Here's Why Acid Reflux Seems Worse When You Sleep at Night

Most people have experienced acid reflux, a burning and uncomfortable feeling in their chest, at some point in life following a big meal. But acid reflux is a chronic condition for about 20% of adults in the United States. And, to make matters worse, this common condition seems to intensify just when you want to relax and fall asleep. 

Fortunately, in most cases, lifestyle and medications help relieve the burning and pain. In some cases, surgery might be necessary to treat symptoms and prevent damage. 

At Michael Sutker, MD, in McKinney and Dallas, Texas, board-certified general surgeon Dr. Michael Sutker and our team can develop a personalized treatment plan for your acid reflux so you can eat again without worry — and fall asleep without discomfort.

Why does acid reflux seem to intensify when you hit the sack? Here, Dr. Sutker discusses the reasons for these nighttime symptoms, and explains what you can do about them. 

What causes acid reflux?

Acid reflux occurs when stomach acid flows back into the esophagus, causing painful burning sensations in your chest and throat. This happens when the lower esophageal sphincter (LES) — a muscular ring separating the stomach from the esophagus — relaxes or weakens, allowing the backflow of digestive acids. 

The sensitive tissue that lines the esophagus gets irritated when doused with acid and, as a result, you experience heartburn and a backwash of food or sour liquid. When acid reflux is chronic, it’s called gastroesophageal reflux disease, or GERD. 

Why is acid reflux worse at night?

Yes, GERD symptoms do hit harder at night — it’s not just your imagination. Here’s why:

You’re horizontal

When you’re sitting or standing up, gravity helps move your food through your esophagus and into your stomach. One of the primary reasons acid reflux tends to worsen at night is that when you’re in a horizontal position, gravity no longer works in your favor to keep stomach acid from creeping into your esophagus. 

When you’re in a reclined position, your esophagus gets a more prolonged exposure to the acid, resulting in increased discomfort.

Reduced swallowing 

Swallowing helps clear acid from your esophagus, and when this reflex is less active, acid is more likely to linger and cause irritation. During sleep, your swallowing reflex decreases. 

Meal timing and size

Dinner tends to be the biggest meal of the day for the average American. Unfortunately, many people eat dinner too close to bedtime, leaving partially undigested food in their stomach that can flow back into their esophagus. And, if that meal is spicy, acidic, or fatty, your symptoms can be even worse. 

How to reduce acid reflux attacks

Fortunately, there are many simple strategies to make your sleeping habits more compatible with digestion. Here are a few ways to reduce nighttime acid reflux attacks:

Sleep with your head elevated

Using a wedge pillow or extra pillows to support your head, neck, and shoulders in a more elevated position, you can get gravity back on your side. This position can keep your food down in your stomach for proper digestion.

Eat smaller meals

If you know you’re eating a late dinner and plan to head to bed soon after, eat less. Also, opt for less fat and spice. This tip can also help with weight management. 

Eat earlier

It takes the stomach four to five hours to empty a meal fully. Try to eat your final meal of the day at least three hours before you plan to go to bed.  

If you’re having trouble sleeping because of acid reflux, we can help. To get personalized advice on how to relieve symptoms and get a good night’s sleep, call Michael Sutker, MD, today, or request an appointment online any time.