What causes throat blockage when lying down, which improves upon sitting up?

Lying down causes a sensation of throat blockage, which improves when sitting up. This may be due to improper sleeping posture, gastroesophageal reflux, pharyngeal muscle relaxation, chronic pharyngitis, or tonsillar hypertrophy. Symptoms can be improved by adjusting sleeping posture, modifying diet, exercising throat muscles, or using medication. If symptoms occur frequently or are accompanied by sore throat or acid reflux, prompt medical evaluation is recommended.

1. Improper sleeping posture: When lying flat, an excessively low head position can cause pharyngeal tissues to collapse due to gravity, obstructing the airway and creating a blocked sensation. It is recommended to adopt a semi-reclining position during sleep, elevating the head by 15–20 cm to reduce tissue pressure on the airway.

2. Gastroesophageal reflux: When lying down, stomach contents may reflux into the throat, irritating the mucosa and causing a feeling of blockage; this typically improves upon sitting up. Avoid eating 2–3 hours before bedtime and refrain from spicy or greasy foods to reduce triggers for reflux.

3. Pharyngeal muscle relaxation: With aging or lack of exercise, pharyngeal muscles may lose tone and become lax. When lying down, this relaxation can obstruct the airway. Daily swallowing exercises and voice training are recommended to strengthen pharyngeal muscle contraction.

4. Chronic pharyngitis: Long-term irritation leads to inflammation of the pharyngeal mucosa, with swelling and congestion that worsens the sensation of blockage when lying down, often accompanied by dryness and a foreign body sensation in the throat. Under medical guidance, patients may use medications such as Qinghou Liyan Granules, watermelon frost lozenges, or compound borax mouthwash to relieve symptoms.

5. Tonsillar hypertrophy: Recurrent inflammation can cause tonsillar enlargement, which compresses the pharyngeal airway when lying down and relieves upon sitting up, often accompanied by throat discomfort and difficulty swallowing. Under medical supervision, medications such as amoxicillin-clavulanate potassium dispersible tablets, Pudilan anti-inflammatory oral liquid, or compound chlorhexidine mouthwash may be used to alleviate discomfort.

Maintain regular作息 (sleep-wake cycles), eat light and easily digestible meals, drink plenty of water to keep the throat moist, avoid excessive voice use, and engage in moderate physical exercise to improve overall health and reduce throat discomfort.