While some people may experience heartburn while they sleep, it is possible to prevent these uncomfortable symptoms. Heartburn may occur infrequently or nightly, and it is important to seek treatment to prevent significant consequences. Fortunately, there are many effective treatment options.
What is Heartburn?
Heartburn is a very common condition that causes a sensation of burning in the middle of the upper stomach or behind the breastbone. It is sometimes called gastroesophageal reflux disease (GERD).
People who have GERD may also experience vomiting or pain with swallowing. They may have a hoarse voice or be prone to developing pneumonia. They may also have an acidic taste in their throat or mouth.
What Causes Heartburn?
Heartburn is commonly associated with eating too much, or with eating spicy, acidic, or caffeinated foods. Some problem foods may include:
- tomato products
- fatty foods
Why Can Heartburn Happen While You Sleep?
Food travels from the mouth to the stomach through the esophagus, which is a muscular tube. Between the esophagus and the stomach is a muscular ring called the lower esophageal sphincter (LES). The LES stops food and stomach acid from traveling back up the esophagus, which can lead to symptoms of heartburn.
While lying in bed, gravity is not keeping the contents of the stomach away from the LES. If the LES is weak, it may open a little and allow some of the stomach acid into the esophagus, causing a burning sensation. Certain foods, such as those described above, may also cause this sphincter to relax.
Some people experience a sensation of choking at night. It may be the result of GERD, but another possibility for recurrent choking spells at night is sleep apnea.
How Should Heartburn Be Treated?
There are many highly effective treatment options for heartburn. If you are experiencing symptoms at night, you need to seek treatment as this is not a normal phenomenon. Commonly used over-the-counter and prescription medications include:
- antacids (Tums, Maalox, Mylanta)
- histamine antagonist medications (Zantac, Pepcid, Tagamet)
- proton pump inhibitors (Prilosec, Nexium, Prevacid, Protonix)
Surgical treatment may rarely be necessary in some cases. This is most often reserved for those cases where medications are ineffective. The most common surgery, called Nissen fundoplication, involves surgically wrapping the stomach around the lower esophagus to create reinforcement that prevents reflux.
You may also consider some simple lifestyle modifications. These include avoiding large meals late at night, especially those that include troublesome foods. Losing weight is another excellent option. Also, raising the head of the bed 6 to 8 inches with the use of blocks of wood, a foam wedge, or commercial products can be very effective. However, it is not recommended to use extra pillows as this may create a bend and unnatural pressure on the stomach, causing worsened reflux.
DeVault, KR et al. “Updated guidelines for the diagnosis and treatment of gastroesophageal reflux disease.” Am J Gastroenterol. 2005; 100:190.
Kaltenbach, T. et al. “Are lifestyle measures effective in patients with gastroesophageal reflux disease? An evidence-based approach.” Arch Intern Med. 2006; 166:965.