As many as one in four Americans may suffer heartburn at night, according to a study published in 2005 in the journal CHEST. The figure is even higher among people who say they suffer chronic heartburn, or gastroesophageal reflux disease (GERD).
In a separate 2005 survey of 1,900 people with GERD in the U.S. and Europe, 55% said they had trouble sleeping at night. The people estimated that their symptoms caused a 22% impairment of leisure activities and a 15% impairment of their ability to work.
A physical exam for hiatal hernia is similar to that for heartburn, with two additions: X-rays may be ordered to show the hernia, and if anemia is a concern, a blood sample may be taken to check your red blood cell count.
A hiatal hernia can be diagnosed with a specialized X-ray study that allows visualization of the esophagus and stomach (barium swallow) or with endoscopy (a test that allows the doctor to view the hernia directly). An esophageal manometry test (pressure study) may also be performed...
If you've been waking up at night with heartburn, here are tips to help you sleep better:
Raise the head of the bed by 4 to 6 inches, so you can sleep with your head and chest elevated. You can lift the top end of the bed by sticking blocks underneath -- although your spouse may object once he or she has slid out of the bed a few times. You could also lie on special wedge pillows designed to help you sleep on an incline.
Eat meals two to three hours before bed, since this will reduce the risk of nighttime heartburn. Avoid bedtime snacks.
Don't wear clothes that fit tightly around the waist, since they can aggravate your symptoms.
Chew gum during the evening. This can boost the production of saliva, which neutralizes stomach acid.
Try sleeping on your left side. Some studies have shown that this helps with digestion, simply because of a quirk of the body's design. Sleeping on your right side seems to be most likely to aggravate symptoms.
Avoid foods that can trigger reflux or irritate the esophageal lining. These include alcohol, chocolate, peppermint, coffee, carbonated drinks, citrus fruits and juices, tomatoes, pepper, vinegar, catsup and mustard, and spicy or fatty foods.
Don't use medicines that can worsen reflux. Examples include aspirin, other painkillers, and calcium-channel blockers. Check with your doctor about alternatives if you are currently taking any reflux-worsening medications. Never stop a medication without first talking to your doctor.
If you smoke, stop.
If you're overweight, try to lose some of your excess pounds.
SOURCES: Fass, R. CHEST, 2005; vol
127: pp 1658-1666. 2005 Digestive Diseases Week, News Release, University of
California, Los Angeles (UCLA), May 16, 2005. Lawrence J. Cheskin, MD, FACP,
co-author of Healing Heartburn (2002); director and founder, Johns
Hopkins Weight Management Center; and associate professor, international health
and human nutrition; and associate professor of medicine, Johns Hopkins School
of Medicine. Stuart Spechler, MD, spokesman, American Gastroenterological
Association; chief, division of gastroenterology, Dallas VA Medical Center; and
professor of medicine, University of Texas Southwestern Medical Center at