Dealing with Nighttime Heartburn

It is estimated that about 70 percent of people suffering from gastroesophageal reflux disease (GERD) will experience nighttime heartburn, starting in their chest and even rising into their throat, disrupting their sleep.

The natural sleep position, lying prone, actually exacerbates the acid reflux problem. “When you are in an upright position, gravity helps the esophagus clear the refluxed material back to the stomach,” says Scott Gabbard, MD, a gastroenterologist at the Cleveland Clinic. “But when lying flat, we lose the help of gravity, and there may be more delayed clearance of the refluxed material.”

Of course, the most effective “cure” here is to treat the GERD and defeat it through proper care and nutrition. But in the meantime, what can you do to improve your heartburn-interrupted sleep?

The first step to avoiding heartburn troubles at night is to eat early and eat light. Don’t stuff yourself, but keep portions small and your intake slow and easy — and quit eating at least three hours before bedtime, even four or five. If you want to learn a secret to light — even weight-controlling — eating habits, just follow the Okinawan approach — eat only 80 percent of what’s put in front of you (providing it’s a normally sized meal).

Also, when you sleep, sleep on your left side, which lessens the effects of acid reflux, whereas sleeping on your right worsens matters, according to Michael Vaezi, MD, PhD, a professor of medicine in the division of gastroenterology, hepatology and nutrition at Vanderbilt University Medical Center in Nashville, Tenn.

Also, sleep with your head elevated to prevent or retard passage of the acid up the esophagus. You can accomplish this with special pillows or with a mattress that adjusts (expensive, though). Two  pillows, one large on the bottom and one smaller on the top, might accomplish the elevation you need, so experiment. Also, wear loose-fitting clothes, as tight garments can increase your heartburn symptoms.

Finally, avoid alcohol at night. It will only make matters worse, both for your heartburn and for your overall sleep. Smoking too should be ceased hours before bedtime.

Ultimately, losing weight is the best path to getting rid of GERD — and also for avoiding other nighttime difficulties such as snoring and even sleep apnea (repeated, intermittent cessation of breathing). Whatever your problem with sleeping, see your family doctor for help, and if need be, seek out a sleep professional for a full sleep evaluation.

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