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Understanding the Connection Between GERD and Snoring

If you have gastroesophageal reflux disease (GERD) and you snore, you might not think the two conditions have much in common. After all, GERD is a digestive issue and snoring is a sleep issue, right?

It turns out, they may be linked. And it can be a chicken-and-egg situation: GERD can make snoring worse and snoring can make GERD worse. Kevin F. Moynahan, MD, an internal medicine specialist with Banner – University Medicine, explained more about the connection between snoring and GERD.

GERD is a condition where stomach acid backs up into the esophagus, which causes irritation. With GERD, you may notice heartburn, regurgitation or chest pain.

Snoring is a common sleep disorder where the soft tissues in your throat vibrate when you’re sleeping. Occasional snoring is usually harmless but frequent snoring can be a sign of health issues such as sleep apnea.

When you have both GERD and snoring, the two conditions can make each other worse, disrupting your sleep and decreasing your quality of life.

How GERD may impact snoring

With GERD, stomach acid can travel beyond the esophagus into your throat and voice box. “GERD often worsens when people lay down because acid contents more easily reflux up to the esophagus and beyond,” Dr. Moynahan said. 

The acid can: 

  • Irritate your throat.
  • Cause swelling and inflammation in your soft palate.
  • Make you clear your throat or cough.
  • Narrow your airway.
  • Trigger more mucus production to counteract the irritation.

A smaller airway, made even smaller by mucus building up, could make it more likely that your airway will vibrate when you’re sleeping and you’ll snore. 

GERD can also cause muscle spasms in your throat and chest that can make snoring worse.

How snoring may impact GERD

“Increased airway obstruction and relaxation of the throat muscles associated with snoring can worsen GERD,” Dr. Moynahan said. When you snore, the soft tissues of your throat relax, and your airway narrows. This narrowing creates a vacuum-like effect in your airway that can pull acid up through your esophagus. 

Many people with GERD have a weak or damaged lower esophageal sphincter (LES). That’s the muscle connecting the esophagus to the stomach. When that’s the case, it’s easier for the vacuum effect from snoring to move stomach acid up into the esophagus, throat and voice box. More stomach acid in those areas means more symptoms of GERD.

Snoring’s vibrations can also cause microtraumas in the throat and airway. Those areas can become irritated and inflamed, leading to conditions called pharyngitis or laryngitis. When this happens, it can be harder to swallow and clear stomach acid from the throat, making acid more likely to contact delicate tissues.

When your airway is inflamed, your LES muscles might not be coordinated as well as they should. That can also worsen GERD symptoms. And airway inflammation can make the nerve endings in your throat more sensitive so you may be more likely to notice symptoms of GERD like heartburn.

How snoring and GERD affect your sleep

When you snore, the noise and vibrations can wake you up (they can wake up your partner, too!). Snoring is also linked with obstructive sleep apnea, which can wake you up frequently during the night. You might wake up so briefly that you don’t even realize it, but you’ll still probably be sleepy the next day.

GERD can wake you up, too. Symptoms like heartburn, regurgitation and chest pain can keep you awake, and coughing or clearing your throat can also disrupt your sleep. 

Poor sleep, whether from snoring, GERD or for any other reason, can make it harder for your body to heal and repair damage.

Managing GERD and snoring

It’s not always clear if you started snoring first and that made GERD worse or if the opposite is true. Either way, you’ll want to see a health care provider to come up with a treatment plan for both conditions. 

“I recommend that all patients with chronic symptoms of snoring and/or GERD have an evaluation by their health care team to assess their risk for more serious forms of both conditions. For GERD, this would be Barrett’s esophagus, which can lead to esophageal cancer, and for snoring, this would be obstructive sleep apnea,” Dr. Moynahan said.

Based on your symptoms, medical history and test results, your provider may recommend: 

  • Losing excess weight to reduce pressure on your stomach, which can decrease acid reflux and improve your airflow when you’re sleeping. “Obesity increases the risk of both obstructive sleep apnea and GERD. A comprehensive weight loss program resulting in weight loss will help both snoring and GERD significantly,” Dr. Moynahan said.
  • Avoiding spicy foods, citrus fruits, caffeine and carbonated drinks that can worsen GERD symptoms.
  • Not eating for two to three hours before bedtime.
  • Raising the head of your bed with risers to help keep stomach acid from flowing up into the esophagus. This position may also improve airflow and reduce snoring.
  • Avoiding alcohol and tobacco use, since they can relax the muscles in your throat and make your GERD symptoms worse.
  • Taking medication such as antacids, protein pump inhibitors and histamine-2 blockers for GERD.
  • Using appropriate therapies to help snoring that’s caused by congestion or allergies.  This may include nasal corticosteroids, oral or nasal antihistamines or nasal ipratropium. Do not use over-the-counter (OTC) nasal decongestants for more than three days, as this can lead to rebound symptoms and worsening nasal congestion.
  • Using dental devices such as mandibular advancement devices (MADs) or tongue-retaining devices (TRDs) to help reduce snoring by repositioning the tongue or jaw while you’re sleeping.
  • A continuous positive airway pressure (CPAP) machine, if obstructive sleep apnea is causing snoring. 
  • In severe cases of GERD, endoscopic techniques such as fundoplication or radiofrequency ablation to tighten the LES and prevent acid reflux. 
  • Surgeries such as laparoscopic Nissen fundoplication or LINX device placement to treat severe or refractory GERD symptoms. 
  • Upper airway surgery, such as uvulopalatopharyngoplasty (UPPP) or palate implants, to help with severe snoring or OSA that hasn’t responded to other treatments.

The bottom line

GERD and snoring may seem like two unrelated conditions, but each can make the other worse. Combined, they can interrupt your sleep and make you tired during the day. If you snore, have GERD symptoms or both, reach out to your health care provider or an expert at Banner Health for evaluation and a treatment plan. 

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