to experience Sleep Apnoea, and those with Sleep Apnoea are more likely to experience GERD. The acid reflux from GERD can irritate the throat, affecting the quality of someone’s sleep over time, leading to OSA.

Are there any remedies to help prevent choking in sleep?

Choking during sleep can be a serious issue and can be caused by various factors mentioned above. There are specific treatment methods for the identified cause; however, there are some products and lifestyle adjustments to help prevent choking in sleep.

Lifestyle adjustments to stop choking in sleep

• Changing your sleep position: Your chosen sleep position can impact the quality of your sleep and the risk of choking. A quick way to help keep your airway open during sleep is by sleeping on your side. Sleeping on your back or stomach can increase the risk of choking during sleep, as the tongue and soft tissues in the throat can block the airway.
• Elevate your head: Elevating the head of the bed by a few inches can help reduce the likelihood of choking during sleep, especially if the cause is related to acid reflux.
• Avoid sedatives: Alcohol and certain medications are sedatives that can relax the muscles in the throat, increasing the risk of choking. While sedatives can be helpful for some medical conditions, they should be used with caution and under the guidance of a healthcare provider. Sedatives can have a range of side effects, including drowsiness, dizziness, impaired coordination, memory problems, and respiratory depression. In some cases, sedatives can also increase the risk of choking during sleep, especially if taken in high doses or combined with other substances such as alcohol.
• Quitting smoking: Smoking damages the lungs and airways, making breathing more difficult and increasing the risk of choking or gasping for air during sleep. If you smoke and are experiencing choking during sleep, quitting smoking can be important in reducing your risk of this and other health problems. Quitting smoking can help reduce inflammation in the airways, improve lung function, and reduce the risk of respiratory conditions that can cause choking during sleep. It can also help reduce the severity of acid reflux and improve overall respiratory and digestive health.
• Losing weight: Excess weight around the neck increases the risk of Obstructive Sleep Apnoea and GERD. Losing weight through a combination of diet and exercise can help reduce the risk of choking during sleep by improving the function of the muscles in the throat and reducing the severity of OSA and acid reflux.

Products to stop choking while sleep

Various products are available that may help reduce the risk of choking during sleep or alleviate symptoms associated with conditions that can cause choking during sleep.

Positional Sleep Therapy

Positional therapy is a type of treatment that helps you change your sleeping position to keep your airway open to stop choking in sleep and keep breathing normal. The devices keep you on your side during the night. Sleeping on your side can help keep the tongue and soft tissues in the throat from blocking the airway.

There are several options for positional therapy, including devices you wear around your body. If you want to try something less intrusive, you could try the Somnibel positional sleep therapy trainer – a small vibrating device which is worn on the forehead. This small medical device gently vibrates when the user sleeps on their back, encouraging them to roll onto their side.

Many people use positional therapy as an alternative to a CPAP machine, which is the most common treatment for Sleep Apnoea.

Oral Appliances

Oral appliances, mouthguards or mandibular advancements are devices worn in the mouth to help keep the airway open during sleep. They fit into your mouth, covering your teeth comfortably like a gumshield.

They gently position your lower jaw forward and tongue to reduce the risk of an obstruction causing you to choke, also helping to prevent snoring and OSA.

You can purchase these devices online or visit your dentist to have one made.

Mandibular Devices

Could choking while sleeping be Sleep Apnoea?

If you experience frequent choking in your sleep and waking up gasping for breath, there is a high chance you have Obstructive Sleep Apnoea (OSA). Choking in sleep is one of the most common symptoms of OSA. Those suffering from this condition may also find themselves choking on their salvia or choking on acid reflux. OSA is a very common sleep disorder that affects millions of adults in the UK, and around 80% of those people have not been diagnosed.

Other Common Sleep Apnoea Symptoms include:

• Excessive daytime sleepiness
• Loud and constant snoring
• High blood pressure
• Depression and anxiety
• Morning headaches
• Difficulty losing weight

OSA can affect anyone, although it is commonly associated with individuals who are overweight and have a BMI over 25%. It is also more prevalent in those with diabetes.  

How do you get rid of choking while sleeping?

If you are experiencing symptoms, you need to take a Sleep Apnoea test or NHS sleep study. Our In-Home Sleep Test will confirm if you have OSA in 7-10 working days. If Sleep Apnoea is confirmed, you can successfully begin treatment within 2 weeks or consider what the other causes could be. 

An Intus Healthcare In-Home Sleep Test is a reliable alternative to the NHS sleep clinic, and the report we provide contains extensive results and recommendations. 

Studies have shown that sufferers can take up to seven years before seeking treatment.

If you are unsure if you are at risk of Sleep Apnoea, click the link below for a free risk test:

In-Home Sleep Study

An In-Home Sleep Study provides a quick, convenient and affordable way to have Sleep Apnoea confirmed. The most common symptom of Sleep Apnoea is choking while sleeping, so a sleep test can help determine if this is the cause. All studies are independently analysed by experienced NHS-qualified sleep professionals and use the WatchPAT recording device for unrivalled accuracy.

In-Home Sleep Study

Sleep Apnoea Treatments