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Waking up gasping for air can be jarring. Some people describe experiencing shortness of breath and feeling like they’d been suffocated. Many cultures share the myth that it happened because some sort of supernatural spirit was sitting on a person’s chest. Read on to learn about the health conditions found that explain this phenomenon.

There are several different causes that can lead you to wake up gasping for air. Some are temporary and benign, while others are more serious.

Postnasal drip

Postnasal drip can cause nasal secretions to move down your throat at night and get trapped there, especially if you’re lying on your back. This can block your airway, which triggers the coughing and gasping reflex.

People who wake up gasping for air as a result of postnasal drip often say they feel like they’ve been suffocating. They may also have symptoms like a sore throat, a bad taste in their mouths, or sinus headaches.

Learn more about postnasal drip.

Hypnagogic jerk

Hypnagogic jerks are the involuntary movements of the body that happen right when you’re falling asleep. They’re also sometimes called hypnic jerks. They can be small twitches of an arm or involve your entire body and make you feel like you’re falling upon waking.

Sometimes when this occurs, your muscles will be tense, causing you to gasp for air. You may have a heavy feeling in your chest. Other symptoms may include:

  • rapid heart rate
  • fast breathing
  • sweating

Hypnagogic jerks can be made worse by:

  • stress or anxiety
  • caffeine
  • sleep deprivation
  • an irregular sleep schedule

Obstructive sleep apnea

Obstructive sleep apnea can cause your breathing to start and stop while you sleep. It can lead to the throat muscles relaxing so much that they block your airway. You may wake up abruptly gasping for air or choking.

Other symptoms that accompany sleep apnea may include:

  • excessive daytime fatigue
  • loud snoring
  • morning headaches
  • high blood pressure
  • mood changes
  • difficulty concentrating during the day

Learn more about obstructive sleep apnea.

Pulmonary edema

Pulmonary edema occurs when excess fluid collects in air spaces and tissue in the lungs. This makes it more difficult to breathe. While pulmonary edema can develop slowly over time, it can also develop suddenly. The difficulty in breathing can cause you to wake up gasping for air and feel like you’re suffocating or drowning. Acute pulmonary edema is a medical emergency.

Other symptoms you may experience include:

  • difficulty breathing or shortness of breath that gets worse when lying down
  • wheezing
  • sudden anxiety or restlessness
  • rapid and irregular heartbeat
  • chest pain
  • a cough that may produce frothy sputum, which may be tinged with blood

Learn more about pulmonary edema.

Anxiety and panic attacks

Both anxiety and panic attacks can cause you to wake up gasping for air. Attacks can occur while sleeping without any obvious trigger. Both conditions can bring about an increase in hypnagogic jerks.

Other symptoms include:

  • feeling faint or dizzy
  • sweating
  • having chills
  • feeling a loss of control
  • chest pain
  • sense of terror or impending doom
  • shortness of breath

Learn more about anxiety and panic attacks.

Acid reflux

Acid reflux can cause a backflow of the stomach’s acid into the esophagus. This condition is also known as GERD. Sometimes this acid will move far enough up the larynx or throat. This can lead the person to wake up choking, coughing, and gasping for breath.

Other common symptoms of acid reflux include:

  • heartburn
  • erosion of the enamel of the teeth
  • bad breath
  • chronic sore throat

Learn more about acid reflux.

Heart failure

Congestive heart failure can cause extra fluid to accumulate in or around the lungs, resulting in congestion and difficulty breathing. While symptoms are most often seen with strenuous exercise, it can occur when laying down and sleeping as the heart failure progresses.

Other symptoms may include:

  • swelling in the legs
  • extreme fatigue
  • chest pain
  • lethargy
  • abdominal distension
  • gastrointestinal problems

Learn more about heart failure.

Treatment of this symptom heavily depends on the underlying condition.

Treating postnasal drip

If you’re experiencing postnasal drip, you can use sinus irrigation tools like a neti pot to help flush out excess mucus. Saline nasal sprays can help moisten the nasal passages. Sleep with your head elevated to promote proper drainage, and prevent the mucus from blocking the airway.

You can also take nondrowsy antihistamines. Your doctor may prescribe a steroid nasal spray.

Shop for neti pots.

Treating hypnagogic jerks

Hypnagogic jerks can be treated with lifestyle changes, including:

  • regulating your sleep schedule
  • getting better quality sleep
  • reducing stress
  • cutting out caffeine at least six hours before sleeping

Treating anxiety and panic disorders

Reducing stress and caffeine can also help to reduce symptoms of anxiety and panic disorders. Talk therapy with a therapist can also be beneficial to help identify the cause and triggers of anxiety or panic attacks and find ways to manage the symptoms. Prescription medications are also available for both anxiety and panic disorders.

Treating obstructive sleep apnea

Obstructive sleep apnea can be a dangerous medical condition and requires treatment. Your doctor may recommend losing weight if you’re currently overweight, and to quit smoking if you haven’t yet.

They may also prescribe positive airway pressure. This involves using a machine to deliver oxygen at a slightly higher airway pressure than normal to keep your airways open. Your doctor may also prescribe a mouthpiece that’s designed to keep your airway open by bringing your jaw forward.

Treating pulmonary edema

Pulmonary edema should be treated immediately. Your doctor may prescribe:

  • Preload reducers. These decrease the pressure caused by the fluid in your heart and lungs. They may include diuretics.
  • Afterload reducers. These dilate the blood vessels to take the pressure off the heart’s left ventricle.
  • Blood pressure medications.

Treating acid reflux

If you have acid reflux that’s causing you to wake up gasping for air, your doctor will probably recommend a mix of lifestyle changes and medications. Lifestyle changes include quitting smoking and avoiding foods and beverages that can cause GERD. These include:

  • greasy foods
  • spicy foods
  • those high in acid
  • alcohol

Avoid eating for two to three hours before bed. Sleep with your head and upper body slightly elevated. If needed, your doctor can prescribe antacids and H2 receptor blockers to decrease acid production.

Treating heart failure

Heart failure is a chronic disease and will need consistent on-going treatment. Your doctor may prescribe medications like ACE inhibitors, beta blockers, diuretics, and inotropes.

In severe cases, surgery may be needed to treat certain causes of heart failure, like a coronary bypass for blocked arteries. Surgery can also include treating the damage from heart failure, like a heart valve replacement.

Waking up gasping for air can be alarming, but it’s not something that’s uncommon. If you otherwise feel fine or if your symptoms subside soon, you can go back to sleep. Should you continue to wake up gasping for air regularly or have symptoms that suggest a more serious underlying condition, make an appointment to see your doctor. They can help you find or confirm the cause.

If you experience any of these emergency symptoms, seek immediate medical attention:

  • continued symptoms of shortness of breath, chest pain, or both
  • losing consciousness
  • severe chest pain