Nighttime acid reflux can bring on symptoms of coughing, snoring and burning pain that can disrupt sleep and have a strong negative impact on quality of life. Of the many lifestyle changes recommended for relieving acid reflux, inclining the upper body while sleeping is one of the most effective and proven changes you can make. Acid reflux is a symptom of gastrophesophageal reflux disease, or GERD, which is characterized by severe and frequent reflux episodes. Elevating the upper body to 11 inches has been shown to reduce reflux episodes, lessen the time acid stays in contact with the esophagus and decrease reflux symptoms overall.
Importance of Bed Elevation
Reflux occurs because of a weakness or malfunction in the muscular valve that protects the esophagus, which is the tube that connects the mouth to the stomach. When this valve is weakened, stomach contents can leak through. During the day, gravity helps keep stomach contents in their place. When you're lying flat, acidic liquids can more easily leak through this valve, also known as the lower esophageal sphincter, or LES. These fluids irritate the throat and esophageal lining and can disrupt sleep. Raising the head of your bed to a height of 11 inches has been shown to reduce both the number of times acid may leak through the LES and the length of time acid stays in contact with the esophagus.
Techniques for Bed Elevation
The use of risers or foam wedges to raise the head of your bed to a height of 11 inches or at least 8 inches will enable you to sleep on an incline. The important thing is for your esophagus to be higher than your stomach so that digestive acids remain in the stomach. The entire head of the bed can be raised using risers, bricks or foam blocks. Alternatively, you can use wedge pillows -- available at medical supply stores and elsewhere -- to raise your upper body. This option may be more comfortable, especially if you are sharing your bed with your significant other. An adjustable bed is another option.
The side of the body you sleep on may also be important. For reasons that aren't well understood, sleeping on the right side causes the band of muscle between the esophagus and the stomach to relax more often, leading to more frequent episodes of reflux and prolonging the time it takes for acid to move through the stomach. By contrast, sleeping on the left side may cause the band of muscle to tighten and lower overall acidity.
Conclusions and Warnings
Although acid reflux occurs less often at night than during the daytime, acidity may actually be worse while asleep, when swallowing and involuntary movement of the esophagus happen less frequently, allowing acid to settle into the esophagus and causing irritation and inflammation. GERD is a disease that is also effectively treated with medications. Acid-reducing drugs called proton pump inhibitors, or PPIs, are helpful in reducing the symptoms of GERD and allowing the esophagus to heal. They are available over the counter and by prescription. If you suffer from nighttime acid reflux, in addition to elevating the head of your bed it may help to avoid eating 2 to 3 hours prior to bedtime and to stay away from any foods that you know trigger your symptoms. Be sure to tell your doctor if you are experiencing chest pain, difficulty swallowing or hoarseness, as these may be signs of the more serious complications of GERD.
Medical advisor: Jonathan E. Aviv, M.D., FACS
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