It’s so frustrating. You crawl under the covers, tired and ready to sleep after a busy day. But soon after you get into bed, you feel the familiar symptoms of acid reflux begin to kick in. The heartburn starts up in your chest, you feel a sour taste in your throat and you might even feel queasy when stomach contents move up in your esophagus.
When you’re awake and upright, gravity helps control the symptoms of acid reflux, since stomach contents are more likely to stay in the stomach, below the throat and esophagus.
But once you lie down, it’s easier for those stomach contents to make their way up into your esophagus and throat.
Plus, other factors may make acid reflux worse at night:
- The muscles that connect your esophagus to your stomach don’t close as tightly. So it’s easier for acid to enter the upper sphincter, a valve in the upper part of the esophagus.
- Your stomach produces more acid at night.
- You don’t salivate or swallow as much. Saliva helps dilute stomach acid and swallowing helps push acid back into the stomach.
That’s why acid reflux can make it hard for you to fall asleep and can wake you up well before morning.
Avin Aggarwal, MD, a gastroenterologist with Banner Health, recommends these strategies for fighting nighttime acid reflux so you can get a good night’s sleep.
Raise the head of your bed
To get gravity back to work for you, elevate the head of your bed. “That way, stomach acid is more likely to stay in the stomach rather than travel into your esophagus,” Dr. Aggarwal said. Here’s how to do it:
- Use an adjustable bed frame, bed risers, blocks or a wedge pillow to raise the head of your bed by at least six inches.
- Be sure to raise your upper body, not just your head and shoulders.
- Don’t just prop yourself up with an extra pillow — it won’t give you the support you need.
- Try sleeping on your left side if you’re a side sleeper. This position is less likely to cause reflux.
Modify your diet to help reduce your symptoms
What and when you eat can make a difference in how much acid reflux interrupts your sleep. These tips can help:
- Don’t eat anything for at least three hours before you go to bed. “This is one of the most important steps you can take,” Dr. Aggarwal said.
- Avoid acidic foods like tomatoes and tomato sauce, coffee and other foods or drinks that contain caffeine, carbonated drinks, spicy food, chocolate, mint and citrus fruits like grapefruit and oranges. “Some people also need to steer clear of fatty foods and fried foods, especially in the three hours before bedtime,” Dr. Aggarwal said.
- Choose lean proteins, vegetables other than tomatoes, non-citrus fruits and whole grains. Drink water, herbal teas and non-citrus juices.
- Stay upright after meals so your digestive system can process what you’ve eaten.
- Steer clear of alcohol (and tobacco).
- If you’re overweight, try to lose some excess pounds.
Set yourself up for sleep success
Acid reflux might not be the only thing keeping you from a good night’s sleep. You’ll improve your odds of sleeping better if you:
- Keep to a regular sleep schedule where you go to bed at the same time every night and wake up at the same time every morning.
- Have a calming routine for winding down before bedtime. Consider taking a bath, reading a relaxing book or listening to gentle music.
- Relax with techniques like deep breathing before you go to sleep.
- Keep your bedroom cool, dark and quiet.
- Limit screen time before bed and keep phones, tablets, TVs and computers out of the bedroom.
If these tips aren’t helping you sleep, talk to your provider – even if you don’t think you have acid reflux. “A lot of nighttime reflux symptoms go unnoticed early on. They can hamper your quality of sleep, cause sleep deprivation and impact your quality of life,” Dr. Aggarwal said.
Try over-the-counter (OTC) medication
You can choose from a lot of medications that can treat your symptoms. Be sure to talk to your health care provider, since some of these medications might not be good choices if you have certain medical conditions or if you’re taking other medications.
A provider can also give you advice about taking these medications if you’re pregnant or you need to treat acid reflux in a child under age 12.
You may want to try:
- Antacids such as calcium carbonate, magnesium hydroxide or sodium bicarbonate for fast relief from heartburn. They neutralize stomach acid.
- H2 blockers, which can relieve and prevent heartburn. Some of these include ranitidine (Zantac), famotidine (Pepcid) and cimetidine (Tagamet).
- Proton pump inhibitors, which suppress acid production. Some examples are omeprazole (Prilosec), lansoprazole (Prevacid) and esomeprazole (Nexium).
Know when to see an expert
Sometimes, talking to a health care provider about your symptoms and sleep problems is best. If these tips aren’t helping, schedule an appointment.
“If you have persistent symptoms and need to use OTC medication more than twice a week, or if your episodes are getting more severe, you should see an expert,” Dr. Aggarwal said. "There are long-term side effects from taking OTC anti-reflux medications too often.”
Other red-flag symptoms include:
- Trouble swallowing
- Unexplained weight loss
- Feeling full when you’ve only eaten a small amount
- Black stools
- Severe chest pain
- Chronic cough
- Hoarse voice
- Symptoms that last for more than two weeks
- Symptoms that affect your quality of life
Prescription medications and other treatments can help get your symptoms under control. It’s important to diagnose and treat reflux. Untreated, it could lead to more serious conditions like ulcers, Barrett’s esophagus and even esophageal cancer.
The bottom line
Nighttime acid reflux can make it tough for you to get the rest you need. Elevating the head of your bed, changing your diet and taking medication can help.
If acid reflux is keeping you up at night and these tips aren’t bringing relief, talk to your provider or connect with an expert at Banner Health.
