Ask a Best Doctor: Why Do I Wake Up Gasping?

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Q: When I go to sleep at night, I occasionally find myself waking up just as I start to doze off, gasping and choking for air. It goes away after a little coughing, but it's scary. What's going on?

A: Well, we can probably rule out Freddy Krueger dream-choking you. Yosef Krespi, director of the sleep-disorder center at Lenox Hill's New York Head and Neck Institute, says there are two likely causes for your discomfort: a sleep-related airway obstruction like sleep apnea, or a reflux-related irritation of the throat.

In the latter case, your choking or burping is caused by improperly digested food flushing upward in the throat. The solution may be as simple as taking an antacid, having a light and early dinner, or elevating the head in bed. If the periodic choking is sleep-related, your ENT will need to look at your throat for a possible obstruction like sleep apnea, Krespi says. "Say the patient has daytime sleepiness, snores, has lack of sleep and wakes up many times during the night, and is overweight, then a sleep study may be justified."

Sleep apnea is quite common — as many as one in five Americans suffers from it — and it has been linked to an increased risk of heart disease, diabetes, weight gain, and even car accidents. As with so many specific medical queries, your best bet is to tell your ear, nose, and throat doctor about the situation — the answer will be dependent on your sex, body type, digestion issues, and sleep habits, among other things.

There is also a similar phenomenon known as a hypnogogic jerk, where you feel yourself falling and suddenly wake up to one of your limbs going haywire: legs kicking, arms waving. Scientists aren't sure what cause these twitches, but they're generally harmless.

Got a health question? Send it to askadoctor@nymag.com and we’ll find a doctor to answer it.