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Sleep Care

Acid Reflux (G.E.R.D.) & Sleep

If you’ve ever awakened with a bitter taste in your mouth, or a burning sensation in the back of your throat, you’ve likely experienced some acid reflux (also known as gastroesophageal reflux disease or GERD). Heartburn—a burning or inflamed sensation around the heart in the middle of the chest—is another common symptom. This situation is experienced by roughly one-third of Americans a year and accounts for up to $10 billion in related healthcare costs.

Acid reflux occurs when some of the digestive acid normally in the stomach

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escapes and works its way up the esophagus. This acid is what produces the bitter taste or burning sensation. While not typically serious, chronic episodes of acid reflux can cause damage to the esophagus.

Causes of Acid Reflux

There are a number of causes that can produce acid reflux symptoms in an individual. One of the most common is eating a large meal, particularly close to bedtime. Obesity and pregnancy can play a role as well. Foods such as tomatoes, citrus fruits, onions, and chocolate, as well as spicy or fatty food, will often produce acid reflux, particularly if a person bends over at the waist right after eating. Other causes can include smoking, drinking certain beverages (i.e., alcohol, coffee, tea), and taking some medications, such as muscle relaxers or blood pressure meds.

Acid Reflux and Sleep

Since acid reflux involves acid from the stomach working its way back up the esophagus, the horizontal position that most people lay in when sleeping can serve to significantly increase acid reflux symptoms. Eating foods high in chemicals that can promote sleepiness (such as turkey, which has lots of tryptophan), and then sleeping before the food can be completely digested also increases the odds for acid reflux to occur.

People who suffer from sleep apnea may notice that their heartburn and reflux are made worse by their apnea. During the respiratory events associated with sleep apnea, the negative pressure present in the airway makes it more likely that stomach acid will rise up into the esophagus, causing irritation. GERD can also have a negative effect on a person’s sleep apnea. When the acid rises into the esophagus, it becomes irritated and swollen, and this swelling makes it more likely that the airway will close during the night, increasing the intensity of the sleep apnea.

Reducing Acid Reflux Problems

Fortunately, there are a number of things an individual can do to reduce acid reflux symptoms, particularly as they relate to sleep. Avoid eating the foods mentioned above that are likely to cause acid reflux. Additionally, make sure to leave at least three hours for food to digest completely before going to sleep. If acid reflux problems persist during sleep, try sleeping on several pillows, or in an inclined bed or recliner chair—the elevated angle will allow gravity to help keep the acid down in the stomach rather than have it make its way up the esophagus. In some cases, antacids such as Maalox or Rolaids can be helpful, and medications that reduce production of stomach acid or coat the stomach lining and esophagus can be considered as well. For individuals with sleep apnea—which can lead a person to take deep breaths while asleep to try and recover oxygen—the swallowing reflex can induce acid reflux, so treating sleep apnea can improve their symptoms. If you have been diagnosed with sleep apnea and GERD, or believe you may have them, it is important to seek treatment for both disorders. CPAP therapy has been shown to decrease the frequency and intensity of GERD, and successful management of GERD can help to improve the overall health of your airway.

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