How does sleeping position affect acid reflux. What is the optimal sleeping position for reducing nighttime heartburn. Can certain sleeping positions worsen acid reflux symptoms. How to prevent waking up with acid reflux at night. What are effective home remedies for nighttime acid reflux relief.

Understanding Acid Reflux and Its Impact on Sleep

Acid reflux, a condition where stomach acid flows back into the esophagus, can significantly disrupt sleep patterns. Many individuals experience heightened symptoms at night, leading to discomfort and frequent awakenings. The relationship between sleep and acid reflux is complex, with each potentially exacerbating the other.

Why does acid reflux often worsen at night? When lying down, gravity no longer assists in keeping stomach contents in place, making it easier for acid to travel up the esophagus. Additionally, saliva production decreases during sleep, reducing its neutralizing effect on stomach acid.

Common Nighttime Acid Reflux Symptoms

• Burning sensation in the chest (heartburn)
• Regurgitation of acid or food
• Difficulty swallowing
• Chronic cough or wheezing
• Sore throat or hoarseness

The Science Behind Sleeping Positions and Acid Reflux

Research suggests that sleeping positions can significantly influence the frequency and severity of acid reflux symptoms. The orientation of the body during sleep affects the position of the stomach relative to the esophagus, which can either facilitate or hinder the backflow of stomach contents.

How do different sleeping positions impact acid reflux? Studies have shown that sleeping on the left side tends to reduce acid reflux symptoms, while right-side sleeping is associated with increased esophageal acid exposure and a higher incidence of lower esophageal sphincter (LES) relaxation.

Left-Side Sleeping: The Preferred Position

Sleeping on the left side is often recommended for individuals with acid reflux. This position takes advantage of gravity and the anatomy of the stomach to minimize reflux episodes. The stomach naturally sits to the left side of the abdomen, and in this position, its contents are less likely to flow back into the esophagus.

Right-Side Sleeping: Potential for Increased Symptoms

Conversely, sleeping on the right side may exacerbate acid reflux symptoms. In this position, the lower esophageal sphincter (LES) may be more prone to relaxation, allowing stomach contents to flow back more easily. Additionally, the esophagus enters the stomach on the right side, which can lead to increased acid exposure when lying on this side.

Elevating the Upper Body: A Key Strategy for Acid Reflux Relief

Elevating the upper body during sleep can be an effective method for reducing acid reflux symptoms. This approach utilizes gravity to help keep stomach contents in place and minimize backflow into the esophagus.

How much should you elevate your upper body? Experts typically recommend raising the head of the bed by 6-8 inches or using a wedge pillow designed for acid reflux relief. This elevation is generally more effective than simply using additional pillows, which can create an awkward angle and potentially increase pressure on the stomach.

Benefits of Elevated Sleeping

• Reduces the likelihood of acid reflux episodes
• Minimizes esophageal acid exposure
• Improves overall sleep quality
• Can alleviate related symptoms such as coughing and sore throat

Addressing Specific Acid Reflux Sleep Complaints

Many individuals with acid reflux report specific sleep-related issues. Understanding these common complaints can help in developing targeted strategies for relief.

Waking Up with Heartburn

Nighttime heartburn is a frequent complaint among acid reflux sufferers, with up to 75% reporting at least one weekly episode. This discomfort can lead to sleep disruptions and daytime fatigue.

How can you prevent waking up with heartburn? In addition to sleeping on your left side and elevating your upper body, consider the following tips:

1. Avoid eating large meals close to bedtime
2. Steer clear of trigger foods in the evening
3. Wear loose-fitting pajamas to reduce pressure on the stomach
4. Use an over-the-counter antacid before bed if symptoms persist

Choking Sensations During Sleep

Some individuals with acid reflux report waking up with a choking sensation or feeling of acid in their throat. This can be a frightening experience and may lead to anxiety about sleep.

Is it possible to die from acid reflux choking? While extremely rare, severe cases of nighttime reflux can potentially lead to aspiration of stomach contents into the lungs, which can cause serious complications. However, for most individuals, the risk is minimal, and symptoms can be managed effectively with proper treatment and sleep positioning.

Lifestyle Modifications for Better Sleep with Acid Reflux

In addition to optimizing sleep position, several lifestyle changes can significantly improve sleep quality for those with acid reflux.

Dietary Adjustments

What you eat and when you eat it can have a substantial impact on nighttime acid reflux symptoms. Consider the following dietary modifications:

• Avoid trigger foods such as spicy, fatty, or acidic items
• Eat smaller, more frequent meals throughout the day
• Finish your last meal at least 3 hours before bedtime
• Limit alcohol and caffeine consumption, especially in the evening

Weight Management

Excess weight, particularly around the abdomen, can increase pressure on the stomach and exacerbate acid reflux symptoms. Maintaining a healthy weight through diet and exercise can help alleviate symptoms and improve overall sleep quality.

Stress Reduction

Stress and anxiety can worsen acid reflux symptoms and disrupt sleep patterns. Incorporating stress-reduction techniques into your daily routine can be beneficial:

• Practice relaxation exercises before bed
• Try meditation or deep breathing techniques
• Engage in regular physical activity (but not too close to bedtime)
• Consider cognitive-behavioral therapy for stress management

Natural Remedies for Nighttime Acid Reflux Relief

For those seeking alternatives to medication, several natural remedies may help alleviate nighttime acid reflux symptoms.

Ginger

Ginger has natural anti-inflammatory properties and can help soothe the digestive tract. Drinking ginger tea before bed or incorporating ginger into your evening meal may provide relief from acid reflux symptoms.

Aloe Vera

Aloe vera juice has been shown to have a soothing effect on the digestive system. Drinking a small amount of aloe vera juice before bed may help reduce acid reflux symptoms during the night.

Apple Cider Vinegar

While counterintuitive, some individuals find relief from acid reflux symptoms by consuming a small amount of apple cider vinegar diluted in water before meals or at bedtime. The theory is that this may help balance stomach acid levels, although scientific evidence is limited.

When to Seek Medical Attention for Nighttime Acid Reflux

While occasional nighttime acid reflux is common, persistent or severe symptoms may indicate a more serious condition requiring medical attention.

When should you consult a healthcare professional about nighttime acid reflux? Consider seeking medical advice if:

• Symptoms occur more than twice a week
• Nighttime reflux significantly impacts your sleep quality or daily life
• You experience difficulty swallowing or unexplained weight loss
• Over-the-counter remedies and lifestyle changes do not provide relief
• You develop new or worsening symptoms

A healthcare provider can assess your symptoms, perform necessary tests, and develop a comprehensive treatment plan tailored to your specific needs. This may include prescription medications, further lifestyle modifications, or in some cases, surgical interventions.

Advanced Treatment Options for Chronic Nighttime Acid Reflux

For individuals with severe or persistent nighttime acid reflux that does not respond to conservative measures, several advanced treatment options are available.

Proton Pump Inhibitors (PPIs)

Proton pump inhibitors are medications that reduce stomach acid production. They are often prescribed for long-term management of acid reflux symptoms, including nighttime reflux. While effective, long-term use of PPIs should be monitored by a healthcare professional due to potential side effects.

Surgical Interventions

In some cases, surgical procedures may be recommended to address chronic acid reflux. These can include:

• Fundoplication: A procedure that strengthens the lower esophageal sphincter
• LINX device: A ring of magnetic beads placed around the lower esophageal sphincter to prevent reflux
• Transoral incisionless fundoplication (TIF): A less invasive procedure that creates a valve between the stomach and esophagus

These surgical options can provide long-term relief for individuals with severe acid reflux, but they are typically considered only after other treatment methods have been exhausted.

Emerging Therapies

Research into new treatments for acid reflux is ongoing. Some emerging therapies include:

• Electrical stimulation of the lower esophageal sphincter
• Endoscopic therapies to strengthen the esophageal lining
• Novel medications targeting different aspects of reflux pathophysiology

As research progresses, these new approaches may offer additional options for managing nighttime acid reflux in the future.

By understanding the relationship between sleep positions and acid reflux, implementing lifestyle modifications, and exploring appropriate treatment options, individuals can significantly improve their sleep quality and overall well-being. Remember that effective management of nighttime acid reflux often requires a multifaceted approach, and working closely with healthcare professionals can help tailor strategies to individual needs and circumstances.

What Is the Best Sleeping Position If I Have Acid Reflux?

Sleeping with acid reflux can be downright impossible. Waking up in the middle of the night, choking on acid, and coughing violently are all symptoms of nighttime reflux. 

At times it can feel like you’ll never get a good sleep. However, some research suggests that your sleeping position could in fact influence your nighttime reflux. 

So, what is the best sleep position for acid reflux patients? Studies show that sleeping on your left side is better for acid reflux, whereas right-side sleeping is associated with longer esophageal acid exposure and high incidence of lower esophageal sphincter relaxation.

In this article, we discuss the science behind acid reflux and sleep, as well as the key tips to sleeping with your upper body elevated. 

1 What Is the Best Sleeping Position If I Have Acid Reflux?

1.1 Can Sleeping Positions Affect Acid Reflux?

1.1.1 Lying Down VS Sitting Up

1. 2 Common Complaints From Acid Reflux Patients

1.2.1 1. Heartburn worse when lying on left side

1.2.2 2. Waking up with heartburn in the middle of the night

1.2.3 3. Stomach acid coming out of nose while sleeping

1.3 Does Lying On Stomach Help Reflux?

1.4 What Side Do You Lie On For Acid Reflux?

1.5 Why Does Acid Reflux Improve When Lying Down

1.6 Choking On Acid Reflux While Sleeping: What To Do

1.6.1 What Causes It

1.6.2 Can You Die From Acid Reflux Choking?

1.7 Relieving Heartburn At Home: Tips For Better Sleep

1.7.1 1. Take Antacids

1.7.2 2. Eat Your Last Meal Earlier

1.7.3 3. Sleep with Extra Pillows

1.7.4 4. Wear Loose Clothing

1.7.5 5. Drink Ginger Tea

1.8 Get the Best Sleep of Your Life

Can Sleeping Positions Affect Acid Reflux?

Sufferers of acid reflux know how difficult it can be to try and get a good night’s sleep. Eating a high-fat diet, engaging in exercise before falling asleep, and being exposed to high levels of stress can result in wakefulness throughout the night. But it’s not just these things that could exacerbate reflux symptoms during bedtime.

What position you sleep in at night can also affect your reflux symptoms, studies suggest. As a patient, have you ever noticed that some nights tend to be better than others? That’s because some sleeping positions worsen acid reflux symptoms. 

Lying Down VS Sitting Up

When a person with acid reflux is lying down, the stomach contents don’t go down the stomach. In fact, it’s more likely for the stomach contents to travel back up the esophagus, leading to acid reflux symptoms.

Compare that to sitting or standing where gravity pulls the stomach acids and digested food contents away from your esophagus. 

When in doubt, make sure your head is elevated to help your body keep stomach contents right where they belong. 

Common Complaints From Acid Reflux Patients

The onslaught of reflux symptoms while sleeping vary from one patient to another. The bottomline stands: it’s difficult to get a good night’s sleep if you’re experiencing acid reflux at night.  

Here are just some of the top complaints when it comes to sleeping with acid reflux:

1. Heartburn worse when lying on left side

Sleeping on your side tends to worsen your heartburn symptoms, but you also notice that sleeping on a specific side makes it even worse. It turns out what side you’re lying on can in fact affect how your symptoms flare-up. 

A substantial amount of studies found that reflux patients tend to get worse heartburn when they’re lying on their right side. Although it’s unclear what mechanisms cause this, scientists believe that sleeping on the right side tends to trigger symptoms longer than lying on the left. 

Another study showed that lying on your right side prolongs the esophagus’ exposure to the acid. Doctors believe that lying on your right side is more likely to induce relaxation of the LES (lower esophageal sphincter), which is the muscle responsible for keeping stomach contents in, and preventing acid reflux. 

The general consensus among doctors and patients alike is that lying on your left side is more beneficial for heartburn patients. But if you’re one of the uncommon cases where reflux strikes worse when you’re lying on your left, consider experimenting with different sleeping positions to figure out which one will help soothe your symptoms.

If you realize that your symptoms don’t get better even with different sleeping positions, consider making dietary and lifestyle modifications to reap long-term benefits. 

2. Waking up with heartburn in the middle of the night

Falling asleep soundly can be a feat for reflux patients. Nighttime heartburn is a common occurrence for reflux patients, so much so that 75% of reflux patients report experiencing heartburn at night at least once a week. 

Patients often report waking up choking, coughing, or feeling a strong acid sensation at the back of their throat. This is also accompanied by a sharp chest pain that could easily be mistaken for a heart attack. 

Although doctors have yet to understand what separates daytime and nighttime heartburn, a study revealed the possible indicators of nighttime heartburn, which include:

• High BMI
• Consumption of sodas and carbonated drinks
• Daytime sleepiness
• Use of benzodiazepines (anti-anxiety medicine)
• Hypertension
• Asthma
• Snoring 

Patients with nighttime heartburn tend to be treated differently than those who only experience symptoms in the daytime. This is because nighttime reflux sufferers often have more complex and aggressive symptoms compared to daytime patients. 

At night, patients with heartburn symptoms aren’t just experiencing empty symptoms; they’re also experiencing acid reflux. Nighttime reflux tends to have a “longer clearance time”, which means the acid stays longer in the esophagus before receding again. Because of this, doctors suggest more intensive therapy methods in order to protect the esophagus from prolonged acid contact. 

Chronic esophageal exposure to acid may eventually lead to esophagitis and respiratory complications. Part of the GERD diagnosis involves distinguishing between nighttime and daytime symptoms in order to provide the right treatment plan. 

If you notice that your reflux is more inconvenient at night, let your doctor know. An upper endoscopy might be recommended to you in order to understand whether you’re experiencing sleep apnea (disruptive snoring and breathing) or gastroesophageal reflux disease (GERD).

3. Stomach acid coming out of nose while sleeping

When lying down, stomach acids can travel back up the esophagus and reach the sinuses. This can result in sinus infections, respiratory problems, and bad breath. 

Some patients also report stomach content coming out of their nose or mouth while sleeping. This symptom is observed in more severe cases of GERD and requires immediate medical intervention. When left untreated, this could expose your sinuses to the acid and bacteria in the regurgitated contents, leading to sinusitis. 

Taking antacids before falling asleep is a common remedy for GERD patients. If you don’t feel any relief after taking medication, your doctor might put you on PPIs (proton pump inhibitors) in order to reduce your stomach’s acid production. 

Stomach acids coming out of the nose is a severe type of symptom and would require more drastic measures in order to be alleviated. You might be asked to lose weight and change your eating habits for long-term relief.  

Does Lying On Stomach Help Reflux?

Finding a peaceful position to sleep in can be a tough one for acid reflux sufferers. Because lying down prevents gravity from doing its job keeping the food contents back down, patients feel anxious about falling asleep. Sleep deprivation becomes a problem among acid reflux sufferers in fear of choking or asphyxiation while asleep. 

Lying down alone can trigger acid reflux effects, but it gets worse with certain positions. Lying flat on your stomach produces the same result as lying on your back, if not worse. 

When you’re lying flat on the bed, your stomach and esophagus are on the same level, making it easy for stomach contents to find their way into the esophagus. When you’re standing up or sitting down, you’re allowing gravity to move these digested bits throughout the rest of your stomach. 

Lying on your stomach also tends to put pressure on your stomach. This alone could push the stomach contents to travel upwards and cause heartburn.  

The next time you want to lie on your stomach, make sure your head is elevated. Support your neck with a pillow and keep it a few inches higher than your stomach. Otherwise, you’re asking for a bad reflux episode.

What Side Do You Lie On For Acid Reflux?

Despite the general discomfort associated with acid reflux, sufferers aren’t entirely hopeless. Research shows that sleeping on the left side is the most beneficial position for sufferers. 

Compared to lying down on the right, which has been associated with higher instances of lower esophageal sphincter relaxations and longer esophageal acid exposure, lying on the left side is associated with an increase in sphincter pressure (making it less likely for the LES to malfunction and let in stomach contents) and higher esophageal pH (which neutralizes acid contents from the stomach). 

In order to optimize a patient’s sleeping, researchers underwent a study involving different sleeping positions. They found that patients who slept on the left side elevated experienced the less esophageal acid exposure in comparison to those sleeping on the right.  

Researchers also found that those sleeping on the left elevated position were able to spend more time sleeping in this position than others, making this not only a beneficial but viable sleeping position for reflux sufferers. 

At the end of the day, you should try whatever works best for your body. Some positions work well with patients, while others experience discomfort even after assuming a “good” sleep position. 

Why Does Acid Reflux Improve When Lying Down

Despite being a common gastrointestinal disorder, symptoms aren’t always shared among patients. The general consensus is that reflux gets worse after lying down, but it’s also possible to relieve your symptoms by doing so. 

If you’re a patient who feels relief after lying down, it’s possible that your reflux may be triggered by the following:

• You engaged in a stressful physical activity and lying down relaxes your body and your stomach
• You were emotionally stressed and lying down has physically relaxed  you
• You are in an elevated position, which helps keep the stomach contents from travelling back up the esophagus

As a result, your acid reflux symptoms are alleviated, not aggravated, by lying down. Knowing your triggers is the first step to living with GERD. 

Choking On Acid Reflux While Sleeping: What To Do

What Causes It 

If you’re suffering from chronic reflux, you might have awoken to coughing, vomiting, or general discomfort in your throat. 

When your stomach is regurgitating digested contents, the acid could linger in your throat and irritate the esophageal lining, which could trigger a cough. It’s also possible for acid to travel back up and reach the mouth, which causes choking. 

Patients who experience choking often report the following symptoms:

• Waking up in the middle of the night with a dry cough (cough without phlegm)
• Waking up nauseated and with the strong urge to vomit 
• Strong acid taste and smell after waking up 
• Sharp pain at the back of the throat 
• Difficulty breathing within the first few minutes of waking up

Can You Die From Acid Reflux Choking?

Sleep interruption is the worst thing that could happen to a patient suffering from acid reflux. Although inconvenient, there’s no need to worry about aspiration. Aspiration typically occurs as the result of inflammation or infection. 

Regurgitation on its own is not going to cause aspiration. Having a full stomach and vomiting afterwards are likelier causes of aspiration. Because the body operates on an automatic flight or fight instinct, patients will wake up during a reflux episode and cough as a response. Aspiration is uncommon in reflux patients because the body naturally wakes up and reacts to the presence of acid in the esophagus. 

Aspiration is more common in patients who have an impaired level of consciousness, such as when they’re sedated or drunk. 

Relieving Heartburn At Home: Tips For Better Sleep

1. Take Antacids

Take an antacid an hour before going to sleep to neutralize stomach acids. Note that not all antacids are accessible to pregnant women; avoid antacids with magnesium during your pregnancy. Tums, Maalox, and Rolaids are great antacid options for all patients.  

If you find that over-the-counter antacids don’t help with your nighttime reflux, ask your doctor for reflux prescriptions. Medicine such as proton pump inhibitors can block acid production altogether and allow your esophagus to heal in the process. 

2. Eat Your Last Meal Earlier

Eating meals too late at night is one of the main triggers of nighttime acid reflux. Some patients eat as early as 3 PM in order to prevent nighttime acid reflux. 

If you can’t avoid snacking at night, make sure to wait 1 to 2 hours before lying down to allow the food to travel through your digestive system. Taking a 30-minute walk would improve your chances of a good night’s sleep. 

3. Sleep with Extra Pillows

Sleeping on an inclined position on your left is the best position for acid reflux sufferers. Throw in a few pillows during bedtime to make yourself more comfortable. 

4. Wear Loose Clothing

Wearing tight pajamas can add pressure to your stomach, contributing to your acid reflux symptoms. Wear loose, comfy clothes before going to bed. 

5. Drink Ginger Tea

Ginger is a known home remedy to inflammation, and is also a great remedy for heartburn. Boil some ginger to make tea; this can help relieve nausea, allowing you to get a better quality of sleep. Skip the ginger ale though since it’s carbonated and will only make you more acidic. 

Get the Best Sleep of Your Life

Tired of not getting enough sleep? Living with GERD doesn’t have to be a nightmare. At Gastro Center NJ, we do everything we can to help make GERD a manageable part of your life.

Whether it’s sleeping on a foam memory pillow or prescribing a specific diet, we’re here to give you solutions that will improve your nighttime reflux, facilitating better sleep. 

Get in touch with us today to learn more about nighttime reflux and how the gastroenterologists of Gastro Center NJ can get you the best sleep of your life. 

How to Sleep with Acid Reflux? Positions, Causes, and Fixes

If you’ve ever laid down in bed only to be met with a burning sensation in your chest and a sour taste in your mouth, you know how uncomfortable acid reflux at night can be.  

But it’s more than just uncomfortable. Acid reflux — and all the symptoms that come with it like heartburn, nausea, and stomach pain — can make it hard to fall asleep and may wake you up during the night. 

To make matters worse, all this sleep disruption can make acid reflux symptoms more severe, causing a vicious cycle of more sleep loss and more reflux. 

Luckily, this cycle can be broken. Below, we’ll dive into what acid reflux is, what its more serious cousin GERD is, and what you can do to stop them, both when you’re already in bed and long term. 

‍

What is acid reflux?

What is GERD?

Why is acid reflux worse at night?

How does acid reflux affect sleep?

What position is best for acid reflux?

What to do when you have acid reflux at night?

How to stop acid reflux at night?

‍

What is Acid Reflux?

Acid reflux is the backflow of stomach acid into your esophagus. It causes a burning feeling in your chest, which is known as heartburn.  

Common symptoms of acid reflux include: 

• Heartburn
• A bad taste in your mouth 
• Bad breath 
• Bloating 
• Nausea 
• Stomach pain 
• Sore throat 

Acid reflux every now and again isn’t a problem, but if you get it regularly, it can disrupt your sleep, which disrupts everything else in life including your energy, focus, mood, and mental and physical health. 

‍

What is GERD?

Chronic acid reflux can be a sign of gastroesophageal reflux disease (GERD). This is when stomach acid or stomach contents regularly come up into your esophagus. 

It can be caused by a weak or damaged lower esophageal sphincter (LES), the band of muscle at the bottom of the esophagus that opens to allow food through, and then usually closes again to stop stomach acid washing up. 

GERD is a serious condition. It can cause health issues like ulcers, narrowing and inflammation of the esophagus, Barrett’s esophagus (abnormal growth of esophageal cells), and esophageal cancer.  

Symptoms of GERD include: 

• Heartburn
• Stomach or chest pain  
• A bad taste in your mouth 
• Trouble swallowing
• A chronic cough
• A hoarse voice 
• Regurgitation of stomach acid or food

‍

Why is Acid Reflux Worse at Night?

Acid reflux can hit at any time of day, but it’s often when you’re lying in bed when you feel it the most. There are a few reasons for this: 

• You’re laying down: When you’re horizontal, gravity no longer holds down your stomach acid and it can more easily flow up into your esophagus.
• You make more stomach acid and swallow less at night: Everything in your body runs on a circadian rhythm, a roughly 24-hour biological clock, including several elements of your digestive system. You secrete more stomach acid at night, produce less saliva, and swallow less at night. This means there’s more acid, but less saliva to neutralize it, meaning it’s more likely to wash up and cause heartburn.
• There are other circadian rhythms at play: As well as saliva, other parts of your digestive system’s circadian rhythms can line up to cause acid reflux at night. You have reduced esophageal peristalsis (the contraction of muscles that move food through your digestive system) and delayed gastric emptying (food stays in the stomach longer) at night. You can not only get increased acid reflux, the acid can spend longer in your esophagus, causing more damage.
• You’ve probably eaten a large meal: Large meals are more likely to cause acid reflux as when the stomach is full, it puts pressure on the sphincter muscle. And most of us eat our largest meal at dinner time.

‍

How Does Acid Reflux Affect Sleep?

One survey found out of those who experience heartburn weekly, 79% get it at night. Out of those, 75% say it affects their sleep. Here’s how it can affect your shut-eye: 

• It can keep you up: Heartburn, nausea, stomach pain, and bloating aren’t a recipe for a peaceful night’s sleep. You may find the pain or stress of these symptoms makes it hard to drift off. 
• It can wake you up: Acid reflux symptoms can also wake you up during the night. Either the pain wakes you up, or you wake up for another reason and reflux makes it hard to fall back to sleep.
• It may be linked to sleep disorders: Acid reflux and GERD have been linked to insomnia and sleep apnea. Sleep apnea happens when you temporarily stop breathing during the night. The sleep deprivation caused by sleep apnea may make the esophagus more sensitive. Or GERD may affect your ability to breathe normally, causing more apnea events. It’s thought that up to 75% of those with sleep apnea get reflux symptoms at night, but more research needs to be done to confirm the link. It may be that GERD and sleep apnea share the same risk factors, which include obesity, alcohol consumption, and smoking. 

The link between acid reflux or GERD and sleep problems can go both ways, too. Poor sleep can increase your odds of many gastrointestinal problems, including reflux.

As one study states: “The link between sleep problems and GERD might be bidirectional, i.e., sleep problems might influence the development or increase the severity of GERD, and GERD might influence the development or increase the severity of sleep problems.”

‍

What’s the Best Position for Acid Reflux?

Laying in bed with reflux? Here are the sleep positions to try to get some relief. 

Sleep on Your Left

Sleeping on your left may reduce acid reflux as your stomach will be lower than your esophagus, making it harder for stomach acid to travel up into it. 

Image credit: Gastrointestinal Society

A 2022 study found sleeping on the left helped people have more reflux-free nights. And sleeping on your right side has been shown to make reflux symptoms worse.

If you find side sleeping uncomfortable, try placing a pillow between your knees to keep your spine aligned.  

We’ve covered the best side to sleep on for digestion here and the best side to sleep on in general here.

Elevate Your Head and Upper Body

If you can’t sleep on your left or find it doesn’t help, try elevating your head and upper body. This will make it harder for stomach acid to flow up into your esophagus as gravity comes into play.

One small study found when participants slept with the head of their bed elevated by almost 8 inches for six nights, they had less heartburn and it helped improve sleep disturbances in 65% of participants. 

Want to try this for yourself? The study states elevation needs to be at least 6 to 8 inches, and raising the bed frame is better than stacking up pillows, as this can put pressure on the stomach and make reflux worse.

You can lift the head of your bed by stacking a bed raiser under the bed posts, laying on a special wedge pillow, or using a mattress lifter. These tools make sure your head and upper body are lifted, not just your head.

‍

What to Do When You Have Acid Reflux at Night?

Got a burning chest at bedtime or woken up in the night with a reflux episode? Here’s what to do to help you get the sleep you need. 

1. Change Sleep Position 

If acid reflux hits and you’re already in bed, try changing position. As we explained above, you may get fewer acid reflux symptoms if you lay on your left or if you elevate your head and upper torso. 

Acid reflux symptoms are more common when sleeping on your back and can happen within one minute of changing positions. If you wake up on your back, roll back onto your side and consider positional therapy devices that stop you from sleeping on your back like special pillows and vests. 

2. Change into Looser Clothing 

If your pajamas are tight, they can put added pressure on your stomach and make symptoms worse.

Change into looser clothing to see if it helps — and opt for loose-fitting pajamas going forward.   

3.

Do a Sleep Reset 

If you’ve been lying awake in bed for 20 minutes, get out of bed and do a relaxing activity until you feel sleepy again. This will stop your brain from making an association between your bed and wakefulness. 

Try reading, journaling, doing yoga, or listening to music or a podcast. Make sure to keep the lights as low as possible to stop them from waking you up, and try to avoid looking at the time or worrying about lost sleep. This can cause anxiety — a surefire way to stop you from falling asleep.  

‍

How to Stop Acid Reflux at Night?

The best way to sleep with acid reflux is to stop it from happening in the first place. The good news is many of the ways to do this are simple lifestyle changes and home remedies.

Here’s what you can do to reduce your odds of reflux tonight, and every night going forward. 

1. Give Yourself More Time After Dinner and Before Bed  

The RISE app can tell you when to have your last meal each day.

If you’re used to eating dinner then laying down on the sofa or heading straight to bed, it may be time to rethink your evenings. Try giving your body more time after your evening meal to digest everything before laying down. 

One study found GERD symptoms were found in almost 46% of those who went to bed an hour after dinner, about 42% in those at two hours, 31% for three hours, and 30% for four hours. So, the longer you have between dinner and bed, the less likely you are to get reflux. 

As a general rule, aim to be done with dinner two to three hours before bed and avoid late-night snacking to reduce the likelihood of digestive issues keeping you up.

RISE can remind you when to finish up dinner each day. And we’ve covered more on what time you should stop eating before bed here.

RISE users on iOS 1.202 and above can click here to set up their avoid late meals reminder.

2. Limit Trigger Foods and Drinks 

Dietary changes can help prevent and reduce acid reflux. Take a look at your diet and see if you consume these common trigger foods and drinks. If you do, try to cut down or consider cutting them out altogether. 

Foods and drinks that can trigger heartburn include:

• Coffee 
• Alcohol  
• Spicy foods 
• Fatty foods 
• Acidic foods 
• Peppermint
• Chocolate 
• Carbonated soft drinks 

If you’re not sure what your triggers are, keep a food diary to track your diet and symptoms to see if there’s a pattern.

Beyond acid reflux, the foods you eat can affect your sleep in other ways. We’ve covered the best foods for sleep here. 

And while you’re limiting or cutting out trigger foods, try eating smaller meals and eating more frequently, which can help to prevent acid reflux. 

3. Go for an After-Dinner Walk 

Make walking after dinner a habit. It can help digestion and a regular after-dinner walk has been linked to fewer GERD symptoms. Plus, walking after dinner stops you from laying down or falling asleep, which may trigger reflux.

Exercise in general can also help you keep your weight in check and your stress levels low — two risk factors for GERD.

Opt for a gentle walk over a vigorous run as high-intensity exercise can make reflux symptoms worse. And be sure not to do intense exercise within an hour of bedtime as this can keep you awake. 

We’ve covered more on the best time to work out here.

4. Lower Your Sleep Debt

The RISE app can tell you how much sleep debt you have.

Sleep debt is the running total of how much sleep you owe your body. It’s measured against your sleep need, the genetically determined amount of sleep you need. 

When you don’t meet your sleep need — either because of acid reflux or other reasons like working late or a crying newborn — your sleep debt starts racking up. And this can lead to a whole host of health conditions, including acid reflux and GERD. 

A lack of sleep can make your esophagus more sensitive and make GERD symptoms more severe. It can also worsen symptoms of irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) if you suffer from those, too.  

Plus, when you’re sleep deprived, you feel pain more acutely, meaning heartburn may be harder to deal with. 

Finally, sleep loss ups your odds of obesity (a risk factor for GERD), and it can be harder to resist triggers like fatty foods, chocolate, and large meals when you’re sleepy. 

The good news about sleep debt is you can lower it. Here’s how: 

• Take naps: If acid reflux keeps you up at night, try catching up on sleep during the day. Check RISE for the best time to take a nap. 
• Go to bed a little earlier. 
• Sleep in a little later: Keep this to an hour or two to avoid messing up your circadian rhythm (more on that soon). 
• Improve your sleep hygiene: Focus on sleep hygiene habits that can help you fall asleep faster and wake up less often, helping you get more sleep overall. More on what to do soon.

The RISE app can work out how much sleep debt you have and keep track of it as you pay it back. We recommend keeping your sleep debt below five hours to maximize your energy levels and overall health and well-being.

RISE users on iOS 1.202 and above can click here to view their sleep debt.

5. Live in Sync with Your Circadian Rhythm 

As we briefly covered above, your circadian rhythm is your body’s roughly 24-hour biological clock. You have one master clock in your brain and what’s known as peripheral clocks in almost every tissue and organ system, including in your digestive system.

Living in sync with these circadian rhythms helps improve everything from your energy levels to your gut health and overall digestive health. And it may reduce reflux symptoms, too. 

For example, those who work night shifts are more likely to develop GERD than day-shift workers. It’s not entirely clear why, but this could be due to lowered melatonin production in those with circadian misalignment. This could cause more stomach acid production and esophageal sphincter dysfunction. Another theory is that being out of sync may promote esophageal damage as your body can’t create and repair cells as well. 

Even if you don’t work night shifts, you may be out of sync with your circadian rhythms if you sleep and eat at odd times. 

You can live in sync by: 

• Keeping a consistent sleep pattern: Find a sleep schedule that works for you and stick to it, even on your days off. This will keep the master clock in your brain in check, which communicates with all your peripheral clocks, keeping them more in line, too.  
• Eating meals at roughly the same times and during the day: Eating can change the timing of your circadian rhythm and throw off your peripheral clocks. Avoid eating at night and eat at roughly the same times each day. 
• Going to bed during your Melatonin Window: This is what we call the roughly one-hour window of time when your body’s rate of melatonin production is at its highest. As melatonin primes your body for sleep, going to bed during this window can help you fall and stay asleep.

The RISE app predicts your circadian rhythm each day and shows you when your body naturally wants to wake up, wind down for bed, and go to sleep. You can then sync up your sleep and meal times to it. 

RISE users on iOS 1.202 and above can click here to see their circadian rhythm on the Energy screen.

6. Improve Your Sleep Hygiene 

Sleep hygiene is the name for the set of daily habits you can do to help you fall and stay asleep at night. 

You may find you wake up during the night, and this is when you feel heartburn. Or it may take you a long time to fall asleep because of reflux symptoms, and ill-timed caffeine each day is adding to the problem.

When your sleep hygiene is on point, you’re more likely to have an easier time falling asleep, and minor reflux will be less likely to wake you up.

Here’s how to improve your sleep hygiene: 

• Get bright light first thing: This will reset your circadian rhythm, helping you feel sleepy come bedtime. Get at least 10 minutes of light as soon as possible after waking up. And aim for 15 to 20 minutes if it’s overcast or you’re getting light through a window. 
• Avoid light close to bedtime: Bright light suppresses melatonin. About 90 minutes before bed, dim the lights and put on blue-light blocking glasses to stop light from keeping you up. 
• Avoid caffeine, large meals, intense exercise, and alcohol too late in the day: All four can keep you up or wake you up during the night, and all four can trigger acid reflux, too. 
• Keep your bedroom dark, cool, and quiet: Set your thermostat to 65 to 68 degrees Fahrenheit, invest in blackout curtains, and wear earplugs and an eye mask to make sure nothing in your bedroom keeps or wakes you up. 

To stay on top of sleep hygiene, the RISE app can guide you through 20+ habits each day and tell you the ideal time to do each one to make them more effective.

RISE users on iOS 1. 202 and above can click here to set up their 20+ in-app habit notifications.

7. Lower Stress 

The RISE app can guide you through relaxation techniques.

Stress can cause and aggravate acid reflux. It can also keep you up at night, which means sleep debt from stress can add to the worsening of your reflux symptoms. 

Lower stress by: 

• Doing a calming bedtime routine: Lower stress before bed by doing a relaxing activity in the run-up to bedtime. Try reading, listening to music, or practicing yoga. 
• Doing a brain dump: Write down what you’re worrying about or write a to-do list for tomorrow (research shows this can help you fall asleep faster compared to journaling about other things before bed). RISE’s brain dump feature will remind you of everything you wrote down the next day. 
• Trying relaxation techniques: Relaxation techniques like progressive muscle relaxation and diaphragmatic breathing can calm your mind and body. RISE can walk you through science-backed relaxation techniques for better sleep. 
• Asking for help: If stress is seriously impacting your life, speak to friends and family, ask for help at work or with childcare or caretaking responsibilities, or reach out to a therapist or doctor. 

Anxious thoughts keeping you awake? You can learn more about how to sleep with anxiety here.

RISE users on iOS 1.202 and above can click here to go right to their relaxation audio guide homepage and get started.

RISE users on iOS 1.202 and above can click here to set up their Brain Dump Habit notification

8. Lose Weight 

GERD has been linked to being overweight and obese. In fact, the prevalence of GERD increases as body mass index (BMI) increases. Excess weight may put pressure on your stomach and esophageal sphincter. 

If you’re overweight, losing weight can help reduce your acid reflux, and it may even cure it altogether. Research has found weight loss over a six-month period can help 81% of people reduce their GERD symptoms and 65% eliminate reflux symptoms entirely. 

Being overweight also ups your odds of sleep apnea and losing weight can reduce symptoms.

We’ve covered the best way to lose weight here and the best sleeping positions to lose weight here.

9. Quit Smoking

If you’re a smoker, consider quitting. Your esophagus will thank you. 

Research shows quitting smoking can reduce how often those with GERD experience acid reflux.  

10. Consider Medication 

You can buy over-the-counter medications (OTC medications) to get some heartburn relief. 

OTC medications include antacids, which neutralize stomach acid, h3 blockers like Pepcid AC and proton pump inhibitors (PPIs), which reduce the amount of stomach acid you make. You can also get prescription-strength versions of these medications.

Research shows PPIs can reduce nighttime heartburn symptoms in up to 53% of people and help to reduce sleep disturbances.   

Speak to your healthcare provider if you regularly get acid reflux and think PPIs would help. 

If you take medication for other health issues, talk to a doctor about whether these could be causing or making acid reflux worse. Drugs like blood pressure meds, NSAIDs, antidepressants, and asthma medications may do this.

Heads-up: When considering medication, avoid sleep aids. While it’s tempting to reach for a sleep aid when you can’t sleep, research shows benzodiazepine usage is a predictor of heartburn during sleep. 

11. Get Treatment for Sleep Apnea 

As we mentioned above, many people have both obstructive sleep apnea and GERD, and the two conditions may be linked. 

Sleep apnea treatments have been shown to not only help the sleep disorder, they can reduce reflux symptoms, too. 

Sleeping with a continuous positive airway pressure (CPAP) machine is a common sleep apnea treatment. The machine pushes air into your airways to keep them open at night. It’s been shown to reduce sleep apnea episodes, daytime sleepiness, and nighttime acid reflux. 

We’ve covered how to know if you have sleep apnea here and how to get rid of sleep apnea here.

As high sleep debt can make acid reflux worse, you should also seek treatment for other sleep disorders you may have that are causing sleep deprivation.

12. Speak to a Doctor 

If acid reflux is a common occurrence for you or it’s seriously impacting your sleep and daily life, get medical advice. A doctor can prescribe medication or supplements, recommend the best heartburn treatment options for you, and surgery may also be recommended in rare cases. 

Heads-up: GERD and acid reflux are common in pregnant people, but the symptoms may clear up when the baby arrives. In the meantime, we’ve covered how to get sleep when pregnant and how to get energy when pregnant here. 

Stop Acid Reflux Before Bedtime 

If you’re laying in bed with acid reflux, try sleeping on your left or with your head elevated. To stop symptoms before they start, aim to finish dinner two to three hours before bed, limit trigger foods, and go for a post-dinner walk. 

Lowering your sleep debt and living in sync with your circadian rhythm can also help. The RISE app can tell you how much sleep debt you have and it can predict your circadian rhythm each day to help you sync up to it. 

RISE can also remind you when to do 20+ Acid reflux is worse at night because when you’re horizontal, it’s easier for stomach acid to travel up into your esophagus. You also produce more stomach acid and less saliva (to neutralize the stomach acid), and have fewer esophageal movements (to clear the acid) at night.sleep hygiene habits to make it easier to get a good night’s sleep, even when you have acid reflux. 

Lifestyle advice for gastroesophageal reflux

September 6, 2021

Repina Nadezhda Arkadievna

Gastroenterology

Have you been diagnosed with GERD (gastroesophageal reflux)?
Gastroesophageal reflux is manifested by a number of unpleasant symptoms that significantly reduce the quality of life. Heartburn, burning and pain behind the sternum, difficulty in swallowing food… However, timely diagnosis, treatment and lifestyle changes can neutralize these manifestations.

So, here are some recommendations for lifestyle modification in gastroesophageal reflux: reflux symptoms occur at night).

Foods consumed must be neither too hot nor too cold. To determine the temperature of drinks, use the “bowl” rule: if you can hold the cup by the walls, and not by the handle, when drinking, then everything is fine – the temperature of the drink is not high.

Dietary advice for gastroesophageal reflux

Certain types of foods can exacerbate the symptoms of gastroesophageal reflux. To identify foods that aggravate symptoms (heartburn, belching), it is you who need to keep a food diary.

The most common triggers to avoid from the diet:

• Coffee and other caffeinated drinks (black tea, hot chocolate) – help to relax the lower esophageal sphincter.
• Citrus fruits (oranges, limes, lemons, grapefruits, tangerines, pomelo), as well as juices from them – contain a large amount of acids.
• Tomatoes and tomato-containing sauces, dishes (eg lecho) have a high level of acidity.
• Carbonated drinks (cola, kvass, lemonade, energy drinks, carbonated mineral water, etc.) create increased pressure in the stomach cavity, due to which reflux symptoms increase.
• Chocolate, due to the content of a caffeine-like substance – methylxanthine, helps to relax the lower esophageal sphincter.
• Peppermint, onion and garlic help relax the lower esophageal sphincter.
• When chewing gum, a large amount of air is swallowed, and the presence of sweeteners in its composition provokes belching and bloating.
• Slowdown of evacuation from the stomach is provoked by an abundance of fatty foods, which include 20% cream, butter, margarine, cakes with cream filling, fatty fish – herring, mackerel, trout; fatty meat: pork, beef
• Spicy (mustard, pickles, pickles, vinegar) and fried foods have a direct damaging effect on the mucosa of the esophagus.

Follow these rules and the unpleasant manifestations of the disease will recede. And if the correction of lifestyle and nutrition does not bring relief, this is a reason to turn to a gastroenterologist.

The memo was prepared by gastroenterologist Repina Nadezhda Arkadyevna.

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How is gastric reflux treated? – Obezite ve Diyabet Cerrahisi

İçindekiler

• Treatment of gastric reflux
• Medical treatment of gastric reflux
• Effect of drug treatment on reflux
• Surgical treatment of gastric reflux
• After reflux surgery

Treatment for gastric reflux

Diet and lifestyle changes
First, diet and some lifestyle changes can improve acid reflux. Treatments for gastric reflux are as follows:

• If you smoke, stop smoking
• Avoid foods and drinks that cause acid reflux.
• Do not eat 2-3 hours before bedtime
• lose weight if you are overweight or obese
• sleep with high pillow
• Eat less food by increasing the number of meals

Medical treatment of gastric reflux

Medical therapy is considered in patients whose complaints persist despite changes in diet and lifestyle. A group of drugs called proton pump inhibitors (PPIs) are effective in reducing stomach acid, relieving symptoms. (Lansor, Nexium and similar drugs). Most, if not all, reflux patients feel very comfortable while taking these medications. In fact, this is a typical situation of a real patient with reflux. The patient feels comfortable while taking the medication. When he stops taking the medicine, after 3-5 days, the burning starts again.

These drugs do not address the underlying cause of reflux disease. Just because they effectively suppress stomach acid, acid leakage back into the esophagus is reduced and complaints disappear. These drugs can be used for many years, but there are some studies showing that side effects (dementia) may occur with long-term use.

Effect of drug treatment on reflux

Drugs show benefits through two types of effects:
1. They prevent acid secretion by applying a patch to the inside of the esophagus.
2. Reduces the secretion of gastric juice or reduces the acidity of the secreted acid.

Drug therapy fails to eliminate acid leakage into the esophagus.
The expectation of medication should not be to eliminate reflux, but to delay it. If the patient wants a permanent solution, he should try the surgical method of treatment.

Surgical treatment of gastric reflux

In some cases of gastro-reflux disease, surgical treatment comes to the fore. These;

• If the main reason for your complaint is a large hernia
• If your complaints do not disappear completely despite taking medication and you are sure that you have reflux
• If you are a person who is not on medication or does not want to take medication for a long time
• If a barretto esophagus is found in the lower esophagus due to acid reflux for many years

Barrett’s esophagus is a change in the epithelial lining of the lower esophagus as a result of prolonged exposure to gastric juice. (Barrett’s Metaplasia) Actually, the body goes to such a change to protect itself from the acid. However, the long-term risk of esophageal cancer has been found to be slightly higher in those who develop Barrett’s esophagus than in healthy individuals.

Today, laparoscopic antireflux surgery (closed surgery) is the gold standard for the surgical treatment of reflux disease. Nissen fundiplication (full wrap) and Tupe fundiplication (half wrap) are the two most common surgical techniques. Many studies have shown that both surgical methods have the same degree of success in preventing acid reflux. Postoperative bloating (gas bloating) is more common with the Nissen method (full wrap). This is less common in the toupet method.

In our own practice, we mainly use the semi-wrap method (Toupet fundiplication), which has the same effectiveness but less side effects of edema.

After reflux surgery

After reflux surgery, the patient does not experience any pain.