Awakenings from sleep with gasping and feeling of choking can be due to nocturnal frontal lobe epilepsy (NFLE) as well as sleep apnea (OSA). We describe the case of an overweight man, referred to us with suspected OSA and reporting awakenings from sleep accompanied by gasping and a choking feeling, which proved to be, after investigation, NFLE seizures in a patient with comorbid OSA. We underline that gasping or choking on awakening, especially when accompanied by abnormal motorbehavioral manifestations, should be interpreted with caution. Careful investigation by means of video-polysomnography is warranted in selected cases, including patients with a strong clinical suspicion of sleep apnea.
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