Choking on saliva in the trachea while sleeping is usually caused by airway sensitivity, esophageal reflux, and postnasal drip syndrome. 1. If you have been drinking and smoking or suffer from chronic pharyngitis, it may cause the glands in the throat to secrete vigorously, leading to increased secretion of saliva or salivation, which can lead to choking due to accidental inhalation while you sleep, but it can be discharged from the body through the normal coughing reflex. 2. Sometimes the choking cough is not caused by saliva, but by various digestive enzymes and gastric acid caused by esophageal reflux, and even by accidental inhalation of part of the refluxed gastric contents, especially if there is a history of gastric disease and reflux esophagitis, and if there is a history of overeating at dinner, drinking a lot of alcohol, or eating a large amount of food before going to bed, etc., it is more likely to cause the above situation. 3. If you suffer from post-nasal drip syndrome, due to the sinuses, the inflammatory secretions from the nasal cavity flow to the throat, thus appearing to sleep choking on saliva. If you are choking on saliva while sleeping, you need to perform the Heimlich maneuver immediately if you have difficulty breathing, and you should go to the hospital in time at the same time.