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While there are a lot of frustrations that come along with acid reflux and GERD, nighttime reflux is one of the most commonly mentioned ones. Sleeping well with reflux can be challenging; nighttime symptoms like coughing, throat irritation, and regurgitation can worsen when a person lies down or wake them up in the middle of the night. Poor sleep can then increase one's stress, slow down digestion, and make reflux even worse the next day. It's an annoying part of reflux, but it can be mitigated.
During sleep, reflux can intensify for reasons including:
Lying flat removes gravity's assistance
When a person is upright, gravity helps keep stomach acid where it belongs. Once a person lays down, this lets acid reflux travel into the esophagus more easily, since gravity is no longer really helping.
People swallow less when sleeping
Swallowing helps push acid back down into the stomach. Since the rate of swallowing decreases at night, this means acid can stay in the esophagus for longer, causing more irritation.
Saliva production decreases
Saliva helps to neutralize stomach acid. Since the body produces less saliva at night, this can cause irritation to worse.
Late meals
If you eat too close to going to bed, your stomach may still be busy digesting. This increases pressure and raises the chance of having reflux later in the evening.
These normal changes make nighttime a more vulnerable time for reflux, which is why the right approach can help
There are a number of changes that can help reduce acid reflux at night.
1. Elevating the upper body
Adjusting one's sleep position can be an effective way to reduce nighttime reflux. Generally, people either choose to use a wedge pillow, or choose to elevate the head of their bed. Different people often find one to be more comfortable than the other.
Avoid stacking regular pillows, as that will bend the neck and not provide stable support.
2. Adjusting sleeping position
Sleeping on your left side keeps the stomach positioned below the esophagus. Gravity can then work to help keep stomach acid down, which can reduce reflux. The opposite way, sleeping on your right side, can place the stomach in a way that makes reflux more likely. If a person has to sleep on their back, then using a wedge pillow or bed elevation is recommended.
3. Changing evening diet habits
Habits like avoiding meals 2-3 hours before bed, not overeating at dinner, and avoiding common trigger foods in the evening can all make a difference with nighttime reflux. These can all increase stomach pressure or trigger reflux.
4. Building a more reflux-friendly evening routine
A consistent, relaxing routine can reduce stress and help the digestive system. Gentle stretching, reading, or deep breathing before bed can ease tension, and staying upright after dinner (instead of lying down) supports better digestion. Prioritizing-friendly evening snacks can also be helpful, such as oatmeal, yogurt, or bananas.
5. Considering non-prescription options
Products like alginate-based barriers, H2 blockers, and antacids can reduce reflux at night. Make sure to talk to a clinician before adding new things, especially if you already take other medications.
6. Improving overall sleep quality
Apart from reflux-specific changes, other adjustments can help. These include keeping a consistent sleep schedule, limiting screen time before bed, and creating a comfortable environment for sleep.
Many of these adjustments take minimal effort to put into place, but can have a large impact in reducing acid reflux. In combination with good daytime habits, these strategies provide a good foundation for combating reflux at night.
Nighttime reflux should not be ignored- contact a clinician if you experience constant or severe reflux symptoms like frequent nighttime choking, persistent hoarseness, and reflux that wake you up several times a week.
