Is waking up choking serious or a common annoyance?

August 12, 2011 3:14 PM

Is waking up choking on saliva anything to see a doctor about? Can I safely chalk it up to an annoyance and go about my life?

YANA/MD. This has been going on for the past two months or so. It's always when I'm sleeping, never happens when I'm awake. I'll wake up coughing like crazy to clear my throat of some liquid, I'm guessing it's saliva. Sometimes it happens multiple times a night, sometimes I'll go awhile without it happening and then it'll start up again. I never vomit or spit up anything. Just cough for a bit and then I'm fine. T

The choking is distressing but I'd rather avoid a doctor visit unless absolutely necessary. I was in and out of there frequently for stomach troubles and fatigue not too long ago and they ran a bunch of tests, couldn't figure out what was wrong, and I now have a huge bill from it. Sooo, I only want to go in a worse case scenario. Also, I don't think these two problems are related since the stomach/fatigue thing has been going on my whole life. Oh, and I don't snore.

It happens when I sleep on my back, but it doesn't make sense to me that I can suddenly not handle sleeping on my back anymore?
I'm not overweight so I'm guessing it's not sleep apnea. However, my dad does have sleep apnea so... maybe it is and it's genetic? I don't know because he is quite overweight so I don't know if it's genes or his weight.

The only thing I'm concerned about is whether it'll progress to me drowning in my sleep. Is it possible that my body won't wake up and clear the airway? I guess my question is whether it's safe to ignore this, preventing it would be nice as well, but I can live with it as long as it won't get worse.

posted by Pericardium to Health & Fitness (15 answers total)

Lots of skinny folks with apnea and you just listed a half dozen red flags for it, including the choking. Try sleeping on your stomach at least, for better drainage?
posted by availablelight at 3:18 PM on August 12, 2011

You are suffering from GERD. Yes, you absolutely should see a doctor.
posted by VikingSword at 3:21 PM on August 12, 2011 [3 favorites]

You should mention it to your doctor in case it is sleep apnea, but sleeping on your back is the kind of thing that closes your airway.

Try sleeping on your side with your top leg at a right angle. This is pretty close to the recovery position.

I very often stop breathing if I don't sleep in the recovery position, and I don't have sleep apnea.
posted by tel3path at 3:22 PM on August 12, 2011

I do this seasonally and have done for 20 years; in my case it's allergies*. Zyrtec, humidifier if the air is dry (or very heated/conditioned), sometimes sleeping on an extra pillow helps, except I pretty much always sleep on Pillow Mountain already.

*My childhood GP called it "early-morning allergy asthma" even though it's not particularly like asthma.

Unless you are under the influence of something that would prevent you from waking up, the choking is meant to wake you up. You're not likely to die from it. But I find it incredibly uncomfortable and a bitch of a way to wake up, so it definitely keeps me motivated to take my Zyrtec everyday and the humidifier if the air is dry.
posted by Lyn Never at 3:35 PM on August 12, 2011

IANAD, but if you do have GERD and they ran a bunch of tests (endoscopy? what tests?) you can probably just try a course of Prilosec or the other strong OTC anti-reflux med. If that clears it up, you're fine; if not, you can visit the doctor again. Prilosec is basically the first line of treatment for suspected GERD when there's no reason to expect stomach or throat cancer, bleeding ulcers, hernia, etc. (I've been through this very thing; the Prilosec did ameliorate things and I made other changes to my diet and sleeping pattern which finished the job.)
posted by Frowner at 3:43 PM on August 12, 2011

I did this and it was reflux. Prilosec took care of it - come to think of it, hasn't happened in months.
posted by crankyrogalsky at 4:01 PM on August 12, 2011 [1 favorite]

Here's the tricky thing about GERD - not everyone experiences a burning sensation as the acid washes up into your throat. Many people don't. Also, while PPIs, such as Prilosec are very important in controlling GERD, they don't necessarily prevent liquid making its way up into your throat. What it does, is suppress acid production - you may still experience liquids coming up, but it won't have as much acid, so hopefully won't keep distressing your esophagus. What many people with GERD do, especially chronic GERD, is to sleep with their upper body elevated a bit - there are special pillows sold or the head of the bed is raised slightly (it's not easy - people slide in their sleep, their bed-mates are inconvenienced etc.). But go to a doctor. Hopefully, you just have an episode of GERD, and not chronic. With a course of PPI's, some diet changes and perhaps elevated sleeping position, you'll heal and the problem will go away. Also, try to see if some of the problem is not brought on by triggers, such as coffee, citrus fruit, acidic foods, chocolate, alcohol etc. (keep a food diary and note the episodes).
posted by VikingSword at 4:31 PM on August 12, 2011

You may find my previous question on waking up choking helpful. I learned a lot from the thread.
posted by pupstocks at 5:30 PM on August 12, 2011

I can live with it as long as it won't get worse

Can you die from it if it does? This is your breathing we're talking about. See a doctor.
posted by eritain at 5:59 PM on August 12, 2011

My daughter is allergic to dust mites and when she wakes up coughing it sounds like she is choking on her saliva as well. Sounds like a doctor can help you figure out what it is. I'd definitely get it checked out!
posted by dawkins_7 at 7:09 PM on August 12, 2011

It could also be post-nasal drip (from any number of things: a cold, allergies, sinus problems, etc.). If that's the case, benadryl or sudafed will probably help, depending on the cause, and depending on whether either interferes with sleep.

A doctor can certainly help you figure out it's post-nasal drip, and if so what the cause is, although once you know it's just kind-of one of life's annoyances that can be treated with OTC meds, not usually something that actually requires a doctor on any ongoing basis.

Since it "comes and goes" you might keep a log of when it happens and what foods you have for dinner, whether you have a cold or headache, and any other likely suspects you can think of (fatigued from exercise? stressed from talking to Evil Coworker?), etc., to try to see if you can find a likely suspect. If it always happens after you drink orange juice with dinner, you're looking at heartburn, but if it always happens after you visit your friend with cats, you're looking at post-nasal drip due to allergies. And so on. Even if you can't find anything, you'll have good information for when you do talk to the doctor.
posted by Eyebrows McGee at 7:50 PM on August 12, 2011

This essentially also happens to me, except the saliva is kind of thick and mucousy (sorry). I have been formally diagnosed with GERD, hiatal hernia, and allergies (but have never had the test for exactly what I'm allergic to). I have personally found that when I cut out grains and dairy from my diet, I no longer experience these symptoms to even 10% of the degree I experience them when I don't try to control my diet. This leads me to believe it's allergy- AND digestive-related. I don't know if this is what it is for you, but if you were to have some subtle dietary allergies you're not realizing, you'd probably see some improvement in eliminating the food triggers.
posted by so_gracefully at 7:51 PM on August 12, 2011

I was 95 lbs when I was diagnosed with sleep apnea. Sorry.
posted by desjardins at 10:18 PM on August 12, 2011

Another cause of excessive saliva is advanced gum disease, and saliva production maladjustments are also associated with diabetes.
posted by dhartung at 12:14 PM on August 13, 2011

I had nocturnal choking as a symptom of Achalasia (after going to doctors for years they finally diagnosed me properly). I hope you don't have the same thing.
posted by getawaysticks at 11:39 AM on August 16, 2011