Waking Up Gasping For Air: Anxiety, Sleep Apnea, And Other Causes

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Medical News TodaySubscribeWhy do I wake up gasping for air?

Medically reviewed by Alana Biggers, M.D., MPH — Written by MaryAnn De Pietro, CRT — Updated on July 10, 2023

Causes
Diagnosis
Treatment
Seeing a doctor

There are various reasons a person may wake up gasping for air. These include sleep apnea and postnasal drip.

While waking up gasping for air is not uncommon, it can be extremely frightening.

Some causes, such as postnasal drip, are easily treated. Others may require medical attention and a long-term treatment plan.

In this article, we describe why a person may wake up gasping for air, tools and medicines that can help, and when to see a doctor.

Causes

An individual may wake up gasping for air for a variety of reasons, including:

Obstructive sleep apnea

Woman with sleep apnea using cpap machine — Sleep apnea may be treated using a CPAP machine.

Sleep apnea refers to involuntary pauses in breathing during sleep. The two main types are:

Central sleep apnea, which is caused by signaling problems in the brain.
Obstructive sleep apnea, which occurs when a blockage in the airway stops airflow.

According to the National Sleep Foundation, around 18 million adults in the United States have obstructive sleep apnea.

A person may be unaware that they have the condition until someone informs them that they snore and gasp for air while asleep. When the person gasping catches their breath, they may not fully awaken.

Additional symptoms of sleep apnea include:

morning headaches
daytime tiredness
memory problems
fatigue
irritability

Anxiety

Anxiety can lead to panic attacks, and when they occur at night, a person may wake up gasping for air. According to the Anxiety and Depression Association of America, around 70 percent of people with anxiety disorders report difficulty sleeping.

Other symptoms of anxiety include:

restlessness
feelings of dread or worry
a fast heart rate
panic
difficulty concentrating

Asthma

Asthma is a chronic condition that causes inflammation in the airways. Nocturnal asthma is the medical term for having symptoms while sleeping. When the condition is poorly controlled, nocturnal asthma is common.

Additional symptoms of asthma include:

coughing
wheezing
feeling unable to catch a breath
tightness in the chest

Chronic obstructive pulmonary disease (COPD)

COPD occurs when small air sacs in the lungs are damaged. These sacs, called alveoli, become floppy, making it difficult to push air out of the lungs.

Symptoms can occur while a person is sleeping. They may wake up gasping or feel as if they are suffocating.

Other symptoms of COPD include:

wheezing
excess mucus
coughing
fatigue
tightness in the chest

Heart failure

Man in hospital gown sitting on bed waking up gasping for air. — Though waking up gasping for air is often due to respiratory problems, heart failure may also be a cause.

When the heart is not pumping blood as efficiently as it should, this is called heart failure.

Abnormal heart valves, a history of a heart attack, and coronary artery disease can all lead to heart failure.

Shortness of breath is one of the most common symptoms. At first, a person may only notice it during physical activity. As the condition progresses, a person may develop shortness of breath while resting or sleeping.

A person with heart failure may also experience:

fatigue
swelling of the feet and legs
chest pain
abdominal swelling

Post-nasal drip

Mucus and saliva produced throughout the day typically flow to the back of the nose and throat and are swallowed. A person may be unaware of this process.

Post-nasal drip occurs when this mucus accumulates and trickles down the back of the throat.

As the mucus builds up, a person may feel like they cannot breathe. If they are asleep, they may wake up gasping for air.

Gastric reflux disease, sinus infections, and allergies are all common causes of post-nasal drip.

Additional symptoms include:

bad breath
a sore throat
a bad taste in the mouth
coughing

Diagnosis

A doctor will ask a person to talk about their symptoms and medical history. They may also perform a physical exam.

The following tests can help to determine why a person wakes up gasping:

blood tests
a sleep study, to determine whether the person has sleep apnea
an echocardiogram, to check for heart abnormalities
an electrocardiogram, to measure the heart rate and rhythm
a pulmonary function test, to diagnose respiratory conditions

Treatment

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Bronchodilators may be prescribed to open the airways.

Once a doctor has discovered the cause, they may recommend one of the following treatments:

Medication

Medications can treat heart failure, COPD, and anxiety.

Beta-blockers can improve the function of the heart and eventually reduce breathlessness.

Bronchodilators and corticosteroid inhalers can open the airways and improve airflow in people with COPD. This may result in reduced shortness of breath.

Antianxiety medication can lead to fewer panic attacks, and a person may stop waking up gasping for air.

Continuous positive airway pressure (CPAP)

When obstructive sleep apnea is the culprit, a doctor may recommend CPAP. This therapy involves a machine that delivers air to the lungs, preventing the airway from becoming blocked.

Dental devices

Obstructive sleep apnea may also be treated with a dental device that pushes the tongue and jaw forward, preventing the muscles of the throat from collapsing backward and blocking the flow of air.

Saline nasal sprays

These are often recommended to manage post-nasal drip. Using a neti pot to flush out the sinuses may also help.

Good sleep habits

The following tips can help to reduce anxiety-related gasping and decrease stress overall:

get enough sleep
go to bed and wake up at the same times each day
consume caffeine only in the morning
before going to sleep, do something relaxing, such as meditation, breathing exercises, or reading.

When to see a doctor

A person may not require treatment if they wake up gasping for air infrequently, show no other symptoms, and can get back to sleep quickly.

However, if a person experiences this symptom often, or if other symptoms are present, they should speak with a doctor.

If an individual also has chest pain or cannot catch their breath, they should seek immediate medical care.

Once the underlying cause is identified, a doctor will recommend treatment that can ensure uninterrupted sleep.

Asthma
Respiratory
Anxiety / Stress
Sleep / Sleep Disorders / Insomnia

How we reviewed this article:

SourcesMedical News Today has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Budhiraja, R., Siddiqi, T. A., & Quan, S. F. (2015, March 15). Sleep disorders in chronic obstructive pulmonary disease: Etiology, impact, and management. Journal of Clinical Sleep Medicine, 11(3), 259–270https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4346647/
Chapter 3: Sleep-related breathing disorders. (n.d.)https://sleepdisorders.sleepfoundation.org/sleep-related-breathing-disorders/obstructive-sleep-apnea-syndrome/prevalence/
Martin, R. J. (2017, March 23). Nocturnal asthmahttps://www.uptodate.com/contents/nocturnal-asthma
Post-nasal drip. (n.d.)http://www.entnet.org/content/post-nasal-drip
Stress and anxiety interfere with sleep. (n.d.)https://adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/stress/stress-and-anxiety-interfere
Warning signs of heart failure. (2018, February 13)http://www.heart.org/HEARTORG/Conditions/HeartFailure/WarningSignsforHeartFailure/Warning-Signs-of-Heart-Failure_UCM_002045_Article.jsp#.WuZuBUxFzIW

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Medically reviewed by Alana Biggers, M.D., MPH — Written by MaryAnn De Pietro, CRT — Updated on July 10, 2023

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Tag » Why Do I Breathe So Hard When I Wake Up

Waking Up Gasping For Air: Anxiety, Sleep Apnea, And Other Causes

Causes

Obstructive sleep apnea

Anxiety

Asthma

Chronic obstructive pulmonary disease (COPD)

Heart failure

Post-nasal drip

Diagnosis

Treatment

When to see a doctor

How we reviewed this article:

Latest news

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