What Causes Acid Reflux at Night?

GERD happens when the muscles at the lower part of the esophagus, called the lower esophageal sphincter, become weak or relaxed. This allows stomach acid to escape into the esophagus, leading to GERD symptoms such as heartburn, acid regurgitation, bloating, nausea, and belching.

Gravity and anatomy play a significant role in the occurrence of GERD symptoms. During the day, you are more likely to be upright, standing or sitting up, which makes it easier for gravity and saliva to return stomach acid to the stomach quickly. But, when you lie down, stomach acid can move back up to your esophagus, and this usually happens within the first two or three hours of sleep.

Eating heavy meals late at night, consuming fatty foods, spicy foods, alcohol, and caffeine, smoking tobacco, stress, pregnancy, weight gain, and taking drugs that affect the functioning of the esophagus like anticholinergic drugs (e.g., antidepressants and muscle relaxants) and anti-inflammatory drugs (like diclofenac and ibuprofen) can all trigger acid reflux.

Sleep Positions to Avoid for Acid Reflux

Not all sleep positions are created equal when it comes to managing acid reflux. Here are two sleep positions to avoid if you suffer from nighttime GERD symptoms:

• Sleeping on Your Back

When you sleep on your back, acid can flow freely from your stomach into your esophagus, leading to more frequent and longer-lasting symptoms. If you have stomach fat, it can push down on your stomach and force contents to escape, exacerbating symptoms.

• Sleeping on Your Right Side

Sleeping on your right side is also not ideal for people with GERD. When you lie on your right side, your stomach is above your esophagus, creating a leaky faucet spouting stomach acid into the delicate lining of your esophagus. Plus, if you lie flat on your right side, your symptoms may be more liquid, leading to regurgitation, coughing, and choking.

Best Sleeping Position for Acid Reflux

Now that we know the sleep positions to avoid let's take a look at the best sleeping position for acid reflux:

Sleeping on Your Left Side

Sleeping on your left side can be a game-changer when it comes to managing nighttime GERD symptoms. Gravity works in your favor on your left side, as your stomach now stays below your esophagus, making reflux more challenging. Plus, if stomach acid does escape, gravity can return it to your stomach quicker than when lying on your right side or back.

Studies show that symptoms are less frequent and less severe when a person sleeps on their left side, making it a more desirable sleep position for people with GERD.

Sleeping at an Incline

Sleeping at an incline means sleeping with your head elevated 6 to 8 inches off your body by putting extra pillows under your head and upper back. According to an article published in the journal Missouri Medicine, head of bed elevation is proven to manage GERD. It limits how often stomach acid escapes to the esophagus, allows your body to get stomach acid back to your stomach quicker, and reduces the symptoms of GERD.

As long as your entire torso is raised, not just your head and neck, sleeping at an incline gives gravity a power boost to return stomach acid to your stomach and keep it there. This position can be especially helpful for people who experience symptoms after eating a heavy meal.

The Best Sleep Position for Acid Reflux: Incline + Left-Side

The best way to reduce nighttime acid reflux is to combine an incline with the left-side sleeping position. This combination maximizes the power of gravity and anatomy to protect you from prolonged acid exposure to your esophagus, throat, lungs, and sinuses.

A 2015 study suggests that this combination of sleeping positions is highly effective in preventing nighttime acid reflux. The compound inclined, left-side sleeping position makes acid reflux at night virtually impossible because your esophagus is positioned well above the level of stomach contents, even if your stomach is full. And, if you do reflux, gravity can quickly return the contents to your stomach.

Other Tips to Control Acid Reflux at Night

In addition to adjusting your sleeping position, there are several lifestyle changes you can make to help control acid reflux at night and improve your sleep quality:

• Limit alcohol, heavy meals, fatty meals, and nighttime snacks.

• Eat in the early evening, so your stomach has time to digest before you go to bed.

• Manage your body weight if you are overweight or obese.

• Quit smoking.

• Avoid drugs that may limit the functioning of the esophagus, like non-steroidal anti-inflammatory drugs (NSAIDs).

• Consult with your doctor if you think you have GERD or any other sleep disorder. They can prescribe interventions appropriate for your case.

Final Thoughts

If you suffer from GERD and poor sleep quality due to nighttime acid reflux, making simple adjustments to your sleeping position and lifestyle can make a significant difference in your symptoms. The best sleeping position for acid reflux is the combination of an incline and the left-side sleeping position, which maximizes the power of gravity and anatomy to prevent acid reflux at night.

In addition to adjusting your sleep position, making lifestyle changes such as limiting alcohol and fatty foods, eating early, and managing your body weight, can also help manage GERD symptoms. Don't hesitate to consult with your doctor if you suspect you have GERD or any other sleep disorder. They can recommend appropriate interventions to help you sleep better and manage your symptoms.