Expert: Marc Rubin, RPh Asthma Educator - 4/2/2008

Question
Last night I was sleeping and woke because I couldn't breath.  My throat had closed.  I have asthma, but only have attacks when I'm sick, or exercising, or if I have too much caffeine.

So my throat closed, I sat up and gasped for air, as only a small amount squeezed in.  It felt exactly like an asthma attack, but only in my throat, not chest.  I gasped and exhaled about six or seven times... when finally it opened back up.

Today it feels sore and tight... much like my lungs do after an attack.  Not your typical sore throat sore... more like the muscles are sore.  

So I'm just wondering if this could be related to asthma (I haven't had an attack in a few years)... or something else.

Answer
Hi Carrie,

This could be related to your asthma. It may have been triggered by a number of things. You should try to reflect on what was different that evening: some food, exposure to a pet you are not accustomed to, time of month (pre-menstrually),etc. You should speak with an allergist about this.

You noted that caffeine in high doses has created a problem for you in the past. Although caffeine has properties that would actually open up the airways, it also relaxes the sphincter (valve) at the top of the stomach, which can result in acid reflux. The reflux would then irritate the lining of the throat. The nerve that senses this is also linked to the lungs..the vagus nerve. When stimulated, the vagus nerve will cause the airways to constrict.

I hope you have a rescue inhaler in your possession. If not, you should speak to your physician to get one to ALWAYS keep with you. Be sure to have your technique reviewed, especially since it apparently been some time since you have needed to use one. It is well documented that many asthmatics do not use their devices properly..and this would be a great time for a refresher.

i hope this helped you.

Sincerely,

Marc