Having acid reflux can be distressing – especially if you don’t know what’s causing it. Some people are more prone to this condition than others, but it affects us all at some point.
Experiencing acid reflux during the day is bad enough, but at night it’s even worse. The feeling of choking on acid while you’re trying to sleep is horrible. It can make it difficult to fall asleep, and you’re more likely to wake up suddenly during the night. Waking up choking in the night is scary because you temporarily lose the ability to breathe at normal efficiency.
Today, we’re going to look into what acid reflux is, and what causes it. We’ll examine the difference between acid reflux and GERD (gastroesophageal reflux disease). Finally, we’ll go through the ways that you can prevent acid reflux, and how you can relieve it.
What is Acid Reflux?
According to the American College of Gastroenterology, over 60 million Americans experience it at least once a month. Searching the web for “acid reflux while sleeping can’t breathe” shows you just how common the problem is. So, you’re not alone.
Acid reflux is what it’s called when acid from your stomach flows back into the esophagus. The burning sensation is called heartburn, though sometimes the terms acid reflux and heartburn are used interchangeably.
Your stomach contains acid to help it break down and digest food. This acid plays an important role and is supposed to be there. However, it’s designed to stay in your stomach. There’s a valve at the bottom of the esophagus called the lower esophageal sphincter (LES).
The LES usually holds acid in the stomach and stops it from escaping. It’s when this valve doesn’t work correctly that acid reflux occurs. Sometimes the valve doesn’t close properly after you eat, and sometimes it opens too often.
The reason acid reflux is so uncomfortable is due to the lining of the esophagus. As it’s not designed to interact with acid, the esophageal lining is more sensitive than the stomach lining. This is why you can’t feel acid in your stomach, but it burns when it’s in your gullet.
What is GERD?
It’s common to experience acid reflux occasionally, no matter who you are. It’s just as normal as an occasional headache and isn’t usually a cause for concern. Our bodies aren’t perfect, after all. Sometimes the LES relaxes a bit too soon after eating for no apparent reason. Heartburn and acid reflux happen to everyone from time to time, as annoying as that is.
However, for some people, acid reflux happens far too often. You shouldn’t be experiencing heartburn often enough for it to cause you considerable concern or distress. In short, it shouldn’t be affecting your day-to-day life.
Experiencing acid reflux more often than twice a week is a legitimate medical condition. It’s called gastroesophageal reflux disease (GERD), sometimes called acid reflux disease. With GERD, the episodes of acid reflux can also be more severe than usual, and last longer. You may experience more severe symptoms than you would with mild acid reflux.
Acid Reflux at Night Symptoms
If you have acid reflux during the night, these are the symptoms to look out for. We’ll split this into two sections: common symptoms, and more severe symptoms that are usually associated GERD.
The most common acid reflux symptoms include:
- Burning pain in the chest (heartburn)
- A sour taste in the mouth
- Regurgitating food or stomach acid
- Bad breath
- Persistent hiccups
- A sensation of food being stuck in your throat or chest
- Feeling sick
- The sensation of choking on acid
These symptoms can happen whatever you’re doing. However, they tend to be much worse when you lie down, bend over or exercise.
If you have GERD, you may experience more severe symptoms along with the above. These symptoms are caused by persistent reflux (more than twice a week for an extended period of time).
These include the following:
- A persistent cough
- Acid reflux blocking the airway, so it’s more difficult to breathe
- Excessive saliva production
- Trouble swallowing, due to dysphagia (narrowing of the esophagus)
- Wheezing due to stomach acid getting into the windpipe (trachea)
- A chronic sore throat
- Bloody vomiting or stools
If you think that you have GERD or the above symptoms, you should see a doctor. Having GERD for a long time without treating it can cause further complications. Examples include pneumonia, esophagitis (inflammation of the esophagus) and esophageal cancer.
What are the Causes of Acid Reflux?
It happens to everyone from time to time. Young or old, male or female, you can be sure to experience acid reflux occasionally. However, there are specific risk factors which make acid reflux more likely. These factors also increase your chance of developing GERD.
Heartburn at night due to pregnancy is extremely common. According to WebMD, more than 50% of pregnant women suffer from severe heartburn. This is the case for two reasons.
Firstly, pregnancy hormones slow digestion, to allow the baby more time to absorb nutrients. The LES can relax more as a side effect, causing reflux. Secondly, as the baby gets bigger, the uterus is pushed upwards into the stomach. This can push stomach acid up into the esophagus.
Being a smoker increases your risk of acid reflux. A study published in the scientific journal Gut found that smoking acutely increases the frequency of acid reflux episodes. This is due to two main reasons.
Firstly, nicotine (the main drug found in tobacco) encourages the LES to relax. Secondly, smoking can cause a persistent cough, which can force stomach acid into the esophagus. Coughing frequently is also likely to keep you awake at night.
Being obese increases your chances of acid reflux. Current scientific research hasn’t yet discovered exactly why this is the case. However, it could be due to excess body fat compressing the stomach, leading to reflux.
4] Eating Habits
Consuming specific food and drinks can make you vulnerable. The triggering foods can differ from person to person, and it’s unclear why.
The most common perpetrators are:
- Spicy and strong foods such as chilies, onions, garlic, and pepper
- Fatty, greasy and fried foods
- Citrus fruits such as lemons and oranges
- Tomatoes and tomato-based products
But it’s not just about which foods you eat. Heartburn can also be affected by how and when you eat.
Overlarge meals can trigger reflux, as your stomach acid is pushed upwards by the large volume of food. Also, eating too soon before bed can bring on acid reflux. This is because you haven’t allowed your stomach time to digest the food before you lie down.
5] Hiatal Hernia
A hernia is used to describe a body part pushing into an area where it doesn’t belong.
In the case of a hiatal hernia, it’s your stomach pushing up through a small opening in the diaphragm. Having a hiatal hernia makes acid reflux far more common. Hiatal hernias are most common among women, overweight people, and people over 50.
Being on certain medications can make acid reflux more likely. They can also make heartburn worse once you have it.
These medications include:
- NSAIDs such as aspirin and ibuprofen
- Blood pressure and heart disease medications
- Birth control pills containing progesterone
- Asthma medications
If you suspect that your medication may be causing heartburn, speak to your doctor. Do not stop taking any medication without getting your doctor’s permission first.
How to Stop Acid Reflux at Night
It’s far easier to prevent something from happening than to try and cure it.
The same goes for acid reflux. Once you have a reflux attack, it can be fairly hard to get rid of it. There are steps that you can take to prevent acid reflux from happening in the first place. Follow these steps and you’ll find yourself choking on acid reflux at night a lot less frequently.
1] Quit Smoking
If you’re a smoker, quitting will make your acid reflux crop up far less often. If you’re struggling, there are many guidebooks available to help you quit. You can also buy nicotine patches and gum online to help ease off of the cigarettes.
2] Lose Weight
As previously mentioned, being overweight or obese is a common trigger for acid reflux.
Losing even a few pounds could help reduce how often you suffer from heartburn. Try decreasing your portion sizes and exercising more frequently. Of course, don’t attempt to lose weight if you’re already healthy BMI (18.5 to 25).
Incidentally, you’re more likely to gain weight if you stay up late at night.
3] Change Your Mealtimes
If you eat large meals, particularly before bed, this could be what’s causing your acid reflux.
Instead of eating 2 or 3 large meals per day, split your food up into smaller, more frequent meals. Also, avoid eating in the 4 hours before bed. This will give your stomach a chance to process the food before you lie down.
4] Avoid Trigger Foods
To figure out what’s causing it, keep a food diary for a few weeks. Write down what you eat and when. Also, write down the time and date of any acid reflux attacks. You may notice a pattern of acid reflux after eating certain foods, such as citrus or spicy foods. That will make it easier to rid them from your diet.
5] Stay Upright After Eating
You can often avoid getting acid reflux if you stay upright for at least a few hours after eating.
You may feel sleepy after a meal, but try to avoid lying down straight away. Instead, say standing or sitting up for a while. Also, avoid exercising or exerting yourself before your stomach has the chance to digest your food. You may find that stretching, running or bending over brings acid reflux on.
6] Wear Loose Clothes
Belts and clothes which constrict the stomach can end up pushing stomach acid up into the esophagus.
Try loosening your belts, wearing them lower on your body, and wearing loose clothes. Sleep naked if it’s warm enough. If you must wear clothes to bed, choose a nightdress or very loose fitting pajamas.
7] Change Your Medication
Your medication could be making your acid reflux attacks more frequent or more severe.
If you’ve tried all of the above tips and still have regular reflux, you should talk to your doctor. Express concern that your medication may be causing it, and ask to switch to a different prescription if possible.
What’s the Best Sleeping Position for Acid Reflux?
Many people find that their acid reflux comes on, or gets worse, at night. This is mostly to do with gravity. Most people lie flat in their beds during the night. When you lie down, your stomach acid no longer sits in the bottom of the stomach. It flows up towards the esophagus.
Typically, if your lower esophageal sphincter (LES) is working correctly, this isn’t a problem. But if it’s open for whatever reason, lying down allows acid to flow into the esophagus, causing heartburn. You can remedy this by altering your sleeping position.
Here are our top four tips for sleeping with acid reflux:
1] Sleep on Your Left Side
Acid reflux gets worse when you’re lying on your back, front, or right side. Due to the shape and position of your stomach, these positions allow for acid to flood your LES. However, when you sleep on your left side, your LES stays above your stomach contents. This makes it harder for reflux to happen.
2] Sleep Sitting Up
For the same reasons, sitting up straight while sleeping can help. This will allow gravity to keep your stomach acid away from your esophagus. If you have a particularly comfy chair, you might find it feasible to sleep sat upright. However, not everyone finds it comfortable.
3] Sleep with Extra Pillows
If sitting up to sleep isn’t working for you, you can use extra pillows in bed instead. Lie on your back or side, but prop your head and chest up with pillows. This will help your stomach stay in an upright position.
4] Raise Your Bed
Some people may find it too uncomfortable to sleep with lots of pillows underneath them. If you’re one of them, don’t worry. You can also sleep propped up by raising the head of your bed. Insert books or blocks under the head of your bed to raise it up. This will allow you to sleep lying down, with your normal pillow, while still keeping your stomach elevated.
Acid Reflux at Night Home Remedies
Even if you follow all of the above preventative measures, you may still suffer from reflux from time to time. Fortunately, there are ways to relieve it once it starts. If you’re looking for acid reflux immediate relief, you might have some luck with the following remedies. These are all easy things you can try at home without visiting a doctor.
Over-the-counter antacids often help quite well with acid reflux. These alkaline medicines neutralize stomach acid, ridding you of the burning feeling. They come in the form of chewable tablets and liquids. Some favorite brands include Alka-Seltzer, Rolaids, and Tums. If you don’t have any antacids on hand, you can try baking soda instead. Dissolve a teaspoon into a cup of water.
Ginger is a traditional stomach settler that has been around for centuries. Ginger comes in many forms, but for a simple tea, soak fresh ginger root in hot water. Avoid ginger ale, though, as the carbonation may make reflux worse.
According to research by Harvard University, licorice helps to lubricate and coat the esophageal lining. This helps acts as a barrier to stomach acid, reducing the burning feeling. You can buy pills containing licorice extract, licorice teas, and licorice candy.
Chamomile has a medically proven soothing effect on the digestive tract. A study in Molecular Medicine Reports found that chamomile is as effective as antacids for treating acid reflux. As a bonus, chamomile tea also helps you feel sleepy. Perfect for relieving acid reflux before bed.
What to Drink for Heartburn
It’s always important to stay properly hydrated. However, when you’re suffering from heartburn, you should be careful when choosing which drink to have. This is because some drinks can make acid reflux worse.
- Ginger, chamomile and licorice teas, which are all beneficial for heartburn as we’ve previously covered. However, don’t make the tea too hot as this can make things worse. Leave it to cool down a little before drinking.
- Low-fat milk and yogurt drinks. Milk is alkaline and therefore can neutralize stomach acid. However, high-fat foods can sometimes make heartburn worse, so avoid full-fat milk and cream.
- Decaffeinated teas and coffees. Caffeine can make heartburn worse, so if you’re craving tea of coffee, opt for decaf versions. They won’t necessarily help, but they probably won’t make the problem worse.
Do Not Drink:
- Caffeinated beverages such as black tea, coffee, and energy drinks
- Chocolate-based drinks such as hot cocoa and chocolate milk
- Carbonated drinks such as sodas and sparkling water, even decaffeinated and diet varieties
- Citrus juices such as orange juice, lime cordial or grapefruit juice. Citrus is a known trigger for heartburn.
Does Water Help Heartburn?
Depending on what triggered your acid reflux, water can sometimes help. Drinking a small glass of water can help to rinse the stomach acid back into the stomach, relieving symptoms. However, be careful only to drink a little at a time.
If your acid reflux was caused by eating too large a meal, then drinking a lot of water will only add to the contents of the stomach. This could lead to the reflux getting worse.
What Else Could Cause Choking at Night?
If you find your symptoms aren’t going away, acid reflux may not be your problem. Sleep choking syndrome can be caused by various other things, not just acid reflux.
Some examples include:
- Nocturnal panic attacks: When these occur at night, you can wake up feeling as though you’re choking or can’t breathe. Panic attacks also commonly cause chest pain and a squeezing sensation that could be mistaken for heartburn.
- Sleep apnea: This is a condition whereby air can’t flow freely through your windpipe as you sleep. It causes its sufferers to stop breathing sporadically throughout the night. Often, people with sleep apnea can wake up feeling as though they can’t breathe.
- Upper respiratory tract infections: If you feel as though a liquid is making you choke at night, it may not be acid. You might be suffering from an infection causing postnasal drip, which is where mucus comes out of the sinuses and drips into your throat.
- Tonsillitis: This infection can cause your tonsils to swell to an abnormal size. When you lie down at night, your tonsils can occasionally block your airway. This could lead to a choking sensation that you might mistake for acid reflux.
If you aren’t sure, your best bet is to visit a doctor. They’ll be able to run tests to determine whether you have acid reflux, GERD, or something else. They’ll then be able to offer you medications which might help.