What causes acid reflux at night?

The muscles at the lower part of the esophagus, called the lower esophageal sphincter, prevent food from leaving the stomach. However, when these muscles become weak or relaxed, stomach acid can escape into the esophagus.

Gravity and anatomy also play a role in the occurrence of nocturnal GERD symptoms. During the day, people are usually upright, which allows gravity and saliva to quickly return stomach acid to the stomach. Additionally, people can manage GERD symptoms by staying upright, swallowing saliva, or taking antacids when they are awake.

However, when people lie down to sleep, acid reflux is more likely to occur. Evidence shows that acid reflux usually happens in the first two or three hours of sleep, and it is more frequent when people consume heavy meals late at night (about two hours before bedtime).

Factors like consuming fatty foods, spicy foods, alcohol, and caffeine, smoking tobacco, stress, pregnancy, weight gain, and taking drugs that affect the functioning of the esophagus can also trigger acid reflux.

What is the best sleeping position for acid reflux?

The best sleeping position for acid reflux is on your left side with an incline. Sleeping on your left side can help gravity and anatomy work in your favor, making it more challenging for stomach acid to escape into the esophagus.

When you lie on your left side, your stomach stays below your esophagus, making it more difficult for reflux to occur. If stomach acid does escape, gravity can return it to your stomach quicker than when you lie on your right side or back. Additionally, lying on your left side produces reflux symptoms that tend to be more gaseous, which can be annoying but much less distressing than liquid reflux that comes with lying on your right side.

Studies have shown that people with GERD experience less frequent and less severe symptoms when they sleep on their left side rather than their right side or back.

Elevating your head 6 to 8 inches off your body by using extra pillows under your head and upper back can also help manage GERD symptoms. Sleeping at an incline means your entire torso is raised, not just your head and neck. Sleeping in this position gives gravity a power boost to return stomach acid to your stomach and keep it there.

A 2015 study suggests that the compound inclined, left-side sleeping position makes acid reflux at night virtually impossible. The position places your esophagus well above the level of stomach contents, making reflux less likely to occur, even if your stomach is full. Additionally, if you do experience reflux, gravity can quickly return the contents to your stomach.

What sleeping positions should you avoid?

If you have GERD, it is essential to avoid sleeping on your back and right side. When you sleep flat on your back, acid can flow freely into your esophagus and remain there. This position can make symptoms more frequent and tend to last longer because the acid cannot flow back to the stomach.

When you lie on your right side, your stomach is above your esophagus, allowing stomach acid to easily escape into the esophagus. This is especially true when your stomach is full. Additionally, when lying flat on your right side, reflux symptoms tend to be more liquid, leading to regurgitation, coughing, and choking, which can be very disruptive to sleep.

A study showed that people who sleep on their right side are more likely to be diagnosed with GERD than those who sleep on their left, highlighting the severity of nocturnal GERD symptoms when lying on the right side.

Additional tips to control acid reflux at night

In addition to finding the best sleeping position for acid reflux, there are other lifestyle changes you can make to manage GERD symptoms at night:

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

• Eat in the early hours of the evening

• Manage body weight if you are overweight or obese

• Quit smoking

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

Your doctor may also prescribe medications or recommend surgery to treat GERD when appropriate. If you suspect you have GERD or any other condition that may be disturbing your sleep, consult with your doctor to receive appropriate interventions for your case.

GERD can significantly disrupt sleep, but finding the best sleeping position for acid reflux can help reduce symptoms and promote restful sleep. Sleeping on your left side with an incline can help gravity and anatomy work in your favor, making it more challenging for stomach acid to escape into the esophagus. It is also essential to avoid sleeping on your back and right side, which tend to worsen GERD symptoms.

Lifestyle changes, such as limiting alcohol intake, heavy meals, and nighttime snacks, managing bodyweight, quitting smoking, and avoiding drugs that limit the functioning of the esophagus, can also help manage GERD symptoms at night. If you suspect you have GERD or any other condition that may be disturbing your sleep, consult with your doctor to receive appropriate interventions for your case. By making simple changes to your sleeping position and lifestyle, you can take control of your GERD symptoms and get the restful sleep you deserve.