
Acid reflux, also known as gastroesophageal reflux, is a common condition that affects up to 20% of the US population. It occurs when stomach acid moves up from the stomach and into the esophagus, causing symptoms such as heartburn, irritation, and a burning sensation in the chest and throat. Acid reflux can interfere with sleep, as lying down worsens reflux due to the effects of gravity. This can lead to a cycle where sleep deprivation enhances the perception of acid in the esophagus, further disrupting sleep. However, there are strategies to improve sleep quality for people with acid reflux, including sleeping on the left side, elevating the head, and making dietary and lifestyle changes.
Characteristics and their Values
| Characteristics | Values |
|---|---|
| Acid reflux, also known as | Acid indigestion, gastroesophageal reflux, heartburn |
| Occurrence | A common experience for people with GERD |
| GERD | Gastroesophageal reflux disease |
| Occasional episodes of reflux | Normal |
| Regular episodes of reflux | Serious consequences |
| GERD symptoms | Heartburn, choking, sleep apnea, inflammation of the esophagus, Barrett's esophagus, cancer of the esophagus |
| Risk factors | Alcohol consumption, smoking, obesity |
| Solutions | Sleep on the left side, elevate the head, avoid caffeine, nicotine, alcohol, large meals and beverages late at night, exercise, stick to a sleep schedule, relax before bed, get rid of distractions, lose weight |
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What You'll Learn

Lifestyle changes to prevent acid reflux
Lifestyle changes can help prevent acid reflux and improve your quality of life if you have gastroesophageal reflux disease (GERD). GERD is a chronic condition where stomach acid flows back into the oesophagus, and it can interfere with sleep.
Diet
Trigger foods differ from person to person but often include chocolate, coffee, fried foods, peppermint, spicy foods, carbonated beverages, and foods that are high in fat, salt, or spice. It is recommended to avoid eating problem foods late in the evening and to eat smaller, more frequent meals instead of bigger, heavier meals. You should also avoid late-night dinners and bedtime snacks and not go to bed with a full stomach. Eat meals at least 2 to 3 hours before lying down to give your food time to digest and for acid levels to decrease.
Sleep
Sleep hygiene refers to habits and practices that help you sleep well regularly. This includes your sleep environment, the times you go to bed and wake up, and your bedtime routine. It is recommended to sleep on your left side to reduce reflux episodes and exposure of the oesophagus to stomach acid. You can also prop up the top of your bed by at least 6 inches to keep gravity from pulling food back up into your oesophagus.
Other lifestyle changes
- Quit smoking as it increases stomach acid production and reduces the function of the lower oesophageal sphincter.
- Reduce excess weight around the midsection to ease pressure on the stomach.
- Wear loose-fitting clothes to ease pressure on the stomach.
- Avoid alcohol as it can increase the risk of GERD.
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Acid reflux and sleep: a bi-directional relationship
Acid reflux and sleep disturbances are closely linked. Experiencing acid reflux while trying to sleep can worsen the quality of life for people with the condition. Nighttime acid reflux can cause a burning sensation in the stomach, chest, and throat, and some people feel like they are choking on stomach acid when they suddenly awaken in the night. This can be a scary experience.
During the day, gravity helps send rising digestive acid in your oesophagus back down into your stomach. When you lie down, gravity no longer works in your favour to keep stomach acid from creeping into your oesophagus. When you're in a reclined position, your oesophagus gets more prolonged exposure to the acid, resulting in increased discomfort. Swallowing helps clear acid from your oesophagus, but during sleep, your swallowing reflex decreases.
How to prevent acid reflux at night
- Avoid eating large meals late at night.
- Avoid eating within three hours of bedtime.
- Avoid caffeine and nicotine.
- Avoid alcohol before bed.
- Avoid naps after 3 pm.
- Elevate your head while sleeping.
- Sleep on your left side.
- Exercise regularly.
- Stick to a sleep schedule.
- Lose weight if you are overweight or obese.
When to seek medical advice
If lifestyle changes are not helping improve your symptoms, speak with a healthcare professional. They can help develop a treatment plan that's right for you. Doctors can recommend medications or, in some cases, surgery to treat symptoms and prevent damage.
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Raising your head and sleeping on your left side
Acid reflux, or gastroesophageal reflux, occurs when stomach acid flows back into the oesophagus, the tube that connects the throat to the stomach. This can cause a burning sensation in the stomach, chest, and throat, known as heartburn. Acid reflux can be a normal occurrence, but when it happens regularly, it can have serious consequences and is known as gastroesophageal reflux disease (GERD).
GERD can significantly impact sleep quality, with up to 80% of people with the condition experiencing symptoms at night. The condition is often linked to other sleep issues such as obstructive sleep apnea, and certain factors like alcohol consumption, smoking, and obesity can increase the risk for both GERD and sleep apnea.
One way to help alleviate acid reflux and improve sleep for those with GERD is to raise your head while sleeping. When lying down, gravity no longer helps keep stomach acid down, making it easier for reflux to occur. Elevating the head of the bed by at least 6 inches, not just with extra pillows but by using an adjustable bed frame, can help utilise gravity to prevent food from backing up from the stomach into the oesophagus. This can be especially beneficial for those with GERD, as it can reduce reflux symptoms when lying down.
In addition to raising the head, sleeping on the left side is also recommended for those experiencing acid reflux. A 2016 review found that sleeping on the left side reduces oesophageal acid exposure by up to 71%. Sleeping on the left side helps reduce reflux episodes and exposure of the oesophagus to stomach acid. Sleeping on the back, on the other hand, can make reflux more likely. Therefore, adjusting the sleeping position and elevating the head while lying down can be beneficial for those struggling with acid reflux and GERD, improving their overall sleep quality.
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Acid reflux medicines and surgery
Acid reflux, also known as gastroesophageal reflux or acid indigestion, is a common condition that occurs when stomach acid flows back into the oesophagus (the tube that connects the throat to the stomach). This backflow of acid can irritate the oesophagus and cause a range of symptoms, including heartburn, chest pain, and hoarseness. While occasional episodes of acid reflux are normal, frequent and regular episodes can indicate a more serious condition called gastroesophageal reflux disease (GERD).
Medicines for Acid Reflux
There are several over-the-counter (OTC) medications available to treat acid reflux and GERD. These include:
- Antacids: These drugs neutralise stomach acid to relieve heartburn, acid indigestion, and stomach upset. Some antacids also contain simethicone, which helps eliminate gas.
- Proton-pump inhibitors: Medications such as esomeprazole (Nexium 24HR), lansoprazole (Prevacid 24HR), and omeprazole (Prilosec OTC) are available without a prescription to treat frequent heartburn. Higher-strength versions of these drugs are also available by prescription.
- H2 blockers: These medications are available by prescription and are effective in relieving heartburn and treating reflux, especially in those who have not received prior treatment.
- Promotility agents: These drugs stimulate the muscles of the gastrointestinal tract to help prevent acids from remaining in the stomach for too long. Metoclopramide (Reglan) is an example of a promotility agent used to treat heartburn associated with GERD. However, it can cause serious side effects, including drowsiness, fatigue, diarrhoea, restlessness, and movement problems.
If OTC medications do not provide sufficient relief or if symptoms persist or worsen, it is important to consult a doctor. They may recommend prescription medications or explore other treatment options, including lifestyle changes.
Surgery for Acid Reflux
For individuals who do not respond completely to medications or cannot take them due to certain reasons, surgery may be recommended. Laparoscopic Nissen fundoplication is considered the 'gold standard' surgical treatment for GERD. It involves making small incisions in the abdomen and wrapping the upper stomach (fundus) around the lower oesophagus to create a valve that prevents acid reflux. This procedure has a high satisfaction rate among patients, with most being able to discontinue acid-suppression medications.
Other surgical options include transoral incisionless fundoplication and the LINX® Reflux Management System, which uses a flexible band of magnetic beads enclosed in titanium placed around the oesophagus to prevent acid reflux. Surgery is generally safe and effective, but it is important to discuss the risks, options, and alternatives with a surgeon before proceeding.
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GERD and sleep apnea
Gastroesophageal reflux disease (GERD) is a chronic condition where stomach acid flows back up into the oesophagus, the tube that connects the throat to the stomach. This can cause symptoms such as indigestion, acid reflux, heartburn, chest pain, a sour taste in the mouth, and bad breath. GERD can interfere with sleep, as lying down can make reflux worse.
Obstructive sleep apnea (OSA) is a sleep-related breathing disorder where the upper airway becomes blocked, causing airflow to decrease or stop entirely. This leads to frequent awakenings throughout the night, and people with OSA often complain of daytime sleepiness, headaches, forgetfulness, and dry mouth.
There is a correlation between GERD and OSA, with studies showing that around 12% of people with one condition also have the other. However, the exact relationship between the two is not yet fully understood. Some possible explanations for the link include:
- Risk factors: Certain risk factors, such as obesity, diabetes, and smoking, are common to both conditions and may increase the likelihood of developing both.
- Pressure changes: Pressure changes in the oesophagus due to sleep apnea may increase the risk of acid reflux.
- Sleep disturbances: Sleep disturbances associated with OSA may induce or worsen GERD symptoms, and lack of sleep can also increase sensitivity to acid in the oesophagus.
- Airway irritation: Irritation of the oesophagus due to GERD may negatively affect nighttime breathing, contributing to OSA.
Treating either sleep apnea or acid reflux appears to improve both conditions. Lifestyle changes, such as sleeping on the left side, elevating the head during sleep, and dietary modifications, can help manage both conditions.
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Frequently asked questions
Acid reflux, also known as gastroesophageal reflux, happens when stomach acid moves up from the stomach and into the esophagus. Occasional episodes of reflux are normal, but when they occur regularly, they can have serious consequences and are known as gastroesophageal reflux disease (GERD).
Acid reflux can get worse at night due to several reasons. Firstly, gravity helps send rising digestive acid in the esophagus back down into the stomach. When lying down, gravity no longer assists in keeping stomach acid down, resulting in prolonged exposure of the esophagus to acid. Secondly, people tend to eat dinner close to bedtime, leaving partially undigested food in the stomach that can flow back into the esophagus.
Here are some tips to prevent acid reflux while sleeping:
- Sleep on your left side.
- Elevate the head of your bed or use a wedge pillow.
- Avoid large meals and beverages late at night.
- Avoid eating beyond fullness and too quickly.
- Avoid trigger foods such as spicy and fatty foods.
- Avoid caffeine, nicotine, and alcohol before bed.
- Maintain a sleep schedule and a relaxing bedtime routine.











































