How do I stop from gagging in the mornings?

May 12, 2008 5:12 AM

Please help me. I don't want to throw up every morning.

I'll just state upfront that I'm not pregnant, and the doctor didn't have any great ideas, either, and isn't worried about any underlying problems.

I wake up every morning, my throat is phlegmy, my stomach is upset, and I gag. Often to the point of throwing up. During allergy season only. I'm sure that the problem is that I'm swallowing snot all night.

I'm hydrated. The phlegm is thick. Guaifenesin doesn't seem to help. I sleep mostly on my side. I do snore. I've had a sleep study--no apnea. Um, what else? Allergy meds don't seem to make a difference with this particular problem. My morning coffee worsens it (so sad about that). This has been going on for years, intermittently.

I've found myself having to resort to mindful breathing while driving in order not to throw up on my commute. This morning it's especially bad, and I'd appreciate any, any suggestions on how to make this go away or at least tolerable.

posted by Stewriffic to health & fitness (39 comments total)

Try eating a few saltines with a few sips of a clear carbonated beverage (like Sprite or 7-Up) upon first waking up. That combo is a universal stomach-settler. I suspect that you're nauseated to the point of throwing up because the phlegm and snot are the only thing in your stomach.
posted by amyms at 5:32 AM on May 12, 2008

Are you eating anything for breakfast? What? I've found that water crackers can help when I have a similar problem.

You have four main avenues of attack:

1) Allergy medication. Since you mention Guaifenesin, I'll assume you've tried other allergy meds, but if not, definitely give it a go. Claritin is OTC and was actually pretty good when I tried it.

2) Eliminate allergens from your room. Keep windows & doors closed, clean everything (fabrics, dust, etc) and keep it that way. Kind of a pain, but also reinforces the "fortress of solitude" refuge quality of a bedroom :)

3) Take other health measures to reduce phlegm and/or allergies. Phlegm is often linked to consumption of dairy products. Hard to eliminate, but if you're desperate... You might find other suggestions on this, and it's really _awesome_ that the breathing helps.

4) Deal with the nausea after it starts. I'd avoid caffeine and _anything_ acidic - orange juice and eggs have been particularly awful when I've dealt with this, even green tea doesn't work. Soothing foods - oatmeal, water crackers, or possibly saltines are really good to start. Even just one or two crackers on your stomach might help.
posted by amtho at 5:35 AM on May 12, 2008

I have this too, when my allergies are really bad. Something with salt first thing in the morning seems to help for some reason. For me, thats a swig of pickle juice (but I really like pickles). Saltines as mentioned up above would probably do the trick.

You also may want to talk to your doctor about allergy shots if that hasn't been discussed already. Shots never cleared up my allergies permanently like promised, but they do seem to provide short term relief (even though they're not supposed to work that way. dunno why.)
posted by [insert clever name here] at 5:45 AM on May 12, 2008

Advice an allergist gave me: take a LONG, HOT shower and blow your nose while you are in the shower. If you take medications in the morning, wait until you've got some food in your stomach.
posted by Carol Anne at 5:48 AM on May 12, 2008 [1 favorite has favorites]

I had a similar problem for which my GP prescribed a nasal steroid spray (beclometasone dipropionate sold as Beconase or Nasobec in the UK). I've been using it for several years and it really seems to have helped.
posted by Dan Brilliant at 5:50 AM on May 12, 2008

(washing down my saltines and antacids with a pickle juice and sprite cocktail now)
posted by Stewriffic at 5:57 AM on May 12, 2008

Oh, yumm.

I'll just add - antacids have never helped me with this particular problem.
posted by amtho at 5:58 AM on May 12, 2008

This year allergies hit me the worse than ever. I tried claritan, zyrtec, nasalcrom and flonase without much luck. My doc steered me towards "Chlor-trimeton" (it's OTC) which worked wonders. 1/2 a tablet in the morning and a full one at night. Apparently it's one of the most powerful antihistamines out there but an older generation. Thankfully it didn't make me very drowsy.
posted by jwells at 6:16 AM on May 12, 2008 [4 favorites has favorites]

2 puffs of marijuana smoke settle my upset stomach down very rapidly.
posted by whoda at 6:18 AM on May 12, 2008

It might seem a bit quack-ish, but I have found this advice on how breathing through the nose (even if it's blocked) helps it to clear to be absolutely true in my experience.
posted by tomcooke at 6:19 AM on May 12, 2008

So seriously, the saltines with some weak crystal light-esque beverage helped a little. (I did have a swig of pickle juice, which didn't have a noticeable effect.)

I'm realizing, though, that I don't actually feel nauseated. I just gag. The gagging doesn't get the phlegm out of my throat, and just begets more gagging, until then sometimes I puke. It tends to clear up by mid-morning.

More info on what I've tried--I don't take meds every day for allergies--benadryl at night sometimes is what I've tried for this particular problem. It doesn't make a difference in the mornings. I do fall asleep quite nicely, though. Claritin doesn't seem to work at all on me for some reason. I haven't been on nasal steroids in some time. I don't notice any problems during the day other than a few sneezes, so I don't tend to take

I threw up during my long hot shower this morning. That rocked. It did make me need to blow my nose, too.

On preview: pot makes me puke violently. I'll check out chlor-trimeton. Interestingly, when I do my mindful breathing, it's through my nose.
posted by Stewriffic at 6:33 AM on May 12, 2008

Yeah, I've pretty much had this since I can remember try:

*hot showers before bed, to get all the pollen and dust and junk out of your hair.
*hot shower in the morning to clear sinuses
*Sprite or 7up and something bland for breakfast right away (plain bagel, toast, crackers, etc.)
*decongestants (sudafed) during the day.

For me the key is having something besides snot in my stomach right away. If I skip breakfast, I feel really awful.
posted by Green Eyed Monster at 6:34 AM on May 12, 2008

I used to have bad nausea in the morning, possibly connected to congestion. It helps me to eat more food before going to sleep. Something like a bowl of protein cereal (soymilk for me, might be good for you too if you currently drink cow's milk), toast with hummus, handful of nuts, or something else small that would give your stomach something else to work on during the night. Good luck with it. I know it's miserable!
posted by olecranon at 6:35 AM on May 12, 2008

um... I didn't finish a sentence up there, it looks like. I don't usually take allergy meds during the day unless I am bothered by the symptoms.
posted by Stewriffic at 6:36 AM on May 12, 2008

Oh, ew. I have had this problem in the past. It's so foul and no-one ever seems to understand that, uh, yeah, you're really throwing up every morning.

My doctor explained it to me as snot dripping onto the soft palette triggering the gag reflex. He said it's worse in the morning because you've been lying flat on your back with the snot dripping down your throat all night. Lovely. Although, I you said you sleep on your side, so perhaps that's not so much of an issue for you?

Anyway... it was worst when I lived in places where there was a lot of pollution. Living where there's no pollution at all, I haven't been morning vomity for at all. Other things that made it worse were the pill, orange juice, and dairy. Ymmv, obviously.

Sudafed helped me - dried everything up. No more snot, no more throwing up. Also, no more sleeping, so I didn't really stick with it. In the end, I just would try and help it along with a glass of warm water, or cup of black tea. That would, shall we say, bring things to a head. Getting it all out as soon as poss was much less dreadful than gagging and being nauseous for hours. But still not pleasant.
posted by t0astie at 6:39 AM on May 12, 2008

Same problem here, off and on. I was prescribed Astelin nose spray, which helped a little (but things seem to have settled down now that I *am* pregnant). Zyrtec maybe helped some, but not enough to stay on it. Tried Flonase for a while about 10 years ago, and while I think it helped, I got wicked sinus headaches when I ran out, so I decided that wasn't so cool.

It doesn't look like you've tried the full gamut of allergy medications, so there might be some that help---especially maybe some of the sprays.

Also, do you use a humidifier at night? That might help, too.
posted by leahwrenn at 6:39 AM on May 12, 2008

Neti pot. The idea struck me as unnatural and uncomfortable, but I tried it and got into a daily, before bedtime habit. My sleep breathing has improved and my morning phlegm has left the building. So to speak.
posted by quarterframer at 6:45 AM on May 12, 2008 [3 favorites has favorites]

You might try gargling with some nice, warm salt water upon arising to loosen that phlegm right away so you can spit it out. That will really help. And have you ever tried a neti pot? It will gently wash out your sinuses to temporarily stop a lot of the post-nasal drip that's making you gag. They're really pretty great.
posted by iconomy at 6:47 AM on May 12, 2008

Seconding Neti pot - MeMail me if you want a cheapo DIY alternative.
posted by Koko at 7:01 AM on May 12, 2008

Neti pot, definitely. At night before bed when things aren't so bad, and it should get you through the night better.

On really bad mornings, I have a small juice glass of lemonade (MM Light, generally) right away. It's acidic enough to feel like I've cut a swath through the gunk. (Orange juice may also work, but I hate orange juice.)

If you're sleeping openmouthed because of the drainage, run a humidifier or vaporizer at night. On very, very bad nights I sleep semi-reclined on a pile of pillows.
posted by Lyn Never at 7:05 AM on May 12, 2008

Like previous posters, I also love the Neti pot, or just saline spray if the pot weirds you out.
Claritin-D, not just Claritin.
Oh, and go see an otolarygngologist (may have not spelled that right -- ear, nose and throat doctor). She can give you an allergy test -- maybe you have reactions to, say, feathers from your pillow, or dust. Many allergies come later in life.

The antacids will only work if acid reflux or heartburn are also problems you have. But if you go to an ENT doc, let them know if you have heartburn because that also triggers post-nasal drip problems.

Sadly, I've found that caffeine, alcohol and dairy (especially cheese) trigger especially bad reactions in the post-nasal drip area, so maybe avoiding them at night could help, too.
posted by landedjentry at 7:27 AM on May 12, 2008

you poor thing! I used to have to do mindful breathing to keep from throwing up in the car on the way to work because I took too many vitamins every morning on an empty stomach :-)

I have no suggestions on your specific problem, just sympathy. I use a neti pot for my sinuses when I get sick (many times a year) and it seems to help with the drainage quite a lot. Mine came from whole foods and was cheap.
posted by pinky at 7:55 AM on May 12, 2008

Have you tried sleeping with a humidifier running? It won't keep the phlegm away, but it may keep it from drying out into the thick, goopy stuff that's making you gag.
posted by nebulawindphone at 7:59 AM on May 12, 2008

Air filter in the bedroom, and keep the windows shut. Shower before bed to get the allergens off you. Coversheet over the entire bed that you remove for sleeping.

Some years back I took an OTC med that promised to stop my dripping nose for 12 hours, which it did by making me horribly stuffed up. I hated it and tossed it in the trash about 6 hours in. I don't remember what it was called, but perhaps something like that would help?
posted by yohko at 8:00 AM on May 12, 2008

I sometimes use a neti pot, but when I really need to clean myself out, I use one of those medicine syringes. I plug one nostril and gently press the plunger on the syringe while snorting the water slowly and evenly up the other nostril. This causes it to get the gunk out of the palate/throat area. Then I hack real good and spit it out my mouth, instead of out the other nostril.
posted by peep at 8:23 AM on May 12, 2008

Try switching to a pillow you can sterilize periodically, such as a beach towel inside a pillowcase.

Pillows: A Hot Bed Of Fungal Spores

Aspergillus fumigatus, the species most commonly found in the pillows, is most likely to cause disease... Fungi also exacerbate asthma in adults.

The researchers dissected both feather and synthetic samples and identified several thousand spores of fungus per gram of used pillow - more than a million spores per pillow.

... the team studied samples from ten pillows with between 1.5 and 20 years of regular use.

Each pillow was found to contain a substantial fungal load, with four to 16 different species being identified per sample and even higher numbers found in synthetic pillows. The microscopic fungus Aspergillus fumigatus was particularly evident in synthetic pillows, and fungi as diverse as bread and vine moulds and those usually found on damp walls and in showers were also found.

Professor Ashley Woodcock who led the research said: "We know that pillows are inhabited by the house dust mite which eats fungi, and one theory is that the fungi are in turn using the house dust mites' faeces as a major source of nitrogen and nutrition (along with human skin scales). There could therefore be a 'miniature ecosystem' at work inside our pillows."

posted by jamjam at 8:47 AM on May 12, 2008

If none of the above nose-cleaning advice helps much, you should try sleeping on an incline (which is easier if you sleep alone or have a really forgiving partner).

When I get a cold, I usually get it hard, and wake up with a similar snottage problem. You can buy bed raisers and put them only on the head side of your bed, or you can go cheap and buy a 2x4, and shove it under the legs. Anything that will elevate your head a few inches above your stomach. (You could also put a bunch of pillows in a wedge and sleep on that, but it's difficult and uncomfortable, especially for a side-sleeper.)
posted by phunniemee at 8:52 AM on May 12, 2008

Get a HEPA filter for your bedroom. I wake up with allergy headaches in the morning if I don't remember to run it at night.
posted by metahawk at 9:54 AM on May 12, 2008

See an ear nose throat doc, but in the meantime, maybe you have tonsiliths? I get them occasionally and they make me gag, it's worse in the morning because the combo of empty stomach + gross stuff in my tonsils + post nasal drip is a fatal combo. Oh, and they make my breath stink.

Good luck, this sounds pretty miserable.
posted by sondrialiac at 10:57 AM on May 12, 2008

I have no tonsils. I guess I'll just try a bunch of these suggestions one at a time. I'll start with a Neti pot. This is really unpleasant. I ended up staying home from work today because I felt so pathetic. Emotions meet the physical!

I kind of just want to whine and have someone wait on me now. Strawberries, please!
posted by Stewriffic at 11:06 AM on May 12, 2008

Just to give all you allergy sufferers out there hope, this is the second year in a row where I have had very few, if any, hayfever symptoms in the spring. I'm 36. I do have mild asthma (I developed it when I turned 32), and have relied on prescription-strength antihistamines until I moved into the city. However, I work in a tech park in a rural setting, so I don't think the change of location is enough of an explanation.
posted by KokuRyu at 11:26 AM on May 12, 2008

Post nasal drip will do that to you.

Sudafed before bed will help.
posted by DarlingBri at 11:47 AM on May 12, 2008

Why does AskMe always answer something I want to know. Same problem, I sound like Bill the Cat every morning for about 3 or 4 minutes, I keep a yak cup by the bed. Sudafed helps alot, but with the fake stuff you've got to wake up every 4 hours or so and double dose. Pollution is a big thing... when I went home to Virginia I was fine after the first day, when I came back to Los Angeles, *boom* yakking every morning. Allergy season for me seems to mostly be over, it's just night time sleep that causes problems. Soda (7-up, Sprite, Ginger Ale, even Coke) seems to help in the mornings, sometimes... I've just gotten used to the morning yak, it's a few minutes of *ewww* then I'm fine. Allergist is in the works, but daily symptoms have started to go away.

I feel everybody's pain, it's a bitch to wake up and barf.
posted by zengargoyle at 5:14 PM on May 12, 2008

This will sound bizarre, but do you exercise? I used to have the puke/phlegm thing going on (only with me it was going to bed at night that would make me have to get up and puke, a lot, and various drugs didn't work), but within a month of going to the gym most days of the week, I stopped coughing and puking entirely.
posted by jenfullmoon at 8:38 PM on May 12, 2008

I was thinking about this question again on the way to work.

So your gag reflex is being triggered, and tons of stuff here addresses the phlemy stuff, but why are you so prone to nausea?

Since you specifically said you aren't pregnant, I wonder if you're on the pill. Is the queasiness exactly the same every single morning? Or is it cyclical? If you take the pill did you switch brands or types at any point?

I know a few women who get really sick during parts of their tri-phasic pill packs, so that just popped into my head as a possibility here.
posted by peep at 8:37 AM on May 13, 2008

I don't really have nausea, actually. I took that back a few comments into the thread. Just gagging until I throw up. And I'm not on the pill, so it's not that either.

Last night I used a Neti pot before bed, and then again when I got up this morning. It cleared out my nasal passages, but not the back of my throat, which is where the problem is. I tried to do a salt water gargle, too, but that got the gagging going, both last night and this morning.

I didn't eat or drink anything until about an hour after getting up: coffee and a breakfast sandwich. Neither of them made me gag. Eating something actually seemed to help, in that it felt like it scraped the phlegm off.

Currently I have not thrown up, but I have gagged today. My nasal passages are entirely clear, but there's this low-level, back-of-the-throat phlegmy feeling which is what causes the gag. I'm still resorting to breathing to take my mind off of the gag feeling. If I get nervous that I'm going to puke I gag even more.

I think the next thing I am going to do, since the Neti pot didn't seem to take care of the throat clog, is to take some Sudafed and see if I can get rid of it that way.

Sudafed interferes quite badly with my sleep, though, so I'll try now while it's still daytime.
posted by Stewriffic at 11:03 AM on May 13, 2008

This used to happen to me, though I only actually threw up a few times. Anyway, it all stopped at the same time I resolved to breathe through my nose.

(Starting to breathe through your nose is hard because, for the first 20 seconds, you might not be able to breathe at all due to a blocked nose. Usually your nasal passage opens up pronto.)

While I cannot rule out that breathing through my nose and the sudden complete resolution of my lifelong swallowed-snot problem were merely coincidentally simultaneous, I say breathe exclusively through your nose anyway. It won't be bad for you.
posted by hAndrew at 9:06 PM on May 13, 2008

Take a few days before you switch methods. It takes awhile for the body to clear the backlog and heal the throat which will probably clear up if you give it time and continue using the neti pot. Those didn't work too well for me because the passages were clogged, but they did help.

Please be careful with decongestants like Sudafed. I learnt they dry me out so badly I end up with bronchitis... in one night! So I tried the OTC version you don't need to sign your life away for (thanks meth heads!) thinking it'd be less bad but it turned out to be used in surgery to elevate blood pressure... not so good in a person with high blood pressure. And then just to complete the picture, the nasal inhaler decongestants apparently have a rebound effect if you use them more than a few times. The whole class of drugs is off my list at this point!

You might also try NasalCrom if you can start before things get bad. It's a nasal inhaler but not a decongestant.
posted by jwells at 8:04 AM on May 15, 2008

Hope some of the things you're trying are useful. In the meantime, I switched to a new ear nose throat doc and she told me that a lot of sinus/post-nasal drip issues/gagging are caused by undiagnosed reflux. It can show up without heartburn or other pain. She suggested I see a gastroenterologist.

Maybe this helps!
posted by sondrialiac at 6:07 AM on May 23, 2008