Why is acid reflux worse at night?
Acid reflux (or heartburn) at night is an all-too-common problem, contributing to an estimated 7% of sleepless nights. This can have further repercussions, including fatigue, increased anxiety or concentration lapses the following day.
There are many reasons why acid reflux symptoms can worsen at night, although much of the problem occurs when lying horizontally. When sitting or standing, gravity helps to keep food and acid at the bottom of the stomach, but as you lie down, it becomes much easier for the acid to leak out the top of your stomach and irritate the lining of your oesophagus.
Additionally, when we are asleep we tend to swallow less, which means that the oesophageal contractions which keep stomach acid in the stomach are reduced, making it easier for reflux to occur.
The saliva that we produce helps to neutralise stomach acid, hence reducing symptoms. However, when asleep, saliva production reduces; another contributing factor to worsening symptoms.
Additionally, eating a big meal late at night can trigger heartburn symptoms. This is because the body will be trying to do its night-time clearing and regenerating work whilst struggling to digest at the same time. Lying down with a full stomach increases the likelihood of both food and acid being pushed back up towards the oesophagus. With all this in mind, it is clear why lying down with a full stomach is a recipe for night-long heartburn.
How to improve sleep with acid reflux
There are many tips and tricks to try, and certain things to avoid, which may just be your answer to finally getting a good night’s sleep.
1. Incline the head of your bed
Raising you head slightly more than usual helps gravity do its job and helps prevent stomach acid leaking up into your oesophagus.
Some people achieve this by propping one end of the bed up with blocks. Just make sure it is secure before diving in! However, an extra pillow may be sufficient to prop you up a little.
2. Sleep on your left side
Sleeping on your left side can help because the oesophageal sphincter located at the top of the stomach should then be higher than the level of acid, making reflux less likely.
3. Keep a food diary
By tracking what you eat alongside the severity of your symptoms, you should be able to help identify if certain foods worsen your condition, and therefore take any necessary steps to eliminate reflux triggers.
4. Maintain a healthy weight
Just like in pregnancy, being overweight puts extra pressure on your digestive system, making it more likely that acid will be squeezed out of the stomach.
And the DON’Ts:
1. Sleep on your back or right side
Sleeping on your back or your right side have been found to be the worst sleeping positions for acid reflux sufferers, as they can put pressure on the sphincter at the top of the stomach, encouraging it to open. This can cause acid to leak into the oesophagus and the pain and discomfort to follow.
2. Eat in the three hours preceding bedtime
Improve your digestion by allowing food to be well on its way through your digestive system before lying down. Eating at least 3 hours before bed helps ensure your stomach has done most of its emptying before you settle down for the night.
3. Wear tight clothes
In the same way as being overweight, tight clothes around your middle constrict your stomach and force the acid out. So watch out for any restrictive waistbands in your pjamas or underwear that could be exacerbating your symptoms.
Be aware of your posture, both during and after meals and especially in the lead up to bedtime; keeping your shoulders back to open out the chest gives your stomach more room to operate optimally.
Are there effective remedies to help?
There are many home remedies that may help with acid reflux, including bicarbonate of soda and apple cider vinegar.
If you feel you need a little extra protection, Silicic acid is a compound of silicon and oxygen and has been found to be very effective in treating acid reflux. It soothes and protects the lining of the digestive tract, as well as adsorbing or binding harmful substances, helping to achieve a heartburn-free night. Silicic acid can be found in Silicol® gel.
Originally published on 25/09/19, updated on 14/05/19