The loss of muscle tone that allows the tongue to obstruct the airway is triggered by conditions causing deep unconsciousness. The most frequent cause is any event that results in a significant depression of the central nervous system, such as severe head trauma.
Drug overdose, particularly involving sedatives, opioids, or alcohol, leads to central nervous system depression and widespread muscle relaxation. Similarly, during the post-ictal phase immediately following a seizure, the body’s muscles often remain completely relaxed. General anesthesia during surgery is another controlled scenario where muscle relaxants are administered, making airway management a primary concern.
Extreme muscle relaxation also occurs in certain stages of sleep in people with obstructive sleep apnea. In these cases, the tongue repeatedly falls back and partially or fully blocks the airway, leading to repeated awakenings and chronic oxygen deprivation. However, the acute emergency associated with a “swallowed tongue” is most often linked to trauma or sudden, deep loss of consciousness.
