Nausea and vomiting at night are often related to digestive concerns, like acid reflux or ulcers. But they can also have some unexpected causes, like anxiety.
Nausea can happen at any time of the day. But some conditions may be more likely to make you feel nauseous at night.
Sometimes you can be nauseous without an underlying cause, but it’s most often a symptom of another condition.
Read on to learn more about what can cause nighttime nausea, when to see a doctor, the treatment options, and how to help ease your nausea at home.
The possible causes of nausea at night include the conditions outlined below.
Anxiety includes feelings of nervousness and worry. It’s common to have these feelings from time to time. Almost everyone experiences anxiety at some time or another.
If, however, you have these feelings often, or if your anxiety seems out of proportion to your current situation, you may have a condition called generalized anxiety disorder.
Whether you have everyday worries or an anxiety disorder, anxiety can get worse at night. This may be because you have fewer distractions at night, compared to the daytime when you’re occupied with work, school, or family matters.
When your mind isn’t focused on something else, you may be more likely to dwell on your worries or problems.
All types of anxiety can cause gastrointestinal issues, including nausea. Since anxiety may be worse at night, you may be more likely to have nausea at night, too.
Other symptoms of anxiety include:
- trouble concentrating
- increased heart rate
- panic attacks
- trouble falling asleep
- trouble thinking about anything except what’s causing your anxiety
It occurs when the band of muscle between your esophagus and stomach doesn’t properly close or tighten. This allows the digestive juices in your stomach to move up into your esophagus.
The most common symptom of GERD or acid reflux is heartburn — an uncomfortable burning sensation in your chest. You might also notice a bitter taste at the back of your mouth. Nausea may accompany these symptoms, too.
Other symptoms of GERD include:
- trouble swallowing
- feeling like something is stuck in your throat
- dry cough
- pain in your chest or upper abdomen
Eating late at night can increase symptoms of GERD, including nausea. This is because lying down, especially after eating a big meal, makes it easier for acid to flow up into your esophagus.
Medication side effects
Nausea is a common side effect of medications, especially:
- nonsteroidal anti-inflammatory drugs (NSAIDs)
- some types of blood pressure medication
If you take your medication at night, you might notice more nausea at night.
Other symptoms or side effects depend on the medication.
Peptic ulcers are sores on the lining of your stomach or small intestine. The bacteria H. pylori can cause it.
The most common symptom is pain between your ribs and belly button. Other symptoms include:
- feeling full after eating a small amount of food
- black or bloody stool
- unexplained weight loss
These symptoms often get worse after meals and at night.
An increase in hormones causes nausea during pregnancy. It usually begins around week 6 and ends around week 12 of pregnancy. It’s not dangerous to you or baby, unless you can’t keep food down.
Another possible cause of nausea at night is gastroparesis. This is a disease in which the stomach can’t normally empty itself of food.
It’s most common in people with diabetes. Other causes include:
- some antidepressants
Gastroparesis can also occur from an injury to the vagus nerve, which helps your stomach muscles contract to move food.
Symptoms may be worse at night, as the food you eat during the day builds up in your stomach.
Symptoms of gastroparesis include:
- feeling full after eating a small amount of food
- weight loss
Although less common, cyclic vomiting syndrome is another possible cause of nausea at night that can affect both adults and children. It’s a rare disorder that causes recurrent episodes of severe nausea and vomiting.
These episodes can last for a few hours or a few days. Most people have episodes about the same length each time. In between the vomiting and nausea you feel healthy.
Besides nausea and vomiting, symptoms may include:
Exhaustion and anxiety are both triggers for cyclic vomiting syndrome, and both are more common at night. This can make cyclic vomiting syndrome more likely to start at night.
In many cases, nausea is temporary and will go away on its own. But it can also be a sign of a more serious problem. See your doctor if:
- your nausea lasts longer than a week
- you consistently feel nauseous after eating
- your nausea leads to severe headaches with vomiting
- you have unexplained weight loss
- nausea and vomiting keep coming back over the course of at least 1 month
- you can’t keep food down, especially if you’re pregnant
- you’re experiencing:
Treatment for nausea at night will depend on the underlying cause.
One of the most effective treatments for anxiety is psychotherapy, especially cognitive behavioral therapy, also known as CBT.
This type of therapy helps you identify negative or destructive thought patterns. Once you notice these patterns, you can start learning how to reframe your thoughts in a more positive way.
Other possible treatment options for anxiety include:
- anti-anxiety medication
- lifestyle changes, such as exercise and reducing caffeine and alcohol consumption
The most common treatment options for GERD include:
- medications called H2 blockers, which reduce acid production (available over the counter or by prescription)
- medications called proton pump inhibitors, which are stronger acid reducers (available OTC and by prescription)
- surgery, if medications don’t help
- lifestyle changes, such as avoiding spicy food, not eating at night, eating smaller meals, and limiting alcohol and caffeine
Medication side effects
If a prescription medication is causing your nausea, talk to your doctor about switching medications or taking them at a different time of day to alleviate nausea and other side effects. You may also need to take your medication with food or water.
It’s important that you don’t stop taking your medication on your own. Always talk to your doctor about the best way to change your medication or the way you take it.
The most common treatment options for peptic ulcers include:
- antibiotics to get rid of H. pylori bacteria
- antacids, H2 blockers, or proton pump inhibitors to reduce stomach acid
- medications to protect your stomach’s lining
- lifestyle changes, such as quitting smoking and avoiding foods that make your symptoms worse
Treatment for gastroparesis typically includes:
- medications that help your stomach muscles move normally
- lifestyle changes, such as eating smaller meals and eating food that’s easy to digest
Cyclic vomiting syndrome
Treatment for cyclic vomiting syndrome may include:
There are steps you can take to help reduce the severity of your nausea at home. If your nausea persists for longer than a week, or if it gets worse, it’s important that you see your doctor.
The following self-care measures may help your nausea:
- Prop your head up so you’re not lying flat in bed. If it’s comfortable for you, try to sleep with your head about 12 inches above your feet. This can help keep acid or food from moving up into your esophagus.
- Drink a small amount of a slightly sweet liquid, like fruit juice, but avoid citrus. Drink slowly. Increase the amount as you start to feel better.
- Drink ginger or peppermint tea.
- Suck on a peppermint.
- Eat a small amount of light, bland food, like plain crackers or bread.
- Avoid physical activity until you feel better, but try to avoid lying down.
Nausea at night is usually a symptom of an underlying condition. Some of the most common causes include acid reflux, anxiety, medication side effects, peptic ulcers, or pregnancy.
Nausea at night is usually treatable, either with self-care remedies or by a doctor.
If your nausea is severe or long lasting, or if you have bad headaches or unexplained weight loss together with nighttime nausea, see your doctor. They can diagnose the cause of your nausea and work with you to find the right type of treatment.