Here’s the scenario — in the dead of night you wake up terrified, feeling as if you can’t catch your breath. Maybe you start coughing or maybe you jump out of bed, scaring your partner. After a few minutes, your heart rate slows and things begin to feel normal. What happened?

If you or your partner has gone through this or something like it, it’s okay to feel concerned. What’s important is to narrow down the possible causes so that you can get the treatment you need. Some possibilities like post-nasal drip are easily treatable while others may require long-term treatment.

Here are some possible causes for waking up in the middle of the night.

Anxiety Disorder

Anxiety can affect the body in several strange ways, and one of them is sleep. According to the Anxiety and Depression Association of America, an estimated 70 percent of people with anxiety disorders have trouble falling asleep and trouble staying asleep. Many who have anxiety experience panic attacks, which can lead to rapid heartbeat, rapid breathing, and sweating, but what many don’t know is that these can occur during sleep, as well. It’s common for waking up short of breath but not necessarily coughing or choking.

Post-Nasal drip

The general route for mucus produced during the day is down the throat and into the stomach. However, if there is an excess of mucus caused by allergies or a cold, this could build in a person’s throat causing breathing difficulties while awake or sleeping. Other symptoms include bad breath, a sore throat, or a bad taste in the mouth. If there’s too much mucus in your throat, you might have experienced waking up coughing.


Asthma is a condition that causes your airways to become constricted by mucus and inflammation, which can make breathing difficult and could trigger coughing, wheezing, and shortness of breath. Like anxiety attacks, many people don’t know that you can experience asthma attacks while sleeping. There are many potential triggers for nocturnal (nighttime) asthma, such as allergens or keeping your room too cold at night. But it may also be related to your body’s natural daily cycles.


If you watch TV or use any electronics with blue light, it can affect your sleep. Exposure to blue light can interrupt your internal body clock by blocking your body from producing melatonin to make you feel sleepy. For best results, avoid exposure to blue lights an hour before going to bed. Otherwise, you might have difficulty falling asleep or staying asleep. You can also turn on a blue light filter on your device or wear blue light glasses to help reduce exposure.


Drinking caffeine too close to bedtime can also prevent you from falling asleep or staying asleep. Caffeine stimulates the brain and when you try to go to sleep after consuming it, your brain might not cooperate with your wishes. As a result, you might find it hard to fall asleep and if you do fall asleep you can easily wake up in the middle of the night. For best results, limit your caffeine consumption to two 8 oz servings per day and never within 6 hours of bedtime.


Another factor that can affect your sleep is smoking. It’s not the tobacco but the nicotine in cigarettes that stimulates the brain. Nicotine can instantly make you feel more awake if you smoke before bedtime. If you’re quitting smoking, you can also experience insomnia and sleeping problems as your body detoxes itself.


Alcohol and good sleep do not go hand in hand. When you consume alcohol, the liver metabolizes the alcohol slowly as it circulates around the body. The effects of alcohol can impact the stages of sleep cycles. Each sleep cycle goes through the four stages, but when you drink alcohol, the effects suppress REM during the first two sleep cycles. This can cause people to fall into a deep sleep quickly and then create an imbalance of slow wave sleep and REM sleep which results in sleep disruptions and shorter sleep duration. Drinking alcohol can also result in insomnia which can result in waking up in the middle of the night.

Sleep Apnea

Sleep apnea is a sleep disorder that causes pauses in breathing or periods of shallow breathing during sleep. Generally, these pauses last only a few seconds but can occur multiple times a night (sometimes hundreds), causing blood oxygen levels to fluctuate dramatically. The most common form of sleep apnea is obstructive sleep apnea or OSA. In OSA, breathing is disrupted by a blockage of airflow.

Besides waking up in the middle of the night gasping for air, other symptoms of sleep apnea include daytime drowsiness, morning headaches, frequent nighttime urination, and snoring. If you suspect you have sleep apnea, it’s advised that you see a doctor as soon as possible. It’s also normal for those suffering from sleep apnea to experience waking up choking or shortness of breath. When left untreated, sleep apnea can increase your risk of heart disease, stroke, diabetes, and can even make it more difficult to lose weight.

So how do you know if you have sleep apnea? First off, look to see if you experience any other symptoms. If you have any of the symptoms we listed above, you need to find a physician who can refer you to take a sleep test. There are many services online that will send you a home sleep test. Once you return the test back to the physician, they will review your data and diagnose your sleep condition. The only way to know for sure if you have sleep apnea is with a sleep test.

Sleep Apnea Treatment in Wilmington, NC

While most treatments for sleep apnea include a CPAP machine, your Wilmington dentist can help you treat sleep apnea without a breathing mask. To learn more about possible sleep apnea treatments, please call (910) 392-6060 for an appointment at Kuzma Advanced Dentistry in Wilmington, NC today.