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Heartburn/GERD Health Center

The Special Risks of Nighttime Heartburn

Nighttime heartburn is painful. It disrupts your sleep and it can lead to serious medical problems.
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Why Is Nighttime Heartburn More Dangerous? continued...

When you're lying down, gravity isn't pulling in the right direction. Instead, the stomach contents are pressing on the sphincter muscle that connects the esophagus to the stomach. In people with GERD - which means nearly everyone with chronic heartburn - the sphincter is faulty. It doesn't fully close. So acids can reflux back up into the esophagus. And because you're lying down, once acids get into the esophagus, they can sit there for much longer than during the day. That can increase the damage.

Gravity isn't the only factor. When you're awake, you naturally swallow whenever acid begins to reflux. This pushes the acid back down into the stomach. Saliva also contains bicarbonate, which can neutralize stomach acid. But when you're asleep, the swallowing impulse is suppressed, Spechler says.

The Link Between Nighttime Heartburn and Insomnia

The effects of nighttime heartburn aren't confined to esophagus. It can also result in chronic insomnia. Nighttime heartburn can wake you up and keep you up.

"The symptoms definitely aggravate insomnia," says Dave White, who has suffered from nighttime heartburn for years. "I'll wake up with cutting heartburn pain and then have to wait for the effects of [medicine] to kick in, which can take an hour or so. When that happens, I'll just get out of bed, since I know I'll be up anyway."

One study showed just how common nighttime heartburn can be. Researchers questioned nearly 15,300 average people and found that a whopping 25% reported having nighttime heartburn. The results were published in the journal CHEST.

Another survey of 1,900 people with GERD in the U.S. and Europe found that about half had trouble sleeping at night. In these people, GERD symptoms caused a 22% impairment of leisure activities and a 15% impairment of their ability to work. The findings were presented during the 2005 Digestive Disease Week, an international conference for gastroenterologists. So the pain -- and consequences -- of nighttime heartburn go well beyond that burning in your chest.

Controlling Nighttime Heartburn

Fortunately, there are a lot of different treatments for nighttime heartburn. They can reduce your symptoms and your discomfort. They also lower the risk of developing serious complications.

"Lifestyle changes are very important," Cheskin tells WebMD. "In so many cases, we don't need to go to prescribed medications or more aggressive treatments." Many people can find relief by:

  • Avoiding foods that can lead to heartburn, such as alcohol, chocolate, peppermint, coffee, carbonated drinks, citrus fruits and juices, tomatoes, pepper, vinegar, catsup and mustard, and spicy or fatty foods
  • Not eating anything for two to three hours before bedtime
  • Chewing gum in the evening to boost saliva
  • Putting blocks under the top of the mattress to elevate the head 4 to 6 inches

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