If you have acid reflux, it's not surprising that your symptoms are worse at night. When you sit or stand, gravity helps keep the contents of your stomach in their place. Lie down and the acids can more easily head up toward your throat.
Acid reflux occurs when the stomach acids that help break down the food you eat back up, explains the National Institute of Diabetes and Digestive and Kidney Diseases. When working properly, the muscle known as your lower esophageal sphincter (LES) acts as a gatekeeper, opening to allow food to head down the esophagus and into your stomach and closing once the stomach acids and juices begin to break down what you just ate.
However, in as many as one in five U.S. adults, the LES can weaken and open at inopportune times, allowing stomach acids to come back up, notes the International Foundation for Gastrointestinal Disorders.
Frequent acid reflux is also known as gastroesophageal reflux disease (GERD) — and can be worse at night because you're lying down, causing the telltale symptom of heartburn. And there goes your sleep.
Modify Your Bed
If you suffer from mild reflux and regurgitation, you can make some lifestyle modifications that may help, says Brooks Cash, MD, chief of gastroenterology, hepatology and nutrition at the University of Texas Health Science Center in Houston. One of the simplest things you can do to ease GERD at night is to elevate the head of your bed.
Ideally, you want to raise it by 6 to 8 inches, according the University of Michigan Medicine. And the best way to do this is by putting blocks underneath the frame of your bed. Another option is to place a foam wedge under the head of your mattress. Wedges are available at medical supply stores.
If you also have a serious medical condition affecting your breathing, elevating your head has an added benefit. "Some people with conditions such as congestive heart failure or chronic lung diseases breathe better with the head of the bed elevated," Dr. Cash says, "but for otherwise healthy individuals, elevating the head of the bed makes no difference in breathing quality."
What not to do? Don't use pillows to prop up your head. This could make things worse, according to Harvard Health Publishing. With extra pillows, you're likely to bend at the waist and compress your stomach — exactly what you don't want to do.
Note that raising the head of your bed is not a sufficient treatment if your esophagus is badly damaged, Dr. Cash adds.
More Tips for Better Sleep
Here's what else you can do to improve sleep, according to Harvard Health Publishing, Michigan Medicine and the National Sleep Foundation:
Sleep on your left side. It's not entirely clear why, but it seems that sleeping on your left side is the best position for people with GERD. Sleeping on your right side seems to put more pressure on your stomach and sphincter.
Skip the tight PJs. Don't wear nightclothes that are tight around the waist. This also puts extra pressure on your stomach.
Watch the clock. Time your meals so that the last food you eat is consumed at least two to three hours before you lie down. That means no more snacking just before bed.
Know your trigger foods. Not everyone's trigger foods are the same, but some of the more common ones are alcohol, coffee, tomatoes, citrus fruits and juices, carbonated beverages, chocolate, peppermint, garlic, onions and fatty, spicy or fried foods. If any of these or others are on your trigger list, avoid them as much as possible and most certainly close to bedtime.
Read more: The 10 Worst Foods for Acid Reflux
Take your medication. Acid-reducing medications called proton pump inhibitors (PPIs) and histamine H2-receptor antagonists (H2 blockers) can help reduce your symptoms and allow your esophagus to heal. Talk to your doctor about the best medications for you and when you should take them for the best results.
Is This an Emergency?
- University of Michigan Medicine: "GERD: Controlling Your Heartburn by Changing Your Habits"
- Brooks Cash, MD, chief of gastroenterology, hepatology and nutrition, University of Texas Health Science Center, Houston
- International Foundation for Gastrointestinal Disorders: "Sleep & GERD"
- Harvard Health Publishing: "What Is GERD or Gastroesophageal Reflux Disease?"
- National Sleep Foundation: "Ease Heartburn at Bedtime"
- National Institute of Diabetes and Digestive and Kidney Diseases: "Symptoms and Causes of GER and GERD"