How to sleep to prevent acid reflux

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It’s hard to fall asleep at night when heartburn is your frequent bed partner. How can you give it the boot? In addition to elevating your upper body with a wedge pillow, avoiding meals close to bedtime, and taking heartburn medications, a small study suggests that sleeping on your left side may help. The findings were published in the February 2022 issue of The American Journal of Gastroenterology. A total of 57 people with chronic heartburn were monitored during sleep, spending about the same amount of time on their left side, right side, or back. The positions didn’t make a difference in the number of times participants experienced stomach acid backing up into the esophagus (which causes heartburn pain). But the acid cleared much faster when participants were on their left side, as opposed to their back or right side. Less exposure to acid can reduce heartburn pain and also reduce the risk of tissue damage and more serious problems.

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You’re trying to get a good night’s sleep, but it just isn’t happening. In addition to tossing and turning, the burning sensation of heartburn isn’t making your sleep efforts any easier.

What’s going on? Was it something you ate? Your sleeping position?

Heartburn and gastroesophageal reflux disease, or GERD, are frequent causes of sleeplessness. As many as one in four people who experience sleep disturbances report that they have nighttime heartburn.

For people who have been diagnosed with GERD, the rate is even higher; three people out of four report having nocturnal GERD symptoms. These individuals are more likely to suffer sleep problems such as insomnia, sleep apnea, and daytime sleepiness as a result of their nighttime heartburn.

Sleeplessness poses a serious health problem. In addition to the physical and mental effects that stem from lack of sleep, people who experience nocturnal GERD are at greater risk for some of the worst complications of the disease, including erosive esophagitis, dyspepsia, and esophageal cancer.

How Does GERD Disturb Sleep?

Researchers have figured out several ways in which GERD-related acid reflux interferes with sleep:

• Most obviously, individuals may be awakened by the pain of heartburn, which occurs when stomach acid refluxes into the esophagus and eats away at the esophageal lining.
• If acid reflux reaches the back of the throat or larynx, it may prompt a coughing fit or choking.
• People might wake up when they experience regurgitation, in which a small amount of stomach acid comes up through their esophagus and into their mouth.
• GERD has been identified as a risk factor for sleep apnea, a disorder in which the person repeatedly stops breathing during the night. Researchers believe that refluxed stomach acid causes the voice box to spasm, which blocks the airways and prevents air from flowing into the lungs.

Unfortunately, many of the mechanisms of sleep make GERD more likely. For example, just the act of lying down increases the risk of acid reflux. When you are in a sitting or standing position, gravity helps keep gastric acid in the stomach. When you lie flat, however, it's much easier for stomach acid to backflow into your esophagus.

Also, sleeping people tend to swallow less frequently. This slows the regular esophageal contractions that normally keep food moving down the esophagus and prevent acid from moving back up. Sleepers also produce less saliva, which plays a role in returning esophageal pH levels to normal after an incident of acid reflux.

GERD and Sleep Position: Dos and Don'ts

If you are a GERD sufferer, you can do a lot to improve your quality of sleep by changing your sleeping position. Doctors recommend that you:

• Do elevate the head of your bed 6 to 8 inches to assist gravity in keeping your stomach acid from refluxing.
• Don't sleep on your back, particularly if you are obese, because the pressure on your stomach could help drive acid into your esophagus.
• Don't sleep on your right side. For some reason, this seems to prompt relaxation of the lower esophageal sphincter — the tight ring of muscle connecting the stomach and esophagus that normally defends against reflux.
• Do sleep on your left side. This is the position that has been found to best reduce acid reflux.

You also can improve your chances of a good night's sleep by waiting for three to four hours after you eat before going to bed. That gives your stomach a chance to process your meal and move it through your digestive system. Your stomach will then be empty and less likely to promote reflux when you lie down. Eating a smaller and lighter dinner also is a good idea.

With a few lifestyle adjustments, you can save yourself a lot of the discomfort that comes from the dual problems of GERD and sleeplessness.

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