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Lung diseases

Aspirating Saliva in Sleep

10/07/2010

Question:

Dear Doctor,

I am a generally fit 34 male, healthy weight for my height (6ft 2, 11.5 stone) but most nights I wake up coughing and choking after aspirating saliva into my lungs. This happens when I sleep on my back and it feels as though the saliva is drooling straight from my mouth into my airways.

I have raised my bed on books and do not eat 3 - 4 hours before bedtime, but I`m worried I`ll choke to death or `dry-drown`. I spoke to my GP about this but he said he was puzzled and didn`t know how to proceed with it.

Any help very greatly appreciated.


Answer:

Thank you for your question. There are many reasons a person may wake up with coughing and choking during the night. It may be related to GERD (gastroesophageal reflux disease) and may improve with raising the bed or not eating late at night. Patients may also require medications to control acid production in addition to the other measures. 
 
Some patients can also have problems with sinus congestion and drainage that can lead to choking, coughing and problems with drainage into their lungs. It is also possible that you may have sleep apnea, a disorder where patients have problems with their breathing only during sleep. This can lead to episodes of waking up with choking and coughing during the night. This is diagnosed with an overnight sleep study. 
 
It would be best to discuss these possibilities with you primary care physician or perhaps a sleep medicine specialist.

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Response by:

Nitin Y Bhatt, MD Nitin Y Bhatt, MD
Clinical Assisstant Professor of Pulmonary, Allergy, Critical Care & Sleep
College of Medicine
The Ohio State University