I can only speculate as to what caused mine. Sometimes I wonder if a horrible experience with anesthesia awareness played a part. I experienced an inability to breathe/move/speak, then...I don't know and perhaps don't want to. That only happened maybe months, or max two years, before my choking fear got really bad. [Those times are fuzzy.] I had also had a scary and disgusting incident at 19 years old, where I nearly choked on some corned beef. After that time, I stopped eating that meat, except in very thin slices. In any case, the rough part was when I ate in public or as a guest. As I'm sure you understand, anxiety goes through the roof when you have to cope with the fear in front of others. If served meat (like steak) or cheese, it was like I started to choke and knew I was panicking and knew others could see it, exacerbating it all. I remember once when I thought I had almost licked the fear, I took a cheese appreciation adult school class. They gave us all multiple cheese samples, which would sound great to most. However, even the smallest little cube became difficult for me to eat. I guess the first was OK, but it was the "one after another" that got me. I tried to skip a couple, but the "not trying some" made me anxious, too. I've had enough extreme public embarrassments in my life that new ones are like mini trauma flashbacks. Though the phobia has long since disappeared, on a rare occasion if it springs to mind, it does make the eating less enjoyable. On rare occasions, I do wake up from sleep (or near sleep) with a start, feeling I couldn't breathe. I doubt I have sleep apnea.