5 Ways to Manage Acid Reflux at Night for Better Sleep

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Acid reflux symptoms may flare when you're trying to sleep but it's unlikely you would die from them.
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Acid reflux or heartburn is a painful, burning sensation that occurs when stomach acid travels up the esophagus from the stomach. Almost everyone experiences acid reflux at some point. Symptoms may increase in severity while trying to sleep, according to the Cleveland Clinic.


With severe acid reflux, sometimes acid or stomach contents can be inhaled or aspirated, which can lead to cough, asthma or even pneumonia, cautions Hardeep Singh, MD, a gastroenterologist with St. Joseph Hospital in Orange, California.

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It's unlikely, though, that you would choke and die from acid reflux in your sleep, especially if you are otherwise healthy, he says.

What Is Acid Reflux?

More than 60 million Americans have heartburn at least once a month, and as many as 15 million experience symptoms every day, according to the American College of Gastroenterology. It's more common in pregnant people and older adults.

In some people with chronic acid reflux — known as gastroesophageal reflux disease or GERD — the valve that functions as a seal between the esophagus and stomach becomes weak, Dr. Singh explains. This allows fluids containing digestive acids and enzymes to leak back up into the esophagus. And, when the lining of the esophagus comes into prolonged contact with these fluids, it can become irritated, creating the burning sensation of heartburn.


"The stomach always contains acid, even when fasting, and this acid can irritate the esophagus, causing heartburn, chest pain and nausea," Dr. Singh says.

Acid Reflux Causes and Why It's Worse at Night

Acid reflux is often due to eating too late and not waiting before lying down for bed, Dr. Singh says. Gravity is working against you: Lying down encourages the contents of your stomach to seep up your esophagus. The size and contents of your meal can also be factors.


Other lifestyle factors, such as smoking, drinking alcohol or coffee or taking certain medicines can also make your heartburn worse, according to the Mayo Clinic, including before bed.

Plus, having certain health conditions can boost someone's risk for GERD. These include obesity, hiatal hernia, pregnancy, delayed stomach emptying or living with a connective tissue disorder such as scleroderma, per the Mayo Clinic.



Managing Acid Reflux at Night

Because chronic acid reflux can cause poor quality of sleep, the U.S National Library of Medicine suggests specific lifestyle changes for better sleep with nighttime heartburn.

1. Plan Dinnertime and Bedtime

Don't go to bed soon after eating. Stay upright for at least three to four hours after your last meal or snack. Eating smaller meals throughout the day instead of a large meal at dinner can help, too.


2. Elevate Your Sleeping Position

The best sleeping position for acid reflux is with your head elevated 4 to 6 inches. Extra pillows may not be enough to get the job done. Try using a special wedge support (like the Kolbs wedge pillow, $42.99, Amazon) or use risers at the head of your bed only.

3. Check Your Diet

In addition to eating smaller, more frequent meals, avoid foods that could cause problems too close to bedtime. Limit alcohol, drinks that include caffeine and high-acid fruits and veggies, such as pineapples and tomatoes.


4. Make Other Lifestyle Modifications

If you have overweight, losing weight may provide relief from heartburn. If you smoke, quit. When you choose clothes, including PJs, select styles that are not too tight and don't put pressure on your stomach.

5. Consider Medication

Choose acetaminophen when you need an over-the-counter pain reliever and avoid non-steroidal anti-inflammatory medicines such as aspirin, ibuprofen and naproxen.


For quick relief of acid reflux, try antacids to neutralize the stomach acid. Ask your doctor about over-the-counter medications such as H2 antagonists (Pepcid, Tagamet, Zantac or Axid, for example) or proton pump inhibitors (such as Prilosec, Nexium or Prevacid) that can help stop acid reflux at night.

When to Talk to Your Doctor

If acid reflux is keeping you from getting quality sleep, check in with your doctor to make sure you don't have other underlying health issues.

Waking due to acid reflux could be a sign of a more serious health concern, Dr. Singh says. "Untreated reflux can lead to ulcers, scarring and ultimately esophageal cancer," he says.

If acid reflux is the culprit, your doctor may recommend prescription-strength medications to help you gain relief.


Common Questions

Can you choke on acid reflux while sleeping?

It's unlikely. Acid reflux can make you feel like you're choking and cause you to cough, but this typically wakes you up. Still, it's a good idea to talk to your doctor about your symptoms if you're choking on reflux during the night, according to Mount Sinai.

Does drinking water help acid reflux?

Drinking water before bed could make your stomach feel fuller and produce more acid, LIVESTRONG.com previously reported. Plus, it could further disrupt your sleep by making you wake up to pee.

What are the worst foods for acid reflux?

According to the American Society for Gastrointestinal Endoscopy, GERD trigger foods include: coffee, citrus fruit and juice, chocolate, garlic, onions, tomatoes, carbonated drinks, and high-fat, fried or spicy foods.




Is this an emergency? If you are experiencing serious medical symptoms, please see the National Library of Medicine’s list of signs you need emergency medical attention or call 911.