How to Sleep Better with GERD & Acid Reflux

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Perhaps when lying down for the night after a large meal, you have experienced nighttime heartburn and had trouble sleeping. You are not alone. Research suggests that people with gastroesophageal reflux disease (GERD) are more likely to have sleep troubles. Perhaps surprisingly, the connection also works the other way. Those who fall short on sleep are also more likely to experience acid reflux, in which stomach acid travels backwards into the esophagus. As a result, the two health issues can exacerbate each other, causing a negative cycle.

Obtaining adequate sleep is an important part of breaking the cycle that can form when a person experiences both GERD and sleep troubles. We detail what GERD is, how it impacts sleep, and how to improve your sleep if you are affected by GERD or acid reflux.

What Is GERD?

Gastroesophageal reflux disease, often referred to as GERD, is a condition in which a person regularly experiences acid reflux. The disease is thought to be caused by an issue with the muscle that connects the stomach and esophagus. Acid reflux, or stomach acid flowing upward into the esophagus, can lead to a variety of symptoms. People with GERD often experience:

  • Heartburn, a burning sensation in the chest
  • Pain or burning in the throat
  • Liquid entering the throat or mouth from the stomach
  • A cough
  • Trouble swallowing
  • Breathing issues
  • Chest pain

Up to 20% of adults have GERD, and up to 40% experience acid reflux. Infants can also experience the disease. Infants may have different and more severe symptoms compared to adults, such as vomiting, a lack of desire to eat, or aspiration, in which liquid or food regurgitated from the stomach enters the lungs.

How Does GERD Impact Sleep?

Research shows that GERD and sleep problems overlap significantly. A survey found that nearly 80% of adults with twice-weekly heartburn experience symptoms at night, and 75% of those say heartburn affects their sleep.

When lying down, the digestion process does not flow as smoothly and the contents of our meals do not clear as quickly from the esophagus and the stomach. Swallowing, producing saliva, and contractions of the esophagus usually help clear the esophagus, but these processes slow as well during sleep. As a result, many people with GERD experience sleep disturbances including low-quality sleep, trouble falling or staying asleep, and less sleep overall. In turn, sleep deprivation can make a person more sensitive to acid in the esophagus.

GERD and Obstructive Sleep Apnea

GERD is also closely related to obstructive sleep apnea (OSA), a sleep disorder in which people frequently stop breathing during sleep due to airway obstruction. Up to 75% of people who have OSA experience acid reflux. Also, continuous positive airway pressure (CPAP), a treatment for OSA, has been demonstrated to reduce GERD symptoms, even in people who do not have OSA.

Experts have proposed multiple potential reasons for the relationships among GERD and sleep apnea, though none of these theories has been conclusively proven:

  • GERD symptoms cause brief awakenings that disrupt sleep
  • GERD causes swelling in the throat, which may lead to OSA
  • OSA causes pressure that opens the lower esophagus, which may trigger acid reflux

More research is needed before we can definitively state why these issues interrelate. GERD and OSA are both more likely to occur in people with certain risk factors such as older age, obesity, alcohol consumption, male sex, and pregnancy.

How to Sleep Better with GERD and Acid Reflux

There are steps you can take to improve your sleep if GERD or acid reflux symptoms have been disturbing it.

Choose the Best Sleeping Position for Acid Reflux

Back sleeping is associated with the most frequent acid reflux symptoms. By contrast, sleeping on your left side, rather than your right side, back, or stomach, has been shown to reduce acid reflux symptoms. You may also be able to reduce acid reflux during sleep by raising the head of the bed about 6 inches or using a wedge pillow to prop your head up.

Avoid Trigger Foods

Some researchers suggest making the following adjustments to your diet to reduce acid reflux while sleeping:

  • Eat dinner at least four hours before going to sleep or lying down
  • Reduce fat intake
  • Reduce coffee and chocolate consumption
  • Avoid spicy foods
  • Reduce or avoid alcoholic drinks, especially before sleep
  • Try incorporating foods from the Mediterranean diet, which focuses on fruits, vegetables, whole grains, and healthy fats

Quitting smoking and losing weight if you are overweight might also help decrease GERD symptoms.

Improve Your Sleep Routine

Just as GERD can impact sleep, sleep deprivation can also impact GERD. If you are having trouble getting quality sleep, the following general sleep hygiene recommendations may help:

  • Go to sleep and wake up at the same time every day, including weekends
  • Keep your bedroom dark, quiet, and pleasantly cool
  • Only use your bed for sleep and sex
  • Exercise regularly, but not close to bedtime
  • Take a bath or practice relaxation exercises before sleep
  • Avoid TV and video games before bed
  • Spend time in sunlight early in the day and avoid bright lights at night

Use Medication

Certain prescription medications and over-the-counter medications can help treat acid reflux. Ask your doctor whether these medications might be right for you. If you already take medications for other conditions, you may want to ask your doctor if these could be contributing to GERD symptoms.

When to See Your Doctor

See your doctor if you experience frequent acid reflux that interferes with sleep or does not respond to lifestyle changes. It is important to treat chronic GERD to avoid future health consequences. Your doctor can help you figure out a treatment plan so you can find relief and begin sleeping soundly again.

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