If you're feeling a little run down during the day and experience heartburn at least once a month, it could be from a lack of sleep. That burning sensation in your chest may be causing you to toss and turn at night: Constant tiredness can happen with acid reflux.
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Heartburn affects more than 60 million Americans at least once a month, according to the American College of Gastroenterology, and more than 15 million experience it every day. Most people tend to complain about the burning in their chest or in the back of their throat when they talk about their heartburn symptoms, but fatigue is actually on the list because of the effect acid reflux has on getting a good night's sleep.
Tiredness and Acid Reflux: What’s the Connection?
As many as 4 in 5 people with GERD — a more severe form of acid reflux — experience nighttime symptoms, according to the International Foundation for Functional Gastrointestinal Disorders. Of these, 75 percent said their symptoms affect their sleep, and 40 percent said the hit to their sleep also made it harder to function by day.
Constant tiredness with acid reflux can occur for many reasons, says sleep medicine expert Rajkumar Dasgupta, MD, an assistant professor of clinical medicine at the Keck School of Medicine at the University of Southern California in Los Angeles.
"Studies have shown that acid reflux can cause sleep deprivation with effects of daytime fatigue and sleepiness due to nighttime heartburn, which results in multiple arousals and awakenings," says Dr. Dasgupta, who is also a spokesperson for the American Academy of Sleep Medicine. "Sleep deprivation is usually associated with increased reflux severity and can be improved with treatment of the reflux."
Gravity is not on your side when you're lying on your back in bed, he says. With acid reflux, stomach acid flows backward up into the esophagus, causing the burn, per the American College of Gastroenterology. "Gravity won't keep stomach acid down, making it easier for reflux to occur," Dr. Dasgupta says. Plus, "when sleeping, we swallow less, and swallowing is what helps prevent reflux. Saliva neutralizes stomach acid, and at nighttime, we don't make as much saliva."
That telltale burning sensation in your chest and throat can cause you to wake up frequently and feel fatigued during the day, Dr. Dasgupta says.
Here are five things you can try to cool your heartburn and get better sleep at night
1. Treat the Burn
There are many reasons to treat heartburn, and getting better sleep is certainly on the list. Available over-the-counter and by prescription, drugs known as proton-pump inhibitors reduce stomach acid, says Harvey H. Allen, Jr., MD, a gastroenterologist and medical director of the Mohawk Valley Endoscopy Center in Utica, New York.
When you treat the acid reflux, you will wake up less often from the burn. See your doctor about frequent heartburn because when it's left untreated, it can lead to precancerous changes in your esophagus, Dr. Allen says.
2. Mind Your Triggers
Some common heartburn triggers include citrus fruits, alcohol, chocolate, coffee, high-fat foods, mint and spicy foods, according to the American College of Gastroenterology. It's more than what you eat though. When you eat can also contribute to heartburn and sleep loss, Dr. Allen says. "Eat earlier in the evening," he says.
3. Address Any Underlying Sleep Problems
Acid reflux is tied with sleep disorders such as chronic obstructive sleep apnea, which is marked by pauses in breathing while asleep, Dr. Dasgupta says. Exactly how the two conditions are linked is not fully understood. It may be that they share risk factors such as obesity.
The Sleep Foundation notes that it is possible that GERD affects the airway and ability to breathe normally. "Treating the apnea with a continuous positive airway pressure (CPAP) device that administers air pressure will help with symptoms of GERD, too," Dr. Dasgupta says. Your doctor can order tests to see if you have sleep apnea, or other sleep disorders, and get you on the road to better sleep.
4. Lie on Your Left Side
This is the best position to stop acid from flowing back up, Dr. Dasgupta says. "Your stomach is now positioned below your esophagus, which makes it more difficult for acid to travel upward." Try elevating your head with a few pillows, as that can help keep acid down, too, he says.
5. Practice Good Sleep Hygiene
Set and stick to strict bed and wake times (even on weekends), keep your bedroom cool, dark and conducive for sleep and avoid stressful tasks before bed for better quality sleep, Dr. Dasgupta says.
Read more: 5 Simple Steps to Get the Best Night of Sleep Ever
- International Foundation for Functional Gastrointestinal Disorders: “Sleep & GERD”
- Rajkumar Dasgupta, MD, assistant professor, clinical medicine, Keck School of Medicine, University of Southern California, Los Angeles
- American College of Gastroenterology: “Acid Reflux”
- Harvey H. Allen, Jr., MD, gastroenterologist, medical director, Mohawk Valley Endoscopy Center, Utica, New York
- Sleep Foundation: “GERD and Sleep”