You’d be surprised to find out that vomiting through your nose while sleeping is pretty common. It can be associated with stomach acid reflux, sleep apnea, pregnancy-related changes, and it can also occur in newborns and babies who bring up milk after breastfeeding.
The squeezing action of the stomach muscles causes increased pressure in your abdomen.
Sometimes, the pressure increases so much that it accidentally enters further upwards to the back of your nose and out of it. This forceful expulsion of undigested or partially digested food is called vomiting.
The ’vomit signal’ is sent by your brain and not your stomach. After receiving the signal, your stomach muscles squeeze out all the fluids and contents of your stomach up the chute or food pipe and into your mouth.
Lets see what conditions trigger vomiting while being asleep
1. GERD (Gastroesophageal Reflux Disease)
GERD is a major cause of recurrent backflow of stomach acid and contents into the esophagus, i.e., the tube between the mouth and stomach.
This backflow or regurgitation to the mouth and nose can irritate the lining of the esophagus. This irritation is the cause of the heartburn felt in GERD.
It is caused due obesity, pregnancy, certain medications, some types of food, and hiatal hernia, i.e., the top of the stomach bulges up through a hole in the diaphragm.
In addition, people who experience reflux at night wake up with a sour taste in their mouth, vomit in their nose, and have disrupted sleep and sometimes heartburn.
It is also believed that sleep apnea disrupts the functioning of the esophageal sphincter and thus disrupts the digestive process and causes GERD.
2. Pregnancy
Pregnancy puts pressure on the stomach as the uterus enlarges with the fetus. This causes stomach acid and fluid contents to go up in the esophagus and back to the nose and mouth.
Nausea and GERD symptoms are common in pregnancy and begin around 6 weeks.
3. Sleep apnea
Obstructive sleep apnea happens when your airway is blocked by something while you are asleep. The muscles that help you breathe must work harder to overcome the obstruction and open your airway to get air in your lungs.
When this happens, you may stop breathing for a moment. Your breath can become more shallow.
You breathe loudly and suddenly with a gasp, you snort, or you may jerk yourself awake. This can cause poor sleep, and you probably won’t realize what is happening.
Due to the body’s horizontal orientation, stomach contents come up to the back to the mouth and nose.
Still, while awake during the day, the vertical positioning of the body limits the reflux of stomach acid and contents from rising.
When obstructive sleep apnea occurs, there are pressure changes in the diaphragm and chest. These pressure changes make the acid reflux even more active.
4. Anxiety
Anxiety can affect all systems of our body, and this includes our digestive system. Anxiety causes you to feel butterflies in your stomach.
Anxiety associated with nausea makes you feel like throwing up. Your stomach convulses so much that you have to make a run to the bathroom, and you may even vomit or dry heave.
Anxiety is when you have these feelings frequently, and it is usually not warranted for the current situation.
Anxiety gets worse at night and can cause all types of digestive problems, including nausea and vomiting through your nose while sleeping.
5. Achalasia
Achalasia, a rare autoimmune condition, is known to prevent your esophagus from working normally. It damages your nerves, paralyzes your esophagus, and does not allow food to enter the stomach through the lower end of your esophagus.
Symptoms include dysphagia, heartburn, regurgitation, coughing at night, belching, and hiccups.
This disorder causes bringing the food back up to the nose and mouth for similar reasons as GERD, but the problem here lies in the esophagus and not the stomach.
6. Medications
Certain medications you may take at night like anti-inflammatory(NSAIDs), blood pressure, antibiotics, aspirin can cause more nausea and vomiting at night.
7. Breastfeeding or formula-fed babies
Surprisingly milk coming out of your baby’s nose is normal, and no reason for alarm. It is called nasal regurgitation and is sometimes confused with vomiting.
The nose and mouth are connected, so it sometimes causes some breast milk to come out of both when they cough or spit-up.
It can look dangerous when a lot of milk leaks out of your baby’s nose. He may inhale strongly to get some air, and it causes even more milk to come out.
Even though we understand that this is uncomfortable to witness, a few seconds without air does not cause choking. You can clear your baby’s spit-up using a nasal aspirator.
8. Regurgitation
Babies’ regurgitation is a normal side effect of feeding in the early years of life. It occurs twice daily for the initial 3 weeks due to a poorly coordinated and newly developed gastrointestinal tract.
Regurgitation is often confused with vomiting, and they are not the same. In both vomiting and regurgitation, the contents reach the mouth and sometimes the nose.
Regurgitation is the pushing back of the contents of the food pipe through the path from which it came.
This is usually related to issues with the movement of your food pipe/esophagus that occurs involuntarily. It sometimes does not allow food to reach the stomach.
It can also be due to weakened or relaxed sphincter muscles, i.e., the muscles of the esophageal opening.
| Difference between | Vomiting | Regurgitation |
| 1. | Precedes with nausea | Does not precede nausea |
| 2. | Triggered due to the ‘vomit center’ in the brain | Issues with involuntary esophageal mobility |
| 3. | There are special receptors to trigger the vomiting center | It cannot be triggered |
| 4. | There are forceful and strong stomach muscle movements and other small muscles of the abdomen to help expel the vomitus | Involves less forceful muscle contractions |
Treatments
- GERD can be treated with dietary changes, surgery, lifestyle changes, and medication.
- Apnea can be treated with PAP (positive airway pressure), lifestyle changes like losing weight, and surgery of the polyps, tonsils, or adenoids.
- Achalasia can be treated with myotomy, botox, medication, and pneumatic balloon dilation.
- Anxiety can be treated with cognitive behavioral therapy, psychotherapy, and counseling.
FAQs
Is it normal for the vomit to come out of your nose?
Yes, it is normal for the vomit to come through your nose. There may be some potential dangers to be aware of, but it is not something to be afraid of.
Why do babies spit up through the nose?
It can be due to extra milk or formula consumed that causes babies to spit up. Other reasons can include swallowing air while feeding, coughing or sneezing along with feeding, the immature stomach valve, and the baby may be distracted while feeding.
How to help a baby or child who is throwing up through the nose while sleeping?
You can wipe the milk from the nose like you would if the milk came out of the mouth. Then, turn your baby to the side till the milk stops leaking out. Never leave a baby unsupervised in this position. If the baby still chokes in side-lying, you will have to hold your baby upright and put them to your shoulder. Most importantly, do not panic and comfort your baby.
To Summarize
Vomiting through your nose while sleeping happens more often than we think. You may have vomited, mostly cause you are suffering from GERD. If it happens multiple times, please see a doctor.
Have you ever seen a child sneeze spaghetti out of their nose?, this happens because the soft palate (the soft part at the back of our mouth) is not fully developed and has an opening between the nose and mouth.
This hole between the nose and mouth also causes nasal regurgitation of food in babies. See a doctor if your baby chokes while he spits up or if he has a fever.
