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How to sleep with heartburn: What’s the best sleep position to combat heartburn?

by alexxlab

Acid Reflux at Night: Best Sleeping Positions & Treatments for GERD

When you have to sleep with acid reflux, every night can be a challenge. The burning and discomfort not only makes falling asleep harder but nearly guarantees you’ll be waking up during the night making a good night of sleep difficult.

Acid reflux and GERD are common conditions among adults in the United States— in fact, an estimated 20 percent of American adults suffer from GERD. To make matters worse, most people with acid reflux or GERD experience those symptoms at night, either during sleep or while trying to fall asleep.

Thankfully, there are ways to get a good night’s sleep even if you’re experiencing nighttime symptoms of acid reflux or GERD. But first, let’s take a look at these two conditions, and how exactly they can ruin your sleep.

What are Acid Reflux and GERD?

Acid reflux, also known as heartburn, is when stomach acid flows out of the stomach and into the esophagus. It can be caused by a number of factors, including:

  • Being overweight or obese
  • Pregnancy
  • Hiatal Hernias
  • Certain medications, including NSAIDs or benzodiazepines
  • Improper Diet

A muscle called the lower esophageal sphincter creates a portal between your stomach and your esophagus. When functioning properly this muscle only opens to allow food into the stomach to digest— however, reflux symptoms occur when this sphincter doesn’t function properly. This dysfunction allows stomach acid or stomach contents to flow upwards and back into the esophagus. When this occurs, you experience the symptoms of heartburn or acid indigestion, such as an acidic taste in your mouth, discomfort in your stomach and throat, and possibly some regurgitation of stomach contents.

It’s actually normal to experience acid reflux or heartburn every so often. However, if it happens too frequently, it’s an indicator that you may have gastroesophageal reflux disease. Left untreated, GERD can result in some very serious health issues including erosion of the esophageal lining, conditions like Barrett’s Esophagus, or even esophageal cancer.

How do Acid Reflux and GERD Affect Sleep?

As mentioned above, most people with acid reflux experience their symptoms at night. The uncomfortable symptoms of nighttime heartburn can make getting proper sleep difficult, but the way we sleep can also exacerbate those symptoms.

There are a few reasons acid reflux occurs at night:

  • It’s much easier for reflux to occur while lying in bed, because gravity is no longer keeping everything in your stomach down.
  • Saliva can neutralize stomach acid, but you produce less at night during deep sleep. This negates the potential benefits your saliva can have if you have reflux.
  • Similarly, decreased swallowing during sleep does not provide adequate pressure to keep acid in the stomach, also contributing to reflux.

There is also a connection between GERD and sleep apnea. In fact, around 60 percent of obstructive sleep apnea (OSA) patients also have GERD. While one does not cause the other, they can actually be secondary conditions for each other; Obstructive sleep apnea symptoms can be exacerbated by GERD, and GERD symptoms can be exacerbated by OSA. People who have obstructive sleep apnea often experience more severe symptoms of GERD as well.

For example, a vacuum effect is created around the stomach and throat during an apneic episode, which draws stomach acid out of the stomach and into the esophagus and throat. The chest’s negative pressure brings air in through a constricted opening due to the apnea. This creates a positive pressure in the stomach, which results in reflux, with stomach acid or contents shooting upwards from the stomach and into your throat.

If you have obstructive sleep apnea and GERD, then treatment for one could actually be an effective treatment for the other. CPAP, or continuous positive airway pressure, has been shown to be effective in treating both nighttime heartburn and obstructive sleep apnea.

One study showed that OSA patients experiencing nighttime GERD symptoms had their heartburn scores drop by sixty-two percent when they used CPAP therapy consistently. The study also found that consistent CPAP therapy over time reduced heartburn scores further.

CPAP therapy is one of the most popular and effective treatments available for obstructive sleep apnea. Thankfully, there are other ways to treat your nighttime acid reflux symptoms if you aren’t experiencing sleep apnea.

Sleep Solutions for Acid Reflux and GERD

Positive lifestyle changes can make a huge difference in your nighttime acid reflux symptoms. If you’re looking for relief, these are a great place to start!

1. Change your Sleep Position

I mentioned above how nighttime GERD symptoms can be exacerbated by how we sleep. However, you can reduce or even potentially eliminate those symptoms by changing your sleep position.

Laying flat while you sleep can worsen your symptoms. Laying flat on your back makes it easier for reflux to occur, which can even cause you to wake up coughing or choking on your reflux.

Instead, I recommend sleeping on your left side. This position is most beneficial to alleviating GERD symptoms because gravity will position your stomach below your esophagus, making it harder for reflux to rise into your throat. Even if reflux occurs, gravity can return the reflux to your stomach faster than if you were sleeping on your back or right side.

Similarly, it’s also the most beneficial sleeping position for pregnant women, whether or not they are experiencing nocturnal symptoms of acid reflux.

Sleeping on your right side does not offer the same benefits though. Sleeping on your right side often produces liquid reflux, while sleeping on your left side may produce more gas if you’re still experiencing symptoms. While potentially annoying, however, the latter is much easier to tolerate than the former. So remember this if you’re planning on adjusting your sleep position: Right is wrong.

2. Sleep on an Incline

If you prefer to sleep on your back, elevating your upper body can also relieve or prevent nighttime reflux. Similar to sleeping on your left side, this makes it so your stomach is lower than your esophagus and gravity will make it more difficult for reflux to rise into your esophagus.

However, propping yourself up with pillows won’t be effective, as this only elevates your head and not your upper body. Instead, try using a wedge pillow that is thickest at the top. This will keep your upper body on an appropriate incline to prevent reflux and alleviate discomfort.

3. Watch your Diet

If there are foods that trigger your heartburn, be sure to avoid these before bed. Some of these may include:

  • Spicy food
  • Caffeine and alcohol
  • Acidic foods, like tomatoes or citrus
  • Greasy foods
  • Onions or Garlic

Also, make sure to stop eating 2-3 hours before you lay down— this reduces stomach acid and allows your stomach to partially empty before bed. Similarly, avoiding large meals before bed can also help with acid reflux symptoms.

Weight loss can also help prevent reflux. Excess weight puts more pressure on the stomach and the diaphragm, which contributes to acid reflux and GERD. Losing that extra weight can remove that pressure and help relieve your symptoms.

When to Seek Additional Help

Often sleep disturbances can be alleviated or prevented with some simple changes. In cases where lifestyle changes don’t help your nighttime symptoms though, it’s important to consult your doctor about further treatment options. For severe cases of acid reflux, treatment options can range from taking medication to even receiving special surgery.

If you find that you’re struggling to sleep even beyond your acid reflux symptoms, it’s possible an undiagnosed sleep disorder is to blame. If you think disorders like obstructive sleep apnea or insomnia are contributing to your poor sleep quality, be sure to consult your doctor or a sleep expert. They can provide a diagnosis and help you find the treatment options that work best for you.

To find accredited sleep experts in your area, check out this tool provided by the American Academy of Sleep Medicine.

Acid reflux symptoms can really ruin your night and make it impossible to get a good night’s sleep. Thankfully though, there are easy and holistic lifestyle changes you can make to ensure reflux is a thing of the past. Give them a try and see how you feel!

About The Author

Michael Breus, Ph.D is a Diplomate of the American Board of Sleep Medicine and a Fellow of The American Academy of Sleep Medicine and one of only 168 psychologists to pass the Sleep Medical Specialty Board without going to medical school. He holds a BA in Psychology from Skidmore College, and PhD in Clinical Psychology from The University of Georgia. Dr. Breus has been in private practice as a sleep doctor for nearly 25 years.

Dr. Breus is a sought after lecturer and his knowledge is shared daily in major national media worldwide including Today, Dr. Oz, Oprah, and for fourteen years as the sleep expert on WebMD. Dr. Breus is also the bestselling author of The Power of When, The Sleep Doctor’s Diet Plan, Good Night!, and Energize!

  • Position: Combination Sleeper
  • Temperature: Hot Sleeper
  • Chronotype: Wolf

How to Relieve Heartburn at Night

Waking up with heartburn in the middle of the night? You’re not alone. Studies show about 20 percent of adults in the U.S. suffer from heartburn at least once a week, and among those, 75 percent experience heartburn at night1,2. The discomfort of having heartburn at night often results in problems falling or staying asleep. Learn about the possible causes and treatment options for heartburn.

What Causes Heartburn at Night?

During the day, when you’re more likely to be sitting or standing, your stomach acid tends to stay in your stomach where it belongs. It’s more difficult for the acid to travel upward into your esophagus (the tube that links your mouth to your stomach)3.

When you lie down at night just after eating, on the other hand, your stomach acid doesn’t have to fight gravity to travel back into your esophagus or throat. This phenomenon, called acid reflux, can leave you with burning heartburn pains or a feeling like you’ve regurgitated food3. Lying down too soon after eating dinner or late night snacks can trigger or worsen heartburn5.

Why Heartburn May Be Worse at Night?

Heartburn may be worse at night because certain heartburn-causing factors occur more often in the evening. For example, alcohol can trigger heartburn, and people more often drink in the evenings than other times of day5. Studies have found that heartburn can also be triggered by certain foods, including fatty, greasy, salty, or acidic foods5,6. You may also realize that other items such as chocolate, spicy food, or carbonated beverages worsen your heartburn symptoms5,6. Consuming these foods in the evening may be a cause of heartburn at night.

Tight-fitting clothing may also worsen heartburn by putting extra pressure on the abdomen, which can force stomach acid into your esophagus4. You may want to change your sleepwear if you tend to wear pajamas or undergarments that are form-fitting, snug, or contain a tight elastic waistband.

Certain medications, including sedatives, can also cause nighttime heartburn4. If you are taking sleep medications that are triggering heartburn or making your heartburn worse, talk to your doctor.

How to Treat Nighttime Heartburn Symptoms

If you tend to get heartburn at night, there’s a good chance you’re experiencing evening discomfort and may have trouble getting to sleep and staying asleep because of that discomfort7. Fortunately, there are several ways you can help prevent or stop acid reflux at night.

Eat a Smaller, Earlier Dinner

Having food in your stomach when you lie down for bed increases your chances of experiencing heartburn symptoms at night.

Eating several smaller meals rather than a couple of large meals can help control heartburn throughout the day and night. In particular, decreasing the size of your dinner may lead to less heartburn in the evening and nighttime hours5.

You can also help prevent heartburn at night by having dinner at least three to four hours before you plan to go bed. This gives your stomach time to completely empty before you lie down to sleep4.

Elevate Your Head When You Lie Down

You can keep gravity working in your favor while you sleep. Propping up your head and neck when you lie down helps keep more of your stomach acid from traveling up your esophagus, helping to you to get rid of or reduce acid reflux at night6.

Use extra pillows under your upper body to lift your head so that it lies 6 to 8 inches higher than your abdomen. Alternatively, get a wedge pillow that naturally props up your head. You can also try to elevate your bed with bricks so that your head is slightly higher than your feet6.

Improve Your Sleep Hygiene

If you suffer from occasional sleeplessness in addition to nighttime heartburn, try correcting any problems with your sleep hygiene — the set of behaviors and habits that helps you get higher-quality sleep. Try staying away from screens in the evenings, blocking light from your bedroom, keeping your sleeping environment cool and quiet, and going to sleep and waking up at the same times each day5,8.

    If you have occasional heartburn symptoms, you can also try over-the-counter (OTC) medications such as PEPCID®. PEPCID® is a histamine-2 (h3) blocker, with the active ingredient famotidine, which can help relieve heartburn by reducing the amount of acid in the stomach. It works fast and will help to control acid all night*. If you do not have OTC heartburn medications readily available, learn more about easy ways to manage with at-home heartburn remedies.

    When Should I See a Doctor?

    Occasional heartburn is common and can often be self-treated with OTC medications and lifestyle changes. However, frequent heartburn at night may be a sign of a more serious disease, so talk to your doctor if your symptoms persist.

    If your nighttime heartburn symptoms worsen, or occur two or more times a week, it may be a sign of gastroesophageal reflux disease (GERD). While GERD is not life threatening, you should talk to a doctor if your symptoms persist for more than a couple of weeks. Some individuals are able to manage the discomfort of GERD on their own, but in some cases stronger medications or surgery may be needed to ease symptoms.

    Learn how to prevent occasional heartburn before it starts with PEPCID® and use diet and lifestyle tips to help manage heartburn in the long term.

    *Based on 12-hour acid control studies during the night. Acid control does not imply symptom relief.

    References

    • 1Definition and Facts for GER & GERD. National Institute of Diabetes and Digestive and Kidney Diseases. Reviewed July 2020. Accessed October 17, 2022.
    • 2Orr WC. Management of nighttime gastroesophageal reflux disease. Gastroenterol Hepatol (N Y). 2007;3(8):605-606.
    • 3Why Does Your Heartburn Always Seem Worse at Night? Cleveland Clinic. Published September 9, 2020. Accessed October 17, 2020.
    • 4Heartburn. MedlinePlus. Reviewed January 14, 2021. Accessed October 17, 2022.
    • 5Sethi S, Richter JE. Diet and gastroesophageal reflux disease: role in pathogenesis and management. Curr Opin Gastroenterol. 2017;33(2):107-111.
    • 6Dağlı Ü, Kalkan İH. The role of lifestyle changes in gastroesophageal reflux diseases treatment. Turk J Gastroenterol. 2017;28(Suppl 1):S33-S37.
    • 7Fass R. (2009). Functional heartburn: what it is and how to treat it. Gastrointestinal endoscopy clinics of North America, 19(1), 23–v.
    • 8Tips for Better Sleep. Centers for Disease Control and Prevention. Reviewed September 13, 2022. Accessed October 17, 2020.

    How are heartburn and sleep position related, on which side is it better to sleep with gastroesophageal reflux?

    31 August 2020

    13 April 2023

    3 minutes

    76179

    ProWellness

    Table of contents

    • Symptoms:
    • Causes:
    • Which side do you sleep on?
    • Left side
    • Right side
    • Back

    Disclaimer

    Please note that all information posted on the site
    Prowellness is provided for informational purposes only and is not a personal program, a direct recommendation for action, or medical advice. Do not use these materials for diagnosis, treatment, or any medical procedure. Consult your physician before using any technique or using any product. This site is not a specialized medical portal and does not replace the professional advice of a specialist. The Site Owner is not liable to any party who has suffered indirect or direct damage as a result of misuse of materials posted on this resource.

    How are heartburn and sleep position related, on which side is it better to sleep with gastroesophageal reflux?

    Heartburn is a burning sensation behind the breastbone that occurs due to the reflux of stomach contents back into the esophagus. It usually occurs against the background of diseases such as peptic ulcer of the intestine and stomach, Zollinger-Ellison syndrome, reflux esophagitis, erosive esophagitis. However, the cause of its appearance can also be malnutrition, smoking on an empty stomach, alcohol abuse, and even an unsuccessful sleeping position. Heartburn can occur in a lover to sleep on the right side.

    Symptoms:

    • hiccups;
    • sour taste;
    • belching;
    • bitterness in the mouth;
    • burning behind the sternum.

      Causes:

      • eating before bedtime;
      • regular stressful situations;
      • overweight;
      • overeating;
      • alcohol abuse;
      • smoking;
      • abuse of fatty, sour, salty, spicy, spicy foods;
      • use of incompatible products.

      Which side do you sleep on?

      Sleep posture affects the risk of heartburn. If you often suffer from heartburn at night and when waking up early in the morning, make sure you sleep on the correct side.

      Left side

      Sleeping on the left side prevents heartburn. The stomach is located to the left of the esophagus. Therefore, when sleeping on this side, the gastric valve does not open so easily, and the contents of the stomach do not fall back into the esophagus.

      This sleeping position is considered the most competent and beneficial for overall health. The main thing is to accept it correctly. It is better to stretch your arms along the body. You can also hug them with a second pillow. Do not slip them under the main pillow, so as not to provoke pain in the neck. Feet should be slightly tucked in. The torso and head should lie flat.

      Right side

      Sleeping on the right side with heartburn is contraindicated. He will definitely make things worse. The stomach is to the left of the esophagus. Therefore, when a person lies on his right side, the contents of the stomach overflows back into the esophagus, irritating its mucous membrane and causing heartburn.

      Other disadvantages of sleeping on the right side:

      • slowing down of the lymphatic system;
      • slowing down the cleansing of the body from toxins;
      • slowing down the digestive process;
      • entry of poorly processed food masses into the esophagus.

      Attention! It is recommended to sleep on the right side for people with cholelithiasis and for those who are often anxious and stressed.

      Back

      Sleeping on your back is the best choice. It is not suitable only for those who suffer from snoring and sleep apnea.

      Sleeping on your back contributes to the rapid recovery of the body, ideal relaxation of the gastrointestinal tract. Nothing presses on the stomach in this position, and it is located below the esophagus, which prevents reflux.

      Another plus of sleeping on your back, which will be appreciated by the representatives of the beautiful half of humanity, is the minimum contact of the face with the pillow, which means less risk of wrinkles and rashes.

      Disclaimer

      Please note that all information posted on the site
      Prowellness is provided for informational purposes only and is not a personal program, a direct recommendation for action, or medical advice. Do not use these materials for diagnosis, treatment, or any medical procedure. Consult your physician before using any technique or using any product. This site is not a specialized medical portal and does not replace the professional advice of a specialist. The Site Owner is not liable to any party who has suffered indirect or direct damage as a result of misuse of materials posted on this resource.

      Expert: Evgenia Bulakh An expert in the field of motherhood, health and proper nutrition

      Reviewer: Ekaterina Vorobieva Adept of a healthy and active lifestyle

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      Which side to sleep on for heartburn?

      Every adult has experienced heartburn at least once in their life. Heartburn is an unpleasant burning sensation behind the breastbone just above the stomach. This condition occurs due to the reverse reflux of the contents of the stomach into the esophagus. A burning sensation is provoked by acids formed in the gastrointestinal tract and which are a natural component of the duodenal contents. When hydrochloric acid, pepsin and lysolecithin get into the esophageal tube, irritation of the organ occurs, as a result of which a person feels a burning sensation of varying intensity.

      Why heartburn occurs

      Recurrent heartburn is a symptom of a gastroenterological disease – gastritis, gastric or duodenal ulcer, reflux esophagitis, Zollinger-Ellison syndrome. Eating on the run, smoking on an empty stomach, acidic foods, drinking alcohol, and even an uncomfortable posture during sleep can provoke heartburn. Most often, heartburn occurs in people who are accustomed to sleeping on their right side. You will find a lot of useful information on the topic of health and beauty on the website https://healthday.in.ua/.

      Symptoms of heartburn:

      • burning just above the stomach;
      • belching;
      • sensation of a foreign body in the esophagus;
      • sour taste;
      • bitterness in the mouth;
      • hiccups that are difficult to stop.

      In addition to the causes described above, the following factors can provoke heartburn:

      • frequent stress;
      • eating shortly before bedtime;
      • overeating;
      • love of fatty, sour, spicy and salty foods;
      • simultaneous intake of products, the mixing of which in the stomach leads to the formation of acid.

      Overweight people often suffer from heartburn. If discomfort in the esophagus often occurs at night and immediately after waking up, make sure that your chosen sleeping position is correct.

      Sleeping on the right side of the body

      This position during sleep with heartburn is absolutely contraindicated. Due to the anatomical features of the body, when sleeping on the right side, food from the stomach is thrown into the esophagus, and the condition will certainly worsen. Sleeping on the right side is also undesirable for other reasons:

      • decreased functionality of the lymphatic system;
      • toxic decay products are removed more slowly;
      • metabolism slows down;
      • food eaten shortly before sleep enters the esophagus.

      However, doctors recommend people with increased anxiety, stress instability and gallstone disease to sleep on their right side.

      Sleeping on the left side

      To prevent heartburn, sleeping on the left side is considered correct. This is due to the fact that the stomach is located to the left of the esophagus, and in this position the valve is very difficult to open. Thus, the contents of the stomach cannot enter the esophagus, and the person sleeps peacefully. Even if a person eats dinner late, he will not have nightmares on his left side.

      Sleeping on the left side is also beneficial for other organs, but the posture must be correct. It is better to stretch your arms along the body or wrap them around another pillow. Putting your hand under the pillow on which the head rests is not necessary, otherwise you can get pain in the cervical spine. The head and torso should lie naturally, with the legs slightly bent towards the stomach.

      Sleeping on your back

      According to gastroenterologists, sleeping on your back is considered the most correct. However, this position is contraindicated for people suffering from sleep apnea and snoring. In this case, breathing can stop during sleep, and the likelihood of respiratory infections increases.