Acid reflux when sleeping

Is GERD Keeping You Up at Night?

You’re trying to get a good night’s sleep, but it just isn’t happening. In addition to tossing and turning, the burning sensation of heartburn isn’t making your sleep efforts any easier.

What’s going on? Was it something you ate? Your sleeping position?

Heartburn and gastroesophageal reflux disease, or GERD, are frequent causes of sleeplessness. As many as one in four people who experience sleep disturbances report that they have nighttime heartburn.

For people who have been diagnosed with GERD, the rate is even higher; three people out of four report having nocturnal GERD symptoms. These individuals are more likely to suffer sleep problems such as insomnia, sleep apnea, and daytime sleepiness as a result of their nighttime heartburn.

Sleeplessness poses a serious health problem. In addition to the physical and mental effects that stem from lack of sleep, people who experience nocturnal GERD are at greater risk for some of the worst complications of the disease, including erosive esophagitis, dyspepsia, and esophageal cancer.

How Does GERD Disturb Sleep?

Researchers have figured out several ways in which GERD-related acid reflux interferes with sleep:

  • Most obviously, individuals may be awakened by the pain of heartburn, which occurs when stomach acid refluxes into the esophagus and eats away at the esophageal lining.
  • If acid reflux reaches the back of the throat or larynx, it may prompt a coughing fit or choking.
  • People might wake up when they experience regurgitation, in which a small amount of stomach acid comes up through their esophagus and into their mouth.
  • GERD has been identified as a risk factor for sleep apnea, a disorder in which the person repeatedly stops breathing during the night. Researchers believe that refluxed stomach acid causes the voice box to spasm, which blocks the airways and prevents air from flowing into the lungs.

Unfortunately, many of the mechanisms of sleep make GERD more likely. For example, just the act of lying down increases the risk of acid reflux. When you are in a sitting or standing position, gravity helps keep gastric acid in the stomach. When you lie flat, however, it’s much easier for stomach acid to backflow into your esophagus.

Also, sleeping people tend to swallow less frequently. This slows the regular esophageal contractions that normally keep food moving down the esophagus and prevent acid from moving back up. Sleepers also produce less saliva, which plays a role in returning esophageal pH levels to normal after an incident of acid reflux.

GERD and Sleep Position: Dos and Don’ts

If you are a GERD sufferer, you can do a lot to improve your quality of sleep by changing your sleeping position. Doctors recommend that you:

  • Do elevate the head of your bed 6 to 8 inches to assist gravity in keeping your stomach acid from refluxing.
  • Don’t sleep on your back, particularly if you are obese, because the pressure on your stomach could help drive acid into your esophagus.
  • Don’t sleep on your right side. For some reason, this seems to prompt relaxation of the lower esophageal sphincter — the tight ring of muscle connecting the stomach and esophagus that normally defends against reflux.
  • Do sleep on your left side. This is the position that has been found to best reduce acid reflux.

You also can improve your chances of a good night’s sleep by waiting for three to four hours after you eat before going to bed. That gives your stomach a chance to process your meal and move it through your digestive system. Your stomach will then be empty and less likely to promote reflux when you lie down. Eating a smaller and lighter dinner also is a good idea.

With a few lifestyle adjustments, you can save yourself a lot of the discomfort that comes from the dual problems of GERD and sleeplessness.

THE FACTS For people with chronic heartburn, restful sleep is no easy feat. Fall asleep in the wrong position, and acid slips into the esophagus, a recipe for agita and insomnia.

Doctors recommend sleeping on an incline, which allows gravity to keep the stomach’s contents where they belong. But sleeping on your side can also make a difference — so long as you choose the correct side. Several studies have found that sleeping on the right side aggravates heartburn; sleeping on the left tends to calm it.

The reason is not entirely clear. One hypothesis holds that right-side sleeping relaxes the lower esophageal sphincter, between the stomach and the esophagus. Another holds that left-side sleeping keeps the junction between stomach and esophagus above the level of gastric acid.

Image Credit…Christoph Niemann

In a study in The Journal of Clinical Gastroenterology, scientists recruited a group of healthy subjects and fed them high-fat meals on different days to induce heartburn. Immediately after the meals, the subjects spent four hours lying on one side or the other as devices measured their esophageal acidity. Ultimately, the researchers found that “the total amount of reflux time was significantly greater” when the subjects lay on their right side.

Sleeping with Acid Reflux

  • Don’t eat just before bed – try to wait at least three hours before settling down
  • Eat small meals regularly to aid digestion – this will prevent your digestive system being overwhelmed
  • Acid reflux remedies – try caffeine-free herbal teas that soothe digestion. There are many sleep-specific teas that can ease your acid reflux
  • Wear comfortable clothes in bed – tight clothing can add to pressure in the body, stopping regular function and causing pain that is heightened by acid reflux
  • Don’t smoke – as well as supporting poor health, smoking can make sleeping with heartburn worse by relaxing the muscles that keep acid in the stomach
  • Relax and de-stress – stress leads to contracted and tense muscles which in turn disrupt regular bodily functions. Try meditation or time out before bed so you can release tension and slumber peacefully

Acid reflux is a common problem but trying to sleep with heartburn can be even more distressing. Try these tips to ease your symptoms and if the pain doesn’t subside see your doctor for further advice.

Ease Heartburn at Bedtime

The fiery feeling of heartburn isn’t just uncomfortable. If you experience it regularly at night—as up to 75% of people who have frequent heartburn do—it could mess with your sleep and leave you exhausted. A National Sleep Foundation poll found that adults who have bedtime heartburn are more likely to have sleep issues such as insomnia, daytime sleepiness, and restless leg syndrome. That burning sensation that you experience with heartburn is due to stomach acid flowing back up the esophagus—the tube that brings food to the stomach from the mouth. But here’s some good news: It’s possible to manage the discomfort. Beat the burn and score better shuteye with these tips.

Watch What You Eat

One of the best ways to prevent heartburn before bedtime is to avoid fatty or fried foods at dinner, as well as alcohol and nicotine. Another smart idea: Have your last meal of the day at least three hours before you head to bed. Lying down too soon after eating can trigger acid to rise up from the stomach—ouch.

Change Positions

Sleeping on your right side can cause heartburn symptoms to flare. Sleeping on your left, however, may ease the discomfort, possibly because it helps to relax the lower esophageal sphincter, which is located between your stomach and esophagus. Sleeping with your upper body elevated may also help, so raise the head of your bed or use a foam wedge to keep your body slightly upright from the waist up while you sleep.

Get Comfy

Skip wearing any pajamas that are restrictive or tight to bed. Loose-fitting, comfortable pajamas help fight heartburn by taking pressure off your abdomen and lower esophageal sphincter while you rest.

Pop a Pill

Antacid tablets, as well as H-2-receptor blockers, can be used to treat occasional heartburn. But if these meds don’t do the trick, talk to your doctor. He or she may test you for gastroesophagael reflux disease (GERD), a more severe form of reflux that can be treated with prescription medication or surgery.

Watch Your Weight

Putting on extra pounds can place pressure on your abdomen and stomach, causing acid to reverse direction and go back up the esophagus.Talk to your doctor about what your goal weight should be, and keep a scale in your bathroom to monitor your progress.

You’ll be able to enjoy more restful sleep once you’ve put out the fire, but if you’re not getting any relief from these tips—or if your heartburn disturbs your sleep frequently—it’s best to see your physician to rule out more serious health issues.

GERD, also known as acid reflux, is an acronym that stands for gastroesophageal reflux disease. It is a chronic illness that affects 5-7% of the world population and is associated with serious medical complications if untreated. GERD is the 3rd most common gastrointestinal disorder in the U.S. Most patients with GERD also experience nighttime heartburn, which is more bothersome. And according to the 2001 NSF Sleep in America poll, adults in America who experience nighttime heartburn are more likely to report having symptoms of sleep problems/disorders such as insomnia, sleep apnea, daytime sleepiness and restless legs syndrome than those who don’t have nighttime heartburn.

GERD describes a backflow of acid from the stomach into the esophagus. Most patients with GERD experience an increase in the severity of symptoms (usually heartburn or coughing and choking) while sleeping or attempting to sleep. If the acid backs up as far as the throat and larynx, the sleeper will wake up coughing and choking. If the acid only backs up as far as the esophagus the symptom is usually experienced as heartburn.

Most people refer to GERD as heartburn, although you can have it without heartburn. Sometimes GERD can cause serious complications including inflammation of the esophagus from stomach acid that causes bleeding or ulcers. In a relatively small number of patients, GERD has been reported to result in a condition called Barrett’s esophagus, which over time can lead to cancer. Also, studies have shown that asthma, chronic cough, and pulmonary fibrosis may be aggravated or even caused by GERD.

GERD is common and may be frequently overlooked in children. It can cause repeated vomiting, coughing, and other respiratory problems. Talk to your child’s doctor if the problem occurs regularly and causes discomfort.

No one knows why people get GERD but factors that may contribute to it include:

  • age
  • diet
  • alcohol use
  • obesity
  • pregnancy
  • smoking

Also, certain foods can be associated with reflux events, including:

  • citrus fruits
  • chocolate
  • drinks with caffeine
  • fatty and fried foods
  • garlic and onions
  • mint flavorings
  • spicy foods
  • tomato-based foods, like spaghetti sauce, chili, and pizza

GERD affects people of all ages, ethnicities and cultures and tends to run in families.

Symptoms

The most frequently reported symptoms of GERD are:

  • Heartburn
  • Acid regurgitation
  • Inflammation of the gums
  • Erosion of the enamel of the teeth
  • Bad breath
  • Belching
  • Chronic sore throat

Some patients with GERD experience no symptoms at all. Because of the wide range of symptoms associated with GERD and the need to distinguish it from heart-related problems, the number of medical visits and tests needed to diagnose or rule out the disease tends to be quite high.

Treatment

GERD is a recurrent and chronic disease that does not resolve itself. If you are diagnosed with GERD, there are several methods of treatment which your doctor will discuss with you including behavioral modifications, medications, surgery, or a combination of methods. Over-the-counter medications may provide temporary relief but will not prevent symptoms from recurring.

The lifestyle changes you can make to minimize GERD include avoiding fats, onions, chocolate and alcohol. Losing weight may also help alleviate GERD symptoms.

Because of the association between GERD and sleep apnea, people with nighttime GERD symptoms should be screening for sleep apnea.

Coping

These lifestyle modifications should help minimize reflux:

  • Avoid lying down after a large meal
  • Eat smaller meals and maintain an upright, relaxed posture
  • Avoid fats, onions, chocolate and alcohol
  • Avoid potassium supplements
  • Always swallow medication in the upright position and wash it down with lots of water

Poll Data

GERD is the 3rd most common gastrointestinal disorder in the US and one of the leading causes of disturbed sleep among people between the ages of 45 and 64, according to the 2002 NSF Sleep in America poll.

Reviewed by William C. Orr, Ph.D.

It’s estimated that 60 to 70 million people in the U.S. are affected by a digestive disease. While that includes everything from chronic constipation to inflammatory bowel disease and pancreatitis, research shows that acid reflux is the most commonly diagnosed of all. And whether it’s due to a physiological reason or the fact that women are more diligent about visiting the doctor, women are diagnosed with GI conditions—including acid reflux—more often than men.

The proper name for acid reflux is gastroesophageal reflux (GER). GER happens when your stomach’s contents move back up toward your esophagus, causing an array of uncomfortable symptoms. It’s extremely common for anyone to experience this on occasion, according to The National Institute of Diabetes and Digestive and Kidney Diseases. But if it happens regularly—more than twice a week for a few weeks—it could be a sign that you have a chronic condition called GERD, or gastroesophageal reflux disease. GERD affects 20 percent of the U.S. population. It’s caused by a malfunction in the lower esophageal sphincter (LES). The LES is supposed to close after allowing food to pass through to the stomach, but when it doesn’t, stomach acid can flow back up where it’s not supposed to be. Over time, GERD can cause damage to the esophagus, including precancerous changes, or lead to respiratory problems like pneumonia, laryngitis, and asthma, so it’s important to get treated.

Though some people are most at risk—pregnant women, smokers, and those who are overweight or obese—acid reflux and GERD can happen to anyone. Here are the most common signs to look out for.

1. Heartburn

This is the most common symptom of acid reflux. “Somewhere between 5 to 10 precent of the population suffers daily heartburn,” Felice Schnoll-Sussman, M.D., gastroenterologist and director of the Jay Monahan Center for Gastrointestinal Health at NewYork-Presbyterian and Weill Cornell Medicine, tells SELF. Heartburn is marked by a burning sensation in the chest, right behind your breastbone, that happens after eating. It can last a few minutes or several hours. Chest pain, especially after bending over or lying down, and burning in the throat are also signs you’re experiencing heartburn. If chest pain is ever paired with shortness of breath or jaw or arm pain, seek medical attention, as you could be experiencing symptoms of a heart attack.

2. Regurgitation

About 80 percent of people with GERD also experience regurgitation, when undigested food and stomach acid move back up from the stomach to the esophagus. You know, that feeling when you kind of burp and get a little taste of your last meal (but, like, mixed with puke). Eating large meals, exercising, or bending over after eating can trigger regurgitation. But it can also happen suddenly.

3. Sour taste in the mouth

“A fair number of people with acid reflux experience a sour taste in their mouth,” Schnoll-Sussman says. It may also seem bitter, and can cause bad breath. This commonly happens along with regurgitation.

4. Difficulty swallowing

This is called dysphagia. Dysphagia makes it take longer to get food down, and can feel like food is sticking in the esophagus. According to the Mayo Clinic, this is caused by GERD-induced damage to esophageal tissues, which can cause the lower esophagus to spasm, scar, and become more narrow.

5. Chronic cough

The reason many people with GERD develop a chronic cough is unclear, but there are two theories in the medical community. One is that cough happens as a protective measure when tiny amounts of acid reaches—and is slightly breathed into—the larynx, which acts as an air passage to the lungs. The other theory is that the cough is simply a reflex reaction to what’s happening in the upper part of your digestive tract.

6. Hoarseness or sore throat

When stomach acid moves up the esophagus, it can irritate the vocal cords. This is often worse in the morning, after lying down all night and may subside during the day. This constant irritation can also make the throat feel a bit sore.

The One Sleeping Position to Avoid for Acid Reflux

This post originally appeared on the blog of medcline.com.

Burning in your throat, regurgitation, choking, coughing, heartburn…all night long. The cause of this intense pain? Stomach acid. Now before you go bad mouthing stomach acid to all your friends, understand that stomach acid isn’t the bad guy here. It plays a very important role in digestion and overall gut health. The problem isn’t the acid. The problem is that for those with acid reflux or gastroesophageal reflux disease (GERD), stomach acid escapes to where it does not belong, into the delicate lining of the esophagus and sometimes even up into your lungs, throat, and sinuses. Plain and simple, stomach acid isn’t meant to be outside your stomach. The key to controlling nighttime acid reflux symptoms is to keep stomach acid where it belongs – in your stomach.

Gravity and anatomy play a huge role in finding relief from nocturnal GERD symptoms. During the day, you are most likely standing or sitting up so when stomach acid escapes, gravity and saliva quickly return this potentially harmful substance to the stomach. Also, when upright, your esophagus naturally flows down into your stomach. This quick return of acid to your stomach typically makes your symptoms shorter, as well as minimizes the potential damage acid can cause to the delicate lining of your esophagus and beyond.

Dangers of Nighttime Acid Reflux

Nights are a different story. When you lie down to sleep, your saliva production and swallowing slow 1 making the return of acid to your stomach more difficult. And, depending on how you are sleeping, your esophagus can actually be below your stomach allowing acid to freely flow out and then just sit in your esophagus, lungs, throat, and sinuses. This is not good for your body. Over time acid pooling in your esophagus can cause severe damage, such as peptic ulcers, strictures, and in more extreme cases Barrett’s Esophagus. In fact, if you have acid reflux at night, there is an 11-fold increased risk of developing esophageal cancer than those without nighttime acid reflux2.

You don’t have to sleep sitting up to take advantage of gravity and anatomy at night. You aren’t a giraffe after all. How you sleep can directly affect how often you feel symptoms, how bad those symptoms are, and how long the acid sits in your esophagus. The good news is that you can drastically change your nights by changing the way you sleep.

Back Sleeping: Avoid Whenever Possible

Back sleeping is the worst for those with acid reflux at night. When acid escapes from your stomach and you are sleeping flat on your back, it is able to flow freely into your esophagus and beyond…and stay there. Studies show that in this position, symptoms are often more frequent and tend to last longer 3 because the acid has nowhere to go. The severity of your symptoms may also increase if you have stomach fat, which pushes down on your stomach forcing contents to escape. Back sleeping should be the #1 position to avoid at night, if you suffer from nighttime acid reflux.

Right Side: It’s not Right for Acid Reflux

Position #2 to avoid at night is…sleeping flat on your right side. When lying flat on your right side, your stomach is actually above your esophagus creating a leaky faucet spouting stomach acid into the delicate lining of your esophagus. This is especially true when your stomach is full. Interestingly, when lying flat on your right side, your reflux symptoms tend to be more liquid in nature4 leading to regurgitation, coughing, and choking, which can be very scary in the middle of the night. Since gravity is doing nothing for you in this position, the amount of time acid lingers in your esophagus is much longer5 so stay off your right side.

So, back sleeping is bad. Right side sleeping is bad. What’s a GERD sufferer to do?

Left Side Reduces Reflux

Sleep on your left side. Gravity will work in your favor on your left side as your stomach is now positioned below your esophagus, which makes reflux more difficult. Should stomach acid escape, gravity is able to return it to your stomach quicker than when on your right side or on your back. Where the right side often produces liquid reflux, when on your left side, reflux symptoms tend to be more gaseous in nature 6, which may be annoying but much less distressing. Studies show that symptoms are less frequent and less severe when on your left side as compared to on your right side or on your back7 making it the most desirable flat sleep position.

Benefits of Propping Up Your Body

Has your doctor recommended that you sleep at an incline using a bed wedge or putting blocks under your bed frame? Studies show that sleeping at an incline decreases reflux symptoms and allows your body to get stomach acid back to your stomach quicker 8. As long as your entire torso is elevated (not just your head and neck), sleeping at an incline gives gravity a power boost to return stomach acid to your stomach and keep it there.

Incline + Left-Side Sleeping for Acid Reflux

So, what if you take the best flat sleeping position, aka the left side, and add an incline? Could the benefits be more than the sum of its parts?

Recent studies show that this is indeed the case 9,10. The compound inclined, left-side sleeping position makes acid reflux at night virtually impossible because your esophagus is now positioned well above the level of stomach contents, even if your stomach is full. And, if you do reflux, gravity is able to quickly return the contents to your stomach. Whew. This ideal sleep position provides a double whammy of decreasing your GERD symptoms and providing protection from prolonged acid exposure to your esophagus, throat, lungs, and sinuses.

So, what’s the secret to controlling your acid reflux symptoms at night and finally getting good, quality sleep? Proper sleep positioning. Discover relief with the ideal position that maximizes the power of gravity and anatomy. Discover the MedCline Reflux Relief System, specifically designed to create and maintain the inclined, left-side position, clinically proven to be the most effective for natural relief from nighttime acid reflux or GERD.

  1. Fass, Ronnie. PPI bashing’ drives use of alternatives. gastoendnews.com, Sept. 2011.
  2. Lagergren J, Bergstrom R, Lindgren A, Nyren O. Symptomatic GER as a risk factor for esophageal adenocarcinoma. N Engl J Med 1999; 340:825–831.
  3. Khoury, Ramez M. Influence of spontaneous sleep positions on nighttime recumbent reflux in patients with Gastroesophageal Reflux Disease. The American Journal of Gastroenterology. Vol. 94, No. 8, 1999.
  4. Shay SS, Conwell DL, Mehindru V, et al. The effect of posture on gastroesophageal reflux event frequency and composition during fasting. Am J Gastroenterology. 1996; 91: 54-60.
  5. Khoury, Ramez M. Influence of spontaneous sleep positions on nighttime recumbent reflux in patients with Gastroesophageal Reflux Disease. The American Journal of Gastroenterology. Vol. 94, No. 8, 1999.
  6. Shay SS, Conwell DL, Mehindru V, et al. The effect of posture on gastroesophageal reflux event frequency and composition during fasting. Am J Gastroenterology. 1996; 91: 54-60.
  7. Khoury, Ramez M. Influence of spontaneous sleep positions on nighttime recumbent reflux in patients with Gastroesophageal Reflux Disease. The American Journal of Gastroenterology. Vol. 94, No. 8, 1999.
  8. Stanciu C, Bennett JR: Effect of posture on gastroesophageal reflux, Digestion 1977, 15: 104-109
  9. Person, E, Freeman, J, Rife, C, Clark, A, Castell, DO. A Novel Sleep Assist Device Prevents Gastroesophageal Reflux: A Randomized Controlled Trial. Journal of Clinical Gastroenterology. 2015 Sep; 49 (8): 655-9.
  10. Allampati SK, Lopez R, Ray M, Birgisson S, Gabbard SL. Use of a Sleep Positioning Device Significantly Improves Nocturnal Gastroesophageal Reflux Symptoms, Diseases of the Esophagus, Volume 30, Issue 3, 1 March 2017, Pages 1–7,https://doi.org/10.1111/dote.12495.

June 6th, 2019

If you suffer from heartburn, you know that burning sensation in your chest is always unpleasant. But you may wonder why it often seems worse when you’re trying to get some sleep. Why is it more likely to flare up at night?

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

Blame it on the natural force of gravity. It doesn’t work in your favor when you’re lying down.

When you sit or stand, gravity helps move your food through the esophagus and into the stomach where digestion occurs.

“But when you are lying down, you lose gravity’s help in allowing your esophagus to clear food, bile and acids. And that can allow for heartburn to happen,” says gastroenterologist Scott Gabbard, MD.

While every person’s experience with heartburn is a little different, most people have heartburn symptoms during the day and at night, he says. But many find it tougher to control at night.

What causes this burning sensation?

When you eat, food passes down your throat and through your esophagus to your stomach. A muscle (the lower esophageal sphincter) controls the opening between the esophagus and the stomach. It remains tightly closed except when you swallow food.

But when this muscle fails to close after food passes through, the acidic contents of your stomach can travel back up into the esophagus. Doctors refer to this backward movement as reflux.

When stomach acid hits the lower part of the esophagus, it can produce a burning sensation. This is what we call heartburn or, more formally, gastroesophageal reflux disease (GERD).

About one in 10 adults has heartburn at least once a week, and one in three have it every month, Dr. Gabbard says. He estimates that 10 to 20 percent of adults have chronic heartburn.

A body pillow that works with gravity

In the past, Dr. Gabbard often advised patients to elevate the head of their bed with bricks or use a wedge-shaped pillow. However, patients saw mixed results, he says.

Now he recommends using a body pillow or sleep-positioning device that helps keep you on your left side with your head elevated.

Lying on your left side allows acidic contents to pass through the lower esophageal sphincter into the stomach. And elevating your head allows gravity to work.

“We get a 2-for-1,” says Dr. Gabbard.

He has led studies to test the effectiveness of the pillows. In a study of patients who had nighttime heartburn despite acid-reducing drugs, the severity of nighttime heartburn was reduced by almost 70 percent after using the pillow.

For some, the acid reflux was so serious that they were considering surgery. Most opted not to have surgery after using the pillow, he says.

The pillow is available online without a prescription. People generally experience less heartburn within two weeks. But full improvement takes four to six weeks, he says.

Tips to reduce nighttime heartburn

There are other steps you can take to reduce heartburn. Dr. Gabbard offers these tips:

  • Lose weight. Body mass index (BMI) takes weight and height into account. People who are overweight (BMI of 25 or above) are at a greater risk for heartburn.
  • Stop smoking. Research suggests that if you can quit smoking, it will help, Dr. Gabbard says.
  • Eat smaller, less fatty meals, especially later in the day. For someone with chronic heartburn, a meal of less than 500 calories and 20 grams of fat is ideal, he says.
  • Wait at least three hours after eating to go to bed. “It takes the stomach four to five hours to fully empty a meal, so give it at least three hours,” he says.
  • Try acid-reducing medications. The most commonly prescribed medications for GERD are proton pump inhibitors. While thought to be generally safe, patients with long-term use of these medications should discuss potential risks with their physicians, Dr. Gabbard says.

While many people complain that spicy foods aggravate their heartburn, Dr. Gabbard says studies don’t support that claim. That said, he advises patients to keep their food sensitivities in mind and avoid foods that may trigger digestive problems for them.

How to Sleep Better with Acid Reflux

By sleeping on an adjustable bed frame with the head raised one can find relief of symptoms and an answer to the question of how to sleep with acid reflux. With the head of the bed raised stomach acids will not be able to be brought back up to the esophagus where they cause major discomfort keeping one awake.

I. What is Acid Reflux and GERD II. What Causes Acid Reflux and GERD III. How does Acid Reflux and GERD Affect Sleep IV. How to Sleep with Acid Reflux and GERD 1. Elevate the Upper Body 2. Loose Bed Clothes 3. Avoid Food Triggers 4. Sleeping Positions V. Conclusion

I. What is Acid Reflux and GERD

The American College of Gastroenterology has seen that most people have experienced some sort of heartburn. Notably the college reports that acid reflux occurrences are suffered by over 60 million Americans at least once a month. Hospitals in the U.S. report that problematic diseases beginning with acid reflux are the most common of gut ailment complaints.
Acid Reflux and GERD have the same symptoms of acidic stomach contents backing up into the esophagus. Once this backup of acid occurs it generates a pain that feels like burning in the area of the lower chest. Most often this will occur following a meal.
Acid Reflux, or heartburn, is reclassified as GERD when the malady occurs more than two times a week. Often lifestyle risks, such as smoking and obesity, can cause the dreaded heartburn symptoms.

II. What Causes Acid Reflux and GERD

Heartburn does not involve the heart. The name comes from the burning feeling in the chest caused by the acid from the stomach coming back up into the esophagus, also known as the gullet or food pipe. This is a digestive disorder involving the lower esophageal sphincter (LES) which is the muscle that works between the stomach and esophagus.
Healthy digestion occurs with the (LES) opening to let food through to the stomach and then closing after. By normal closure food and stomach acid cannot flow back up. Reflux happens because the LES is too weak or relaxed to close properly, thus allowing for the stomach acid to backup back to the esophagus.
Hydrochloric acid is a strong acid that works in the stomach to protect against dangerous bacteria as it breaks down food. The stomach’s lining works to protect the stomach from the acid, but the esophagus is not meant to deal with the acids so it is not protected.

III. How do Acid Reflux and GERD affect Sleep?

Heartburn pain caused by acid reflux and GERD will awaken a person causing sleep disturbance. This happens with the stomach acid flowing back up to eat the lining of the esophagus. Often the acid reflux may travel as far as the throat which will cause a waking coughing fit. The acid can also result in a sickly tasting regurgitation in the mouth.
When lying flat on a bed the acid reflux can be even more serious as it can pool within the esophagus, as well as the vocal cords and sinuses. This can cause extended serious damage. Sleeping on an adjustable bed frame with the head raised can help prevent serious harm while sleeping by keeping the acid from backing up from the stomach to the esophagus. Another contributing factor is that swallowing is less frequent while sleeping which slows the normal contraction of the esophagus that prevents the back up of acid. With the production of less saliva while asleep the return of normal PH levels to the esophagus after an acid reflux episode is hindered as well.
In addition to GERD causing one to wake from the pain of heartburn, it has also been determined to be a factor of risk for sleep apnea. Sleep apnea causes one to stop breathing normally throughout sleep. Experts have determined that the stomach acids backed up result in the spasm of the voice box, which in turn blocks air from the lungs.

IV. How to Sleep with Acid Reflux and GERD

Sleep can be illusive when dealing with acid reflux. The churning of stomach acids and relaxation do not go together well. Acid reflux and sleeping, or the dreaded GERD and sleeping, can cause unneeded suffering and pain when trying to drift off to dreamland on a flat bed. Fortunately, there are some solutions to help sufferers achieve sleep and comfort.

1. Elevate the Upper Body

A flat bed is the enemy when attempting to sleep with heartburn symptoms. The adjustable base bed is the easiest way to find relief from the nasty stomach acids backing up into the esophagus. Elevate the head at least 6 inches to keep the acids in the stomach and the body resting comfortably.

2. Loose Bed Clothes

Tight fitting PJs with a snug waist band are an enemy to those with acid reflux and GERD. The tightness will only put unneeded pressure on the stomach which can lead to the symptoms of heartburn.

3. Avoid Food Triggers

With heartburn most common after a meal it makes sense to avoid foods that can make symptoms worse, especially right before bed. Alcohol, drinks containing caffeine, chocolate, peppermint, garlic, onions, dairy, greasy, and fried foods can all be problematic. Acidic foods such as fruits and tomatoes can certainly cause more acid issues than wanted at sleep time.

4. Sleeping Positions

Experts have determined that the best sleep position for those suffering with acid reflux is to have the head and upper torso elevated from 6-8 inches. Piling pillows behind the head can make the condition worse as it causes more pressure on the esophagus. Using an adjustable bed frame is the best option. If one is not available, then there are sleep wedges made for this purpose.
If back sleeping is uncomfortable and not an option, then the best side to sleep on for acid reflux is your left side. The left side allows for gravity to work with the organs. The esophagus opens into the stomach at an angle on the right side of the body. This means that the contents in the stomach will tend to not be able to travel back up to the esophagus as easily when sleeping on the left side.

V. Conclusion

How to sleep with acid reflux can be a difficult problem for many sufferers. With the right care, along with an adjustable bed base to raise you to a healthy position to keep acids from causing more harm, you will be on the way to better health and sleep. Add to the adjustable bed a comfortable memory foam mattress, great memory foam pillows and bedding to achieve the best sleep possible.

More than 60 million Americans have heartburn at least once a month. I’m one of them. In fact, I was found to have gastroesophageal reflux disorder—aka GERD, more commonly known as acid reflux—back in college because of just how frequently I was getting heartburn.

If you have acid reflux, or even occasional heartburn after a spicy meal, you know that it can keep you awake tossing and turning. Here’s what I’ve learned about coping with acid reflux so it doesn’t get in the way of a good night’s sleep.

What causes acid reflux

Acid reflux is the name for what happens when stomach acid makes its way up into the esophagus. Most often it’s because the lower esophageal sphincter, a muscle valve that is supposed to keep stomach acid where it belongs—in your stomach— isn’t working properly.

There are a few things that can loosen the muscle, making it easier for acid to shoot back up. Eating certain foods, like citrus fruits, tomatoes, chocolate, peppermint, garlic, onions, and anything spicy, fatty, or fried, is one of the biggest causes. So is drinking coffee, soda, or alcohol. Obesity and pregnancy can also lead to acid reflux because they put pressure on your abdomen, which can weaken your lower esophageal sphincter.

How acid reflux affects your sleep

So what’s the connection between acid reflux and sleep? As I can attest, heartburn is usually worse at night, and that can make falling (and staying) asleep more difficult. “Most people are prone to acid reflux when they lie down,” says Scott Huber, MD, gastroenterologist at the Institute for Digestive Health and Liver Disease at Mercy Medical Center in Baltimore. When you’re lying down, you don’t have gravity to pull acid back down into your stomach the way you do when you’re sitting or standing up, Huber explains.

According to an American Journal of Gastroenterology survey of 1,000 people with heartburn at least once a week, 79% of respondents said they experience heartburn at night. Three-quarters of nighttime heartburn sufferers said heartburn affected their sleep, while 63% said they believed heartburn negatively impacted their ability to sleep well, and 40% said they believed it made it harder to function the next day. Per the National Sleep Foundation, if you have acid reflux, you could very well wake up in the middle of the night with heartburn—and you might even experience middle-of-the-night choking or coughing, depending on how far up your esophagus the acid travels.

How to deal with acid reflux at night

There are a few simple lifestyle changes you can make to ensure acid reflux doesn’t cost you a good night’s sleep.

1. Stop eating and drinking three hours before bed. Susan Besser, MD, primary care physician at Mercy Medical Center in Baltimore, suggests nixing late-night snacks and cutting off food and drink three hours before hitting the sheets. The less acid you have in your stomach when you lie down, the less likely you are to experience heartburn at night. (Late-night eating is also associated with weight gain, as a study published in the American Journal of Clinical Nutrition has shown.)

2. Make lunch your biggest meal of the day. Eating a big meal can put pressure on your stomach and allow acid to travel back up into your esophagus—and that will only be compounded if you lie down soon afterward. To prevent a major case of acid reflux at night, Huber recommends eating a heavier lunch and a lighter dinner. (And think about skipping the sugar before bed, since it also interferes with sleep.) I’ve started to spend a few hours on Sunday meal prep so that I can get more substantial lunches ready for the week.

3. Avoid trigger foods and drinks. For me, that would be tomatoes. And coffee. And red wine. (By the way, here’s how alcohol affects sleep.) Besser and Huber both advise limiting the intake of foods and beverages that you know give you heartburn—not just at night, but all the time. I recently bought the book Dr. Koufman’s Acid Reflux Diet for recipes that won’t cause heartburn.

4. Wear loose pajamas. Clothing that’s too tight can put pressure on your stomach, leading to the back-flow of acid into your esophagus, says Besser. While you probably aren’t wearing Spanx leggings to bed since that wouldn’t be comfortable anyway, it’s still worth pointing out that if you have acid reflux, loose pajamas are the best option. (Of course, you could always ditch the PJs altogether and sleep naked.)

5. Elevate your head in bed. Keeping your head up is ideal if you experience acid reflux at night, says Huber. Piling up the pillows isn’t the best way to go about this, though, as pillows are liable to shift. An adjustable base might be a better option for you if you have acid reflux, says Huber. Adjustable bases make it easy to get into a sleeping position that will help mitigate symptoms.

Elevate Your Head with These Saatva Products to Help Curb Acid Reflux

Solaire Precision Adjustable Air

Featuring 50 precise firmness settings for personal customization. Talalay latex and gel-infused memory foam provide luxurious comfort and support.

SHOP >

Lineal Adjustable Base

With weightless, Zero Gravity support, the Lineal adjustable base allows you to set your ideal position for sleeping—and living—with one touch of the remote.

SHOP >

6. Sleep on your left side. Stomach sleepers, take note: This is the worst position to sleep in if you have acid reflux, says Besser. “Sleeping on your stomach puts pressure on your stomach and can cause food to come back up,” she says. The best sleeping position for acid reflux is on your left side, says Huber, although he notes that no one’s entirely sure why. A JAMA Internal Medicine review of studies did find that the lower esophageal sphincter is relaxed for longer when patients lie on their right side. If side sleeping isn’t for you, sleeping on your back is suitable too if you have acid reflux, Besser says. (Find the best mattress for your sleep position in our mattress guide.)

7. Visit your doc. If none of these lifestyle changes makes a difference, it’s time to head to your MD. OTC medications may be able to help, but you should consult a medical professional before taking one, says Besser. And if you’re already on a medication, the fix may be as simple as taking it before bed instead of in the morning, but you should check with your doctor before switching things up.

Another condition that can make it more difficult to snooze: arthritis. Here, learn how to keep arthritis from ruining your sleep.

In the market for a new mattress? Take our quiz to find out which Saatva mattress is right for you.

Is acid reflux keeping you awake at night?

How to ease acid reflux at night

Many people with an under par digestion find that symptoms of acid reflux keep them awake at night. To help ease these symptoms I’ve compiled a list of dos’ and don’ts.
Do:

  • Incline the head of your bed
  • Sleep on your left side
  • Keep a food diary
  • Maintain a healthy weight

Don’t:

  • Sleep on your back or right side
  • Eat in the three hours preceding bedtime
  • Wear tight clothes
  • Hunch

Throughout the blog I explore these themes in more detail, plus offer some remedies to help.

How to improve sleep with acid reflux

There are many tips and tricks to try, and certain things to avoid, which may just be your answer to finally getting a good night’s sleep.

1. Incline the head of your bed

Raising you head slightly more than usual helps gravity do its job and helps prevent stomach acid leaking up into your oesophagus.

Some people achieve this by propping one end of the bed up with blocks. Just make sure it is secure before diving in! However, an extra pillow may be sufficient to prop you up a little.

2. Sleep on your left side

Sleeping on your left side can help because the oesophageal sphincter located at the top of the stomach should then be higher than the level of acid, making reflux less likely.

3. Keep a food diary

By tracking what you eat alongside the severity of your symptoms, you should be able to help identify if certain foods worsen your condition, and therefore take any necessary steps to eliminate reflux triggers.

4. Maintain a healthy weight

Just like in pregnancy, being overweight puts extra pressure on your digestive system, making it more likely that acid will be squeezed out of the stomach.

1. Sleep on your back or right side

Sleeping on your back or your right side have been found to be the worst sleeping positions for acid reflux sufferers, as they can put pressure on the sphincter at the top of the stomach, encouraging it to open. This can cause acid to leak into the oesophagus and the pain and discomfort to follow.

2. Eat in the three hours preceding bedtime

Improve your digestion by allowing food to be well on its way through your digestive system before lying down. Eating at least 3 hours before bed helps ensure your stomach has done most of its emptying before you settle down for the night.

3. Wear tight clothes

In the same way as being overweight, tight clothes around your middle constrict your stomach and force the acid out. So watch out for any restrictive waistbands in your pjamas or underwear that could be exacerbating your symptoms.

4. Hunch

Be aware of your posture, both during and after meals and especially in the lead up to bedtime; keeping your shoulders back to open out the chest gives your stomach more room to operate optimally.

Why is acid reflux worse at night?

Acid reflux (or heartburn) at night is an all-too-common problem, contributing to an estimated 7% of sleepless nights. This can have further repercussions, including fatigue, increased anxiety or concentration lapses the following day.

There are many reasons why acid reflux symptoms can worsen at night, although much of the problem occurs when lying horizontally. When sitting or standing, gravity helps to keep food and acid at the bottom of the stomach, but as you lie down, it becomes much easier for the acid to leak out the top of your stomach and irritate the lining of your oesophagus.

Additionally, when we are asleep we tend to swallow less, which means that the oesophageal contractions which keep stomach acid in the stomach are reduced, making it easier for reflux to occur.

The saliva that we produce helps to neutralise stomach acid, hence reducing symptoms. However, when asleep, saliva production reduces; another contributing factor to worsening symptoms.

Additionally, eating a big meal late at night can trigger heartburn symptoms. This is because the body will be trying to do its night-time clearing and regenerating work whilst struggling to digest at the same time. Lying down with a full stomach increases the likelihood of both food and acid being pushed back up towards the oesophagus. With all this in mind, it is clear why lying down with a full stomach is a recipe for night-long heartburn.

Are there effective remedies to help?

There are many home remedies that may help with acid reflux, including bicarbonate of soda and apple cider vinegar.

If you feel you need a little extra protection, Silicic acid is a compound of silicon and oxygen and has been found to be very effective in treating acid reflux. It soothes and protects the lining of the digestive tract, as well as adsorbing or binding harmful substances, helping to achieve a heartburn-free night. Silicic acid can be found in Silicol® gel.

My Top Tip:

Silicol gel coats the digestive tract and soothes inflammation as well as binding to and removing toxins which might be causing irritation. Take 1 tablespoon, 3 times daily – 1 hour before or after taking medication.

“Lovely soothing product. Works for me for heartburn and IBS.”

Read more customer reviews

Find Silicol gel in a store near you Add to basket – 200ml for £8.29

Also available in the following size: 500ml

Originally published on 25/09/19, updated on 14/05/19

About the author

Leave a Reply

Your email address will not be published. Required fields are marked *