No one likes that sour taste that results when stomach acids back up into the throat, a condition known as gastroesophageal reflux, or GERD. And it always seems to be worse when you're trying to fall asleep.
It's not your imagination, says Julie Stefanski, RDN, LDN, a Pennsylvania-based registered dietitian nutritionist and a spokesperson for the Academy of Nutrition and Dietetics. GERD or acid reflux is worse at night, because it's easier for stomach acid to work its way up when you're lying down, she says.
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The stomach is a very acidic environment because that's key to breaking down food and destroying pathogens (organisms that cause disease) during digestion, Stefanski says. When you lie down, the contents in your stomach can press against the valve at the top of your stomach called the lower esophageal sphincter (LES). The pressure can cause the LES to weaken, allowing the stomach acid to flow back up rather than down.
"The pain and irritation of reflux comes from the stomach contents frequently backing up through this valve," Stefanski says.
Here are easy ways to put an end to indigestion at bedtime.
During the Day
You can start to reduce acid well before bedtime.
1. Be Active
Regular physical activity can help your digestive tract by toning your muscles and increasing how quickly food moves through your digestive system, Stefanski says. "It can also help reduce constipation, another contributor to reflux."
Exercise can also help you maintain a healthy weight — having overweight can contribute to nighttime indigestion, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Talk to your doctor if you need advice to lose weight.
2. Know Your Triggers
You're likely to find certain foods trigger more reflux than others, per the NIDDK. Everyone's list is different, but common triggers include:
Once you've identified problem foods, make a point of avoiding them, especially in the two to three hours before you go to bed, Stefanski says. It's common sense: You'll produce less stomach acid if you stop eating well before you hit the hay, and less stomach acid means less reflux.
3. Time Your Meds
Taking your antacids just before bed when you haven't eaten for a few hours means you could be taking them on an empty stomach, and they won't be as helpful. "It's best to discuss the timing of your antacids with your pharmacist and GI specialist," Stefanski says.
Before Getting Into Bed
Here's what you can do before you nod off.
1. Raise the Head of Your Bed
You want your head to be a few inches higher than your waist as you sleep, according to the NIDDK. You can accomplish this ideal sleeping position by putting blocks under the head of your bed frame so you raise your head about 6 to 8 inches.
2. Loosen Up
Make sure your pajamas aren't tight at the waist, which could put extra pressure on your sphincter muscle, says Santosh Sanagapalli, BSc(Med), MBBS, a Sydney, Australia-based gastroenterologist. (And, ditto during the day: Don't wear tight belts or other clothing that cinches your waist, he says.)
What Not to Do
You may have heard drinking water before bed can reduce stomach acid at night. Not true, Dr. Sanagapalli says. Water makes your stomach fuller and, in response, it will produce more — not less — acid.
If you are going to drink water before bed, time it so most has left your system well before you go to sleep, Stefanski says, so you're not constantly waking up to pee. You may need to experiment with amounts and timing to see what works for you.
- Julie Stefanski, MEd, RDN, CSSD, LDN, CDCES, FAND , registered dietitian nutritionist, York, Pennsylvania, spokesperson, Academy of Nutrition & Dietetics
- National Institute of Diabetes and Digestive and Kidney Diseases: “Eating, Diet, & Nutrition for GER & GERD”
- Santosh Sanagapalli, BSc(Med), MBBS, FRACP, gastroenterologist, Esophageal Disorders Centre, St. Vincent's Hospital, Sydney; associate professor of medicine, University of New South Wales, Darlinghurst, Australia
- National Institute of Diabetes and Digestive and Kidney Diseases: “Treatment for GER & GERD”
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.