Do you go to bed feeling good, only to wake up a couple of hours later with terrible heartburn? If heartburn is keeping you up at night, it’s time to take some action. The best thing you can do — arm yourself with the right knowledge to keep acid reflux symptoms at bay and get a restful night’s sleep.
One word answer – Gravity. Gravity keeps gastric acid in the stomach while you’re standing or sitting. But when you are lying down, it is easier for gastric acid and other stomach contents to rise back up the esophagus, causing heartburn.
Additionally, while we are sleeping, the mouth produces less saliva and rate of swallowing also goes down. This, in turn, hinders with esophageal pH levels to return back to normal after the acid has traveled back up the esophagus. The result – you wake up choking and coughing with a sore throat.
Research has shown that night time heartburn occurs in a large majority of adults with GERD, resulting in sleeping difficulties and impaired next-day function. It’s important to understand that GERD and sleep have a bi-directional relationship. Acid Reflux adversely affects sleep quality by waking you up at night. At the same time, sleep deprivation can adversely affect heartburn severity by enhancing the perception of acid in the esophagus causing esophageal hypersensitivity, and potentially by increasing esophageal acid exposure time. If you have acid reflux, lack of sleep puts your body into stress, which increases the discomfort associated with increased acidity.
So, what can be done to prevent heartburn from keeping you up at night?
We have put together a list of things to avoid at night with heartburn so you can improve your sleep. Remember, when it comes to heartburn, lifestyle and behavior modifications can go a long way toward helping you get a restful night’s sleep.
You may think that a piece of fruit may be a safer way to end a delicious meal, but you would be wrong. Fruit is best eaten before your meal. Eating fruit after dinner may exacerbate acid reflux symptoms as it will tend to ferment in the stomach while waiting for rest of food to digest.
Water dilutes stomach acids essential for digestion. Avoid drinking water after a meal. In fact, it’s best to drink a glass of water 30 minutes before a meal to flush out all old gastric juices from the digestive tract, which will aid in fresh, concentrated acid production. This acid will get to work digesting your dinner immediately after eating and is best not diluted with excess water. Wait for 30 to 45 minutes to have water post dinner.
Digestion begins in the mouth, as saliva contains digestive enzymes that help breakdown food. When you chew your food properly, your stomach has to work less hard to digest the food. Did you know that it takes 20 minutes for the brain to realize you’re full? Eating slow gives the stomach enough time to signal to the brain that you’re satiated, preventing overeating. Challenge yourself to make each meal last up to 30 minutes. Use a timer if necessary!
Peppermint can help freshen up your breath after eating, but it can also trigger heartburn. Avoid peppermint infused foods, beverages, desserts, candy, or mouth fresheners as these can relax the LES or the lower esophageal sphincter that works as a lid between the esophagus and the stomach to keep stomach contents from coming back up the esophagus.
To prevent night time heartburn, eat an early dinner. This gives your body ample time to be able to digest the food before its time to sleep. Make sure there’s a gap of 2 to 3 hours between dinner time and bed time.
Train your body to go to sleep and wake up at the same time every day. A healthy sleep routine ensures a restful night’s sleep, especially when you have eaten two to three hours before bedtime. Have a warm bath, practice deep breathing and keep your room cool to help you drift off to sleep more easily.
Like watching TV to kill time between dinner and going to bed? Make sure you watch TV sitting upright! Posture plays a big role in acid reflux. Sprawling on the couch to catch up on your favorite shows is just as bad at trying to sleep immediately after dinner, as it will make it easier for the stomach acid and food to rise back up the esophagus. Sit up, so that gravity can keep stomach contents where they belong.
Eat breakfast like a king, lunch like a prince, and dinner like a pauper. Overeating is a sure fire way to exacerbate heartburn symptoms, as eating too much too soon puts extra stress on the digestive system. Ease heartburn symptoms by further making that smaller dinner low in fat, because fats are harder to digest. A light meal is easily digested by the body and will also help you lose weight.
We all have some GERD food trigger, and these are best avoided at dinner time. For some this may be spicy foods and citrusy foods, and for others it could be dairy, fried foods, sodas, and chocolates. Be mindful of your heartburn triggers and avoid them at dinner time at all costs. Also, choose your cheese wisely. Hard cheeses like Parmesan or Swiss are easier on reflux than soft ones like Feta and Brie. Pizza and Chinese takeout is also best avoided for dinner.
Eating a snack too close to bedtime can trigger heartburn symptoms. If you do get hungry post dinner, eat a light snack and delay bedtime. Read a book or walk around your home for a while, so that the snack is digested before you hit the bed.
You probably already know that stress and GERD are intricately linked. But did you know stress comes in many forms? It’s not enough to just keep work stress at bay; you also want to avoid emotional stress before bedtime. Don’t get into an argument with your partner or kids at night; somethings are best done in the morning. Also, avoid watching high action movies, a gory TV show or reading stressful new material before bedtime; it will make it harder for your mind to shut down and go to sleep.
Coffee can relax the lower esophageal sphincter (LES), which prevents the backward flow of stomach contents that causes reflux. Have decaf coffee, or better yet, choose an herbal tea at the end of your meal.
Sleepwear that is so tight it cuts into your skin is not only uncomfortable; it will also worsen night time acid reflux. A tight waistband exerts pressure on to your stomach and on the lower esophageal sphincter. Pick comfy pajamas that are light weight and loose fitting instead.
If night time reflux has been keeping you up at night, elevating your headboard can be an easy way to keep stomach acid where it belongs. When your head is raised high, stomach acid can’t flow back up into the esophagus. If it’s not possible to raise the headboard, try sleeping propped up on a wedge pillow for the same effect. Choose a pillow with a 6 to 8 inch incline that supports your head and neck comfortably.
For the same reason that we recommend you raise the head of your bed, we also advice that you don’t sleep on your stomach. Also, this sleeping position exerts extra pressure on the stomach which can relax the lower esophageal sphincter (LES), causing stomach acid to rise up the esophagus.
While scientists are not exactly sure why, it’s better to sleep on your left side. Some studies show that sleeping on the left reduces incidences of reflux. Experts believe sleeping on the right increases transient LES relaxations which are associated with reflux. Use pillows to prop yourself on to the left side and enjoy a restful night’s sleep.
Improve your quality of sleep with these simple tips, and save yourself from all the discomfort that comes from the dual problems of heartburn and sleeplessness. You can also try these amazing natural supplements to find relief from heartburn.
Nighttime heartburn is an under-appreciated clinical problem that impacts sleep and daytime function: the results of a Gallup survey conducted on behalf of the American Gastroenterological Association – http://www.sciencedirect.com/science/article/pii/S0002927003003605
Report from IFFGD Research Award Winner: Sleep and Gastroesophageal Reflux Disease (GERD) –
Night-time and daytime atypical manifestations of gastro-oesophageal reflux disease: frequency, severity and impact on health-related quality of life –
Effects of posture on gastro-oesophageal reflux –
Body position affects recumbent postprandial reflux –
Effect of different recumbent positions on postprandial gastroesophageal reflux in normal subjects – https://www.ncbi.nlm.nih.gov/pubmed/11051341