Nightly heartburn affects four out of five people who regularly suffer from heartburn and acid reflux. The discomfort and bitter taste can make sleep unpleasant or even difficult.
While over-the-counter and prescription medications can treat the symptoms when you have heartburn, „the cornerstone of treatment for any disease or disorder is prevention,“ say Lawrence J. Cheskin, MD, and Brian E. Lacy, MD, PhD, in their book Healing Heartburn.
Fortunately, sometimes a lifestyle change is enough to prevent nighttime heartburn. WebMD reached out to heartburn experts to get tips on how to stop nightly heartburn before it occurs – so you can sleep well tonight.
1. Sleep on your left side. This position seems to help reduce nighttime heartburn symptoms, says David A. Johnson, MD, Chairman of Internal Medicine at Eastern Virginia School of Medicine, Norfolk, Virginia. To remember which side to sleep on, Johnson offers this memory trick: Right is wrong.
2. Lose a little weight. Heartburn often gets worse with weight gain, but losing just two and a half pounds can help alleviate heartburn symptoms, says Johnson.
3. Sleep with elevated upper body. When lying flat in bed, the neck and stomach are practically at the same level, making it easier for stomach acid to flow into the esophagus and cause heartburn. You can elevate your body in two ways:
- Raise the head of your bed on 4 to 6 inch blocks.
- Sleep on a wedge-shaped pillow that is at least 15 to 25 cm thick at one end. Do not substitute it with regular pillows. They only elevate your head and not your entire upper body.
4. Wear loose-fitting clothing. Tight clothing, especially around your waist, can put pressure on your stomach and lead to heartburn.
5. Avoid heartburn-triggering foods. Heartburn-triggering foods vary from person to person. Some of the most common foods and drinks that can cause heartburn and disrupt sleep include alcohol; caffeinated beverages like cola, coffee, and tea; chocolate and cocoa; peppermint; garlic; onions; milk; fatty, spicy, greasy, or fried foods; and acidic foods like citrus or tomato products. Keep a food diary to figure out which foods may trigger your heartburn.
6. Avoid late-night meals or large meals. Avoid eating meals two to three hours before bedtime to reduce stomach acid and allow the stomach to partially empty its contents before you sleep, advises the American Gastroenterological Association. Since large meals put pressure on your stomach, try having a smaller meal in the evening to prevent nighttime heartburn symptoms.
7. Relax while eating. If you feel stressed or rushed while eating, it can cause your stomach to produce more stomach acid. Also, relax after eating – but do not lie down. Some professionals recommend trying relaxation techniques like deep breathing or meditation.
8. Stay upright after eating. This reduces the risk of acid reaching the esophagus. Also, avoid bending over or straining while lifting heavy objects.
9. Wait before exercising. Wait a few hours after a meal before engaging in intense physical activity. This gives your stomach time to empty.
10. Chew gum. Chewing gum stimulates saliva production, which can soothe your esophagus and flush acid into your stomach. Choose a different flavor than peppermint, as it can worsen heartburn in some people.
11. Stop smoking. Smoking is a double danger when it comes to heartburn. Cigarette smoke can not only irritate your gastrointestinal tract, but smoking can also relax the muscles of the esophagus that keep stomach acid where it belongs.
12. Discuss the medications you are taking with your doctor. Some medications can cause or worsen heartburn, including NSAIDs, some osteoporosis medications, some heart and blood pressure medications, some hormone medications, some asthma medications, and some depression medications. Just as the foods that trigger heartburn can vary from person to person, so can the triggers of medications.
If lifestyle changes do not help you manage your heartburn, it may be time for medication or another treatment. Call your doctor if:
- Your heartburn does not go away.
- You have difficulty swallowing.
- Your heartburn causes vomiting.
- You still have heartburn after taking antacids for two weeks.
Never ignore persistent heartburn. Untreated chronic acid reflux can scar and narrow your esophagus, warns Gary Gitnick, MD, Chief of Digestive Diseases/Gastroenterology at UCLA. In the worst case scenario, untreated chronic heartburn – a symptom of gastroesophageal reflux disease (GERD) – can develop into esophageal cancer.