Heartburn waking you up at night? Lying down makes it easier for stomach acids to splash up into your esophagus. To keep acid down, use gravity. Place an extra pillow or two under your shoulders or use a wedge-shaped pillow to prop yourself up. Not enough? Boost the head of your bed 6-8 inches with wood blocks secured under the bedposts. Sleeping on your left side can also help digestion.
Going to bed on a full stomach increases your risk of nighttime heartburn. A full stomach puts pressure on the valve at the top of the stomach, which is supposed to keep stomach acid from leaking into the esophagus. So eat at least two to three hours before bedtime to give your stomach time to empty. Try early dinners and avoiding snacks at night.
Overeating is a common cause of heartburn. It’s better to eat small, frequent meals instead of feasts. Keep your meals small by limiting your portion sizes. Eat just until your appetite is satisfied but before you feel full. This reduces your risk of nighttime heartburn and can help you maintain a healthy weight.
If you're experiencing heartburn more than twice a week, tell your doctor. Frequent nighttime heartburn can signal GERD, which can cause a serious condition of the esophagus lining called Barrett's esophagus. Also beware: Heart attack symptoms can feel similar to heartburn. If you're concerned about sudden pain, tightness, or pressure in your chest, seek medical help immediately.
Being overweight or obese increases your risk of heartburn. One reason may be that excess weight adds pressure on the valve at the top of the stomach. Losing weight isn't easy, of course, but trimming down may help with your acid indigestion. And that may mean better sleep at night and less daytime sleepiness.
Not sure which type of food may be triggering your heartburn? Learn to recognize suspect foods by keeping a diary of what you eat for dinner. Then, the next day record if you had nighttime heartburn. Look for patterns linking certain foods to acid indigestion. Try to avoid those foods for a few days. Later, add them back one at a time, testing to see if they cause trouble.
At night, whether you're lifting the kids to put them in bed or picking up laundry, bend with your knees when performing evening chores. Bending forward at the waist causes some people to experience heartburn. It's especially important to avoid it in the evening if you experience heartburn at night.
Over-the-counter antacids can provide short-term relief for occasional heartburn. Antacids neutralize stomach acid so it won't cause heartburn. Choose from dissolvable or chewable tablets or liquids. If one or two doses of antacid don’t do the trick, you may need to take an antacid every hour through the night to keep acid neutralized. If so, you should see your doctor to determine the right treatment for you.
Drugs called H2 blockers decrease acid production. They can be taken at bedtime to suppress nighttime production of acid. Available both over-the-counter and as prescriptions, H2 blockers help about half of heartburn sufferers. Brands include Axid, Pepcid AC, Tagamet HB, and Zantac 75. Some drugs interact with H2 blockers, so be sure to tell your doctor about all your medications.
Proton pump inhibitors are available over the counter and by prescription. They decrease stomach acid production, and the prescription versions help heal esophagus damage caused by reflux. Brands include Aciphex, Nexium, Prevacid, Prilosec, Protonix, and Zegerid. To control severe heartburn, doctors may recommend more than one drug. Other options: Promotility agents such as Reglan speed up digestion.
Reviewed by Andrew Seibert, MD on November 11, 2011
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