If you frequently experience acid reflux, you’ve probably learned the hard way that symptoms can be worse when you’re trying to sleep.
Lying flat doesn’t allow gravity to help move food and acids down the esophagus and through your digestive system, so the acid is allowed to pool in place.
Thankfully, there are some strategies you can employ to reduce the frequency and intensity of acid reflux, as well as minimize the complications that accompany the condition at night.
These steps are especially important in helping to avoid damage to the lining of the esophagus that can occur if acid reflux is poorly managed, as well as helping you get better sleep.
Treatment for mild or infrequent bouts of acid reflux may include one or more of the following strategies:
Try OTC or prescription medications
Over-the-counter (OTC) medications can sometimes help relieve heartburn:
- antacids, like Tums and Maalox, neutralize stomach acid
- H2 receptor blockers, such as cimetidine (Tagamet HB) or famotidine (Pepcid AC), can reduce stomach acid production
- proton pump inhibitors, like omeprazole (Prilosec), block and reduce stomach acid production
For more serious cases of GERD, these also come in prescription strengths. Always speak to your doctor if you’re using OTC options frequently. PPIs should be taken under a doctor’s guidance.
Avoid food and drink triggers
To help prevent GERD, it helps to know what foods or beverages trigger your symptoms. Each person is different, but some common acid reflux triggers include:
- caffeinated drinks
- spicy foods
- citrus fruits
- fried and fatty foods
Keep track of symptoms
Keeping a food diary and noting when you have symptoms can help you pinpoint what foods might be problematic. This way, you can avoid them or at least eat less of them.
You can also keep track of your symptoms if they’re unconnected to foods.
Know your medication side effects
Certain medications may contribute to GERD. Some common ones include:
- anticholinergics, which treat, among other conditions, overactive bladder and chronic obstructive pulmonary disorder (COPD)
- calcium channel blockers, which help lower blood pressure
- tricyclic antidepressants
- nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil)
If these or other medications are causing acid reflux or other symptoms, tell your doctor. Alternative treatments may be available.
Maintain a moderate weight
Obesity or overweight can influence the frequency of experiencing acid reflux. This is because extra weight, especially around the abdomen, can put pressure on the stomach and lead to acid spilling up into the esophagus.
Sometimes weight loss can help reduce symptoms. Speak to your doctor to see if they recommend this.
To prevent acid reflux at night:
- Sleep with your head elevated. Try a mattress lifter, a wedge-shaped pillow, or add a pillow to help keep your stomach contents from moving upward.
- Sleep on your left side. Sleeping on your left side may help improve the flow of acid and other contents from the esophagus into the stomach.
- Eat smaller more frequent meals. Eat several smaller meals throughout the day rather than two or three large meals. Avoid eating high-calorie, high-fat meals in the evening.
- Try different foods. Eat more vegetables and oatmeal, which are among foods that help acid reflux symptoms.
- Chew a lot. Chewing food slowly and thoroughly makes food smaller and may make digestion easier.
- Time it right. Wait at least 3 hours after eating before lying down.
- Improve your posture. Try standing up straight to elongate your esophagus and give your stomach more room.
- Stop smoking. Smoking can irritate the esophagus, the airways, and can cause coughing, which can trigger acid reflux or make it worse.
- Avoid clothes that put pressure on your middle. Avoid clothes that fit too tightly around your waist.
- Take an easy walk. Try taking a leisurely walk after dinner to help accelerate digestion and reduce the risk of stomach acid seeping up into your esophagus.
Normally, when you eat or drink something, the band of muscle at the bottom of your esophagus — called the lower esophageal sphincter — relaxes and allows food and liquid to flow into your stomach.
The sphincter closes and stomach acid starts to break down whatever you just consumed. If the sphincter becomes weak, or if it relaxes abnormally, stomach acid can move up through the sphincter and irritate the lining of the esophagus.
Pregnancy sometimes triggers acid reflux or GERD as the growing fetus puts pressure on the organs around it, including the stomach and esophagus.
A hiatal hernia can also lead to acid reflux because it causes the stomach and lower esophageal sphincter to move above the muscular diaphragm, which usually helps keep stomach acid from moving upward.
Smoking can contribute to the problem in a few ways, including increasing stomach acid production and weakening the sphincter.
Big meals and eating certain foods
The occasional episode of acid reflux may also just be the result of a little more acid production than usual — perhaps brought on by a particularly large meal or your sensitivity to certain foods.
And if you lie down before all your food is digested, you run the risk of having some of that excess acid leak through the sphincter.
Regardless of the cause of your acid reflux, lying down — whether it’s at night or during the day — is bound to worsen symptoms and prolong the time it will take your body to digest your food completely.
When it’s GERD
If you have acid reflux more than twice a week, you may have gastroesophageal reflux disease (GERD). Unlike infrequent acid reflux episodes, GERD may require a doctor’s care and more involved treatment.
While avoiding any acid reflux is ideal, managing symptoms well before bedtime can make it easier to sleep and prevent ongoing irritation of the esophagus at night.
If you know a particular food may trigger acid reflex, try to avoid it, especially at dinner. And if you have success easing acid reflux with antacids or other medications, be sure to take them well in advance of bedtime.
If you’re still having symptoms, prop up the head of your sleeping surface as much as possible to help you sleep.
Untreated GERD can lead to serious complications. Try out some prevention tips to help manage your reflux and a better night’s sleep.