Choking in your sleep: reasons for lack of air at night, why it’s hard to breathe

Vegetative-vascular dystonia occurs for many reasons, but has one mechanism of development. There are several types of VSD:

• respiratory;
• cardiac;
• hypotonic type;
• according to the hypertensive type;
• mixed.

Doctors at the Yusupov Hospital determine the cause and type of VSD using modern instrumental and laboratory diagnostic methods. After determining the type of VSD, comprehensive treatment is carried out aimed at eliminating the cause of dysfunction of the autonomic nervous system, the mechanism of development of the disease and the leading symptoms. For the respiratory type of VSD, pulmonologists are involved in treatment.

I feel suffocated at night: why and what does this mean?

Sleep is a state of the human body caused by the normal functioning of the brain. For proper rest, a person needs to sleep 8 hours a day, and the 4th part of this time should be in the deep sleep stage. The shorter this phase, the more difficult it is for the body to recover.

Some people wake up at night from lack of air. They are scared and do not understand what is happening to them. The reason for this phenomenon is the cessation of respiratory movements - apnea (ancient Greek ἄπνοια - calmness, lack of breathing). Sometimes several such attacks occur during the night, moreover, they can be repeated several times within one minute.

As a result of an attack of apnea, the amount of oxygen entering the lungs decreases, the person leaves the stage of deep sleep, and sometimes wakes up. No wonder he feels exhausted the next day.

Lack of oxygen in the blood leads to loss of strength in the morning and disruption of metabolic processes in the body. In acute hypoxia, the heart and brain are affected.

How often do you have attacks?
USEFUL INFORMATION: Why does a child twitch in his sleep: reasons

Stress and overexertion

Shortness of breath at night during sleep may occur due to stress suffered the day before or severe physical strain. Emotional outbursts provoke the release of adrenaline into the blood, which leads to an increase in the capacity of the lungs; they begin to “pump” more air than usual. In this case, the following additional symptoms appear:

• all muscles of the body are in hypertonicity;
• a sharp spasm occurs in the throat;
• the skin begins to turn pale and then turn blue;
• cold sweat appears.

This condition is called hyperventilation and is not pathological unless accompanied by panic attacks.

If you are sure that respiratory failure is caused by stress, then seeing a doctor does not make sense. As soon as the nervous system returns to normal, breathing is completely stabilized, most often the next night patients sleep absolutely normally.

A person suffocates in his sleep: all possible reasons

Lack of air during sleep is a serious problem. If a person complains: “I suffocate at night when falling asleep, it becomes suddenly difficult to breathe, I can’t breathe,” sometimes the cause is a common runny nose. However, in some cases, more serious pathologies are present, as listed below.

Obstructive sleep apnea

Cessation of pulmonary ventilation within 10 seconds, caused by a weakening of the tone of the muscles and soft tissues of the throat, as a result of which the airways are blocked and oxygen ceases to flow. A person suffering from this disease feels tired throughout the day. This is perhaps the main manifestation of this pathology. If the patient is overweight, he should sleep only on his side to avoid suffocation.

Another manifestation of apnea is loud snoring that suddenly stops and then resumes again. It can signal that a person has stopped breathing.

Hypopnea

This is the next reason for lack of air. Patients complain that they seem to forget how to breathe in their sleep. This pathology manifests itself in that the airways are half blocked by soft tissues and it takes 10 seconds or more to restore breathing.

Central sleep apnea

It occurs due to disturbances in the functioning of the brain when there is a failure in the transmission of nerve impulses that cause contraction of the respiratory muscles. The brain seems to forget that the body needs oxygen, and the person briefly holds his breath and stops breathing.

INTERESTING FACTS!

• According to the dream book, if a person suffocates in a dream, this means that serious changes in life await him, and deprivation is possible. Another interpretation is being dependent on a certain person or on certain circumstances.
• From a scientific point of view, such a dream plot can be dictated by physiology: when breathing becomes difficult or stops during apnea, a person experiences suffocation in his dream. However, according to surveys and studies, patients diagnosed with sleep apnea do not see such dreams more often than healthy people.

Acid reflux

Choking occurs because the muscles that keep stomach contents from returning to the esophagus weaken. The acid gets into the throat and causes a severe cough, making it difficult to breathe. Thanks to coughing, the throat clears after some time. An important symptom of acid reflux is a sharp feeling of heartburn in the chest area, which can wake a person up.

USEFUL INFORMATION: Weakness in the body and drowsiness: causes in adults

You can get rid of the pathology by changing your lifestyle: eat small portions, have dinner four hours before bedtime. To prevent acid from the esophagus from entering the respiratory tract, it is recommended to sleep on high pillows: this way you will not suffocate.

Nocturnal asthma attacks

If bronchial obstruction occurs at night, suffocation also occurs.
The person begins to cough, cannot breathe, feels like he is suffocating. Signs of developing an attack of bronchial asthma (appear simultaneously):

• labored breathing;
• coughing;
• wheezing;
• heaviness in the chest;
• arrhythmia.

Postnasal drip

Associated with the accumulation of large amounts of mucus in the nasopharynx and usually develops against the background of a runny nose.
In certain cases, it can occur in completely healthy people. In this case, thick mucus gets into the back of the throat or the back of the nose, blocking the movement of air, and it becomes difficult to breathe. Dizziness and convulsions are symptoms indicating the presence of this pathology. They, however, can also be observed in nephropathy and multiple sclerosis. Therefore, it is necessary to undergo an examination as soon as possible to find out the true nature of the problem.

Reasons for violation

A variety of diseases can cause respiratory failure. Most often, the disorder manifests itself when a person is sleeping, because all organs and organ systems work in a “saving mode.” This means that the pulse, blood circulation, breathing, etc. slow down. If there is any serious illness, it manifests itself precisely at this time, since it is difficult for the body to launch compensatory functions that can work during the day.

Let's consider what pathologies can be a harbinger of lack of air during sleep.

1. Cardiac asthma or paroxysmal nocturnal dyspnea.

This condition is caused by chronic heart failure, the development of which most often results from ischemia. This disease is characterized by the loss of the heart’s ability to fully pump blood, which causes it to stagnate in the pulmonary or systemic circulation. In the case of cardiac asthma, stagnation is detected precisely in the small circle. Shortness of breath appears at night because, when in a horizontal position, all the fluid in the human body rushes to the upper part. This increases the pressure in the capillaries of the lungs, and fluid leaves them into the interalveolar space, which leads to disruption of gas exchange. The patient experiences primarily problems with inhaling air rather than exhaling.

What will help? Most often, respiratory distress occurs with a low head position. If you take a sitting position during an attack, the situation improves. It is for this reason that people often sleep half-sitting. However, this does not help cure the disease; the lack of drug support can lead to pulmonary edema and suffocation. The doctor may prescribe medications to increase heart activity and diuretics.

1. Bronchial asthma.

This is an allergic disease that causes spasm of the small airways. The patient may experience attacks of respiratory failure, which very quickly intensify and lead to suffocation. However, it also happens that the pathology manifests itself only as a dry, hysterical cough, during which it is difficult to breathe.

What will help? Correctly prescribed treatment completely eliminates attacks of suffocation or lack of air. If this symptom does appear, you should immediately use bronchodilators, then you should contact a pulmonologist, who will adjust the therapy.

1. Excess weight.

The presence of internal fat in the body is a more serious problem than an unattractive waist. If a person is overweight, then his stomach puts strong pressure on the diaphragm, pushing it up. This leaves very little space for the lungs, which causes oxygen starvation. Fat can also envelop the lungs and heart, preventing these organs from functioning properly, causing shortness of breath.

What will help? Only weight correction will get rid of extra pounds and breathing problems. You should contact a nutritionist who will create a proper balanced diet. Cardiac exercises will also be useful - they trigger metabolism in the body and help you lose weight faster.

1. Arrhythmia.

Atrial fibrillation is often manifested by air deficiency. The disease stimulates chaotic contraction of muscle fibers located in the atria. The pulse becomes irregular and the patient cannot breathe normally. Obesity, diabetes, alcohol addiction and diseases of the cardiovascular system lead to the development of pathology, which worsens with age.

What to do? If such a problem is detected, you should urgently contact a cardiologist; the doctor will be able to find out the degree of advancedness of the disease and prescribe medications to maintain normal functioning of the heart muscle.

1. Sleep apnea.

Sudden respiratory arrest syndrome occurs due to the fact that the pharyngeal muscles completely relax, the gap between them narrows significantly or even closes. Micro-awakening of the brain occurs at the moment when the amount of oxygen in the blood becomes critically low. This protective mechanism tones the muscles and allows you to breathe. Immediately after an attack, a person experiences a lack of air; it is noteworthy that at this time he may not even wake up. To replenish the cells with oxygen, the patient takes long breaths and short exhalations, his heart rate accelerates. When balance is restored, respiratory function returns to normal.

What will help? Obstructive sleep apnea syndrome must be treated as it can lead to suffocation and death. The doctor may prescribe medication, a CPAP machine that provides oxygen throughout the night, or surgery.

1. Panic attacks.

This disorder is associated with an unstable psyche and high emotional excitability. At night, difficulty breathing can occur due to a sudden feeling of panic, while the heart rate accelerates and chills appear.

What will help: people with panic attacks do not have any pathologies or deviations from the norm in terms of physical health; the root of evil lies exclusively in a suspicious and anxious temperament, the correction of which is prescribed by a psychiatrist.

Other violations:

• angina pectoris;
• sleep paralysis;
• thyroid diseases;
• inflammatory processes in the respiratory organs;
• presence of neoplasms;
• pulmonary embolism;
• neuroses.

Sleep apnea in a child

Apnea is especially dangerous in children under one year of age, which is due to the imperfection of their respiratory system. If a child suffocates during sleep, this may be due to the following reasons:

• insufficient formation of respiratory centers (in premature infants);
• birth injuries;
• gastroesophageal reflux disease (GERD);
• infections;
• anomalies in the structure of ENT organs;
• adenoids or chronic tonsillitis;
• allergic reactions to microorganisms living in pillows and bedding (the most common cause in adolescents);
• asthma;
• bronchospasm;
• runny nose;
• dry air in the room.

Sleep apnea - symptoms and treatment

Therapy for OSA is aimed at restoring oxygen levels, eliminating snoring, increasing alertness during the day, reducing respiratory arrest and normalizing sleep. In the modern world, there is a wide range of therapeutic measures, including surgical and conservative treatment, as well as lifestyle modification (weight loss, first of all, etc.). Before starting treatment, it is necessary to conduct a full diagnosis to determine the severity of OSA.

Timely treatment begins to lead to a significant reduction in clinical symptoms, and most importantly, to preventing the progression of the disease.

Surgical methods include ENT interventions (uvulopalatoplasty, etc.) and orthognathic operations. Uvulopalatoplasty is effective for uncomplicated snoring (isolated, extremely rare) and for mild, less often moderate, OSA. It should be performed after a thorough additional examination (polysomnography, sleependoscopy). In severe cases of OSA, ENT surgery is contraindicated due to low effectiveness and sometimes worsening of the condition.

Surgeries on the upper and lower jaw (orthognathic) can be used for any severity of the disease. They are quite effective, but the preparation for them is very long (about a year), and the operation itself is very labor-intensive. This method can be used if the patient refuses CPAP therapy.

Intraoral devices are used as an alternative to orthognathy. Their goal, like surgical treatment methods, is to expand the airways at the level of obstruction. Abroad, there is a method of electrical stimulation of the hypoglossal nerve[12], which has proven effective for any severity of the disease, but it is very expensive and is currently not available in Russia.

However, the main treatment method today is non-invasive continuous positive pressure ventilation (CPAP therapy). The essence of this therapy is to create an air flow that prevents the collapse of the airways.[10] At the beginning of therapy, a trial course is conducted to select the operating mode of the device and train the patient. After which the patient uses the device at home independently and only at night. This method is recommended for patients with moderate and severe forms of OSA and has virtually no contraindications. In addition to its main goal - eliminating respiratory arrest - using this method it is possible to significantly reduce weight and reduce the number of antihypertensive drugs for resistant arterial hypertension.[13]

How to prevent sleep apnea

Under no circumstances should one ignore such a dangerous pathology as sleep apnea. Most often, the person suffering from it does not suspect anything, because he simply does not remember what happens to him at night. But close people may notice something is wrong. If you have problems breathing during sleep, the first thing to do is to find out the cause of apnea in order to choose the right treatment. To do this, you need to see a doctor and undergo a medical examination, which includes:

1. Blood tests - general, lymphocytes, immunoglobulins, CEC, protein.
2. Analysis of urine.
3. Sputum examination.
4. X-rays of light.
5. ECG.
6. Allergen tests.
7. Appointment with an allergist and otolaryngologist.

USEFUL INFORMATION: The baby's head sweats during sleep and feeding: reasons

Further action depends on the results of the examination.

• If the patient has very enlarged adenoids or tonsils, they are offered to be removed surgically. If the septum is deviated, it is recommended to have it corrected.
• When a person is obese, he is prescribed a special diet to normalize his weight.
• For bronchial asthma, long-acting bronchodilators taken in the evening will help prevent night attacks.
• If respiratory arrest is caused by a neurological disease, drug treatment is prescribed.
• To correct a weakened, flabby palate, radio waves are used (this method is considered the most effective, as it allows you to permanently rid a person of the occurrence of apnea attacks at night), liquid nitrogen and laser (not popular).

If the treatment methods described above do not help, resort to CPAP therapy. The patient sleeps in a mask, where a special device creates comfortable pressure, which allows him to breathe normally and sleep peacefully throughout the night.

How to deal with night suffocation

First of all, you need to make a correct diagnosis. After all, there can be many reasons for night awakenings with lack of air: these are bronchial and cardiac asthma, obstructive and central sleep apnea, laryngospasm in gastroesophageal reflux, hyperventilatory attacks in patients with severe vegetative dystonia or hypoventilation in obesity.

So you shouldn’t trust know-it-alls from online forums and online consultants from online stores who promise miracles. It is almost impossible to independently understand and cope with the problem of night suffocation without qualified medical assistance. It is necessary to contact a specialist - a somnologist, and ideally - a somnologist-pulmonologist. This is the kind of doctor who deals with diseases of the respiratory system and disorders of its functioning, including during sleep.

During the examination, the patient will most likely be invited to visit the somnology laboratory for one night for an accurate diagnosis of breathing disorders during sleep

Cardiorespiratory monitoring or, possibly, polysomnography will help determine the presence of apnea and hypoventilation during sleep, as well as clarify their severity. A sleep examination in a sleep laboratory will allow you to establish the correct diagnosis. And depending on the results obtained, the doctor will prescribe adequate treatment. But this condition can and should be treated, since it not only greatly worsens the quality of life, but is also very dangerous due to its consequences and complications.

Traditional methods of treating apnea

There are also traditional medicine recipes that help combat sleep apnea. Here are some of them:

• Before going to bed, it is necessary to free the nasal passages from the accumulation of mucus and crusts in them. To do this, it is recommended to rinse your nose with warm boiled water with the addition of sea salt.
• In the evening you need to drink a glass of freshly squeezed white cabbage juice mixed with one teaspoon of honey (you need to take the product for a month).

If you use folk recipes in addition to drug treatment, you can get rid of the problem much faster. However, before trying any recipe on yourself, you should definitely consult your doctor.

Mechanism of shortness of breath in the supine position

Shortness of breath while lying on your back, or orthopnea, occurs due to increased pressure in the blood vessels of the lungs. When lying down, blood flows from the lower extremities to the heart and then to the lungs. In healthy people, this distribution of blood does not cause any difficulties. But with a number of diseases, the heart's ability to pump excess blood out of the heart may decrease. As a result, blood accumulates in the pulmonary circulation passing through the lungs3.

Increased blood pressure in the pulmonary artery can contribute to the release of fluid into the alveoli and the development of pulmonary edema. This makes breathing while lying down even more difficult3.

Orthopnea is not a disease, but a symptom that occurs only in a horizontal position. An attack can develop at night, when a person wakes up due to lack of air. This phenomenon is called nocturnal paroxysmal (sudden) shortness of breath. In a sitting or reclining position, breathing, as a rule, becomes easier or completely normalized3.