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

Some causes, such as post-nasal 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:

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:

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

Man discussing prescription medication with pharmacist.
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.