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How to Sleep with Acid Reflux? Positions, Causes, and Fixes

Reduce acid reflux by sleeping on your left or with your head elevated, eating dinner two to three hours before bed, and improving your sleep hygiene.
Published
2023-03-03
Updated
22 MINS
Written by
Jeff Kahn, M.S., Rise Science Co-Founder
Reviewed by
Chester Wu, MD, Rise Science Medical Reviewer
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We bring sleep research out of the lab and into your life. Every post begins with peer-reviewed studies — not third-party sources — to make sure we only share advice that can be defended to a room full of sleep scientists.
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Updated Regularly
We regularly update our articles to explain the latest research and shifts in scientific consensus in a simple and actionable way.
Man sleeping with head and upper body elevated to avoid acid reflux

If you’ve ever laid down in bed only to be met with a burning sensation in your chest and a sour taste in your mouth, you know how uncomfortable acid reflux at night can be. 

But it’s more than just uncomfortable. Acid reflux — and all the symptoms that come with it like heartburn, nausea, and stomach pain — can make it hard to fall asleep and may wake you up during the night. 

To make matters worse, all this sleep disruption can make acid reflux symptoms more severe, causing a vicious cycle of more sleep loss and more reflux. 

Luckily, this cycle can be broken. Below, we’ll dive into what acid reflux is, what its more serious cousin GERD is, and what you can do to stop them, both when you’re already in bed and long term. 

What is Acid Reflux?

Acid reflux is the backflow of stomach acid into your esophagus. It causes a burning feeling in your chest, which is known as heartburn. 

Common symptoms of acid reflux include: 

  • Heartburn
  • A bad taste in your mouth 
  • Bad breath 
  • Bloating 
  • Nausea 
  • Stomach pain 
  • Sore throat 

Acid reflux every now and again isn’t a problem, but if you get it regularly, it can disrupt your sleep, which disrupts everything else in life including your energy, focus, mood, and mental and physical health. 

What is GERD?

Chronic acid reflux can be a sign of gastroesophageal reflux disease (GERD). This is when stomach acid or stomach contents regularly come up into your esophagus. 

It can be caused by a weak or damaged lower esophageal sphincter (LES), the band of muscle at the bottom of the esophagus that opens to allow food through, and then usually closes again to stop stomach acid washing up. 

GERD is a serious condition. It can cause health issues like ulcers, narrowing and inflammation of the esophagus, Barrett’s esophagus (abnormal growth of esophageal cells), and esophageal cancer. 

Symptoms of GERD include: 

  • Heartburn
  • Stomach or chest pain  
  • A bad taste in your mouth 
  • Trouble swallowing
  • A chronic cough
  • A hoarse voice 
  • Regurgitation of stomach acid or food

Why is Acid Reflux Worse at Night?

Acid reflux can hit at any time of day, but it’s often when you’re lying in bed when you feel it the most. There are a few reasons for this: 

  • You’re laying down: When you’re horizontal, gravity no longer holds down your stomach acid and it can more easily flow up into your esophagus.
  • You make more stomach acid and swallow less at night: Everything in your body runs on a circadian rhythm, a roughly 24-hour biological clock, including several elements of your digestive system. You secrete more stomach acid at night, produce less saliva, and swallow less at night. This means there’s more acid, but less saliva to neutralize it, meaning it’s more likely to wash up and cause heartburn.
  • There are other circadian rhythms at play: As well as saliva, other parts of your digestive system’s circadian rhythms can line up to cause acid reflux at night. You have reduced esophageal peristalsis (the contraction of muscles that move food through your digestive system) and delayed gastric emptying (food stays in the stomach longer) at night. You can not only get increased acid reflux, the acid can spend longer in your esophagus, causing more damage.
  • You’ve probably eaten a large meal: Large meals are more likely to cause acid reflux as when the stomach is full, it puts pressure on the sphincter muscle. And most of us eat our largest meal at dinner time.

How Does Acid Reflux Affect Sleep?

One survey found out of those who experience heartburn weekly, 79% get it at night. Out of those, 75% say it affects their sleep. Here’s how it can affect your shut-eye: 

  • It can keep you up: Heartburn, nausea, stomach pain, and bloating aren’t a recipe for a peaceful night’s sleep. You may find the pain or stress of these symptoms makes it hard to drift off. 
  • It can wake you up: Acid reflux symptoms can also wake you up during the night. Either the pain wakes you up, or you wake up for another reason and reflux makes it hard to fall back to sleep.
  • It may be linked to sleep disorders: Acid reflux and GERD have been linked to insomnia and sleep apnea. Sleep apnea happens when you temporarily stop breathing during the night. The sleep deprivation caused by sleep apnea may make the esophagus more sensitive. Or GERD may affect your ability to breathe normally, causing more apnea events. It’s thought that up to 75% of those with sleep apnea get reflux symptoms at night, but more research needs to be done to confirm the link. It may be that GERD and sleep apnea share the same risk factors, which include obesity, alcohol consumption, and smoking. 

The link between acid reflux or GERD and sleep problems can go both ways, too. Poor sleep can increase your odds of many gastrointestinal problems, including reflux.

As one study states: “The link between sleep problems and GERD might be bidirectional, i.e., sleep problems might influence the development or increase the severity of GERD, and GERD might influence the development or increase the severity of sleep problems.”

What’s the Best Position for Acid Reflux?

Laying in bed with reflux? Here are the sleep positions to try to get some relief. 

Sleep on Your Left

Sleeping on your left may reduce acid reflux as your stomach will be lower than your esophagus, making it harder for stomach acid to travel up into it. 

Image credit: Gastrointestinal Society

A 2022 study found sleeping on the left helped people have more reflux-free nights. And sleeping on your right side has been shown to make reflux symptoms worse.

If you find side sleeping uncomfortable, try placing a pillow between your knees to keep your spine aligned. 

We’ve covered the best side to sleep on for digestion here and the best side to sleep on in general here.

Elevate Your Head and Upper Body

If you can’t sleep on your left or find it doesn’t help, try elevating your head and upper body. This will make it harder for stomach acid to flow up into your esophagus as gravity comes into play.

One small study found when participants slept with the head of their bed elevated by almost 8 inches for six nights, they had less heartburn and it helped improve sleep disturbances in 65% of participants. 

Want to try this for yourself? The study states elevation needs to be at least 6 to 8 inches, and raising the bed frame is better than stacking up pillows, as this can put pressure on the stomach and make reflux worse.

You can lift the head of your bed by stacking a bed raiser under the bed posts, laying on a special wedge pillow, or using a mattress lifter. These tools make sure your head and upper body are lifted, not just your head.

What to Do When You Have Acid Reflux at Night?

Got a burning chest at bedtime or woken up in the night with a reflux episode? Here’s what to do to help you get the sleep you need. 

1. Change Sleep Position 

If acid reflux hits and you’re already in bed, try changing position. As we explained above, you may get fewer acid reflux symptoms if you lay on your left or if you elevate your head and upper torso. 

Acid reflux symptoms are more common when sleeping on your back and can happen within one minute of changing positions. If you wake up on your back, roll back onto your side and consider positional therapy devices that stop you from sleeping on your back like special pillows and vests. 

2. Change into Looser Clothing 

If your pajamas are tight, they can put added pressure on your stomach and make symptoms worse.

Change into looser clothing to see if it helps — and opt for loose-fitting pajamas going forward.   

3. Do a Sleep Reset 

If you’ve been lying awake in bed for 20 minutes, get out of bed and do a relaxing activity until you feel sleepy again. This will stop your brain from making an association between your bed and wakefulness. 

Try reading, journaling, doing yoga, or listening to music or a podcast. Make sure to keep the lights as low as possible to stop them from waking you up, and try to avoid looking at the time or worrying about lost sleep. This can cause anxiety — a surefire way to stop you from falling asleep.  

How to Stop Acid Reflux at Night?

The best way to sleep with acid reflux is to stop it from happening in the first place. The good news is many of the ways to do this are simple lifestyle changes and home remedies.

Here’s what you can do to reduce your odds of reflux tonight, and every night going forward. 

1. Give Yourself More Time After Dinner and Before Bed  

RISE app screenshot showing showing you when to have your last large meal of the day
The RISE app can tell you when to have your last meal each day.

If you’re used to eating dinner then laying down on the sofa or heading straight to bed, it may be time to rethink your evenings. Try giving your body more time after your evening meal to digest everything before laying down. 

One study found GERD symptoms were found in almost 46% of those who went to bed an hour after dinner, about 42% in those at two hours, 31% for three hours, and 30% for four hours. So, the longer you have between dinner and bed, the less likely you are to get reflux. 

As a general rule, aim to be done with dinner two to three hours before bed and avoid late-night snacking to reduce the likelihood of digestive issues keeping you up.

RISE can remind you when to finish up dinner each day. And we’ve covered more on what time you should stop eating before bed here.

RISE users on iOS 1.202 and above can click here to set up their avoid late meals reminder.

2. Limit Trigger Foods and Drinks 

Dietary changes can help prevent and reduce acid reflux. Take a look at your diet and see if you consume these common trigger foods and drinks. If you do, try to cut down or consider cutting them out altogether. 

Foods and drinks that can trigger heartburn include:

If you’re not sure what your triggers are, keep a food diary to track your diet and symptoms to see if there’s a pattern.

Beyond acid reflux, the foods you eat can affect your sleep in other ways. We’ve covered the best foods for sleep here. 

And while you’re limiting or cutting out trigger foods, try eating smaller meals and eating more frequently, which can help to prevent acid reflux. 

3. Go for an After-Dinner Walk 

Make walking after dinner a habit. It can help digestion and a regular after-dinner walk has been linked to fewer GERD symptoms. Plus, walking after dinner stops you from laying down or falling asleep, which may trigger reflux.

Exercise in general can also help you keep your weight in check and your stress levels low — two risk factors for GERD.

Opt for a gentle walk over a vigorous run as high-intensity exercise can make reflux symptoms worse. And be sure not to do intense exercise within an hour of bedtime as this can keep you awake. 

We’ve covered more on the best time to work out here.

4. Lower Your Sleep Debt

RISE app screenshot showing how much sleep debt you have
The RISE app can tell you how much sleep debt you have.

Sleep debt is the running total of how much sleep you owe your body. It’s measured against your sleep need, the genetically determined amount of sleep you need. 

When you don’t meet your sleep need — either because of acid reflux or other reasons like working late or a crying newborn — your sleep debt starts racking up. And this can lead to a whole host of health conditions, including acid reflux and GERD. 

A lack of sleep can make your esophagus more sensitive and make GERD symptoms more severe. It can also worsen symptoms of irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) if you suffer from those, too. 

Plus, when you’re sleep deprived, you feel pain more acutely, meaning heartburn may be harder to deal with. 

Finally, sleep loss ups your odds of obesity (a risk factor for GERD), and it can be harder to resist triggers like fatty foods, chocolate, and large meals when you’re sleepy. 

The good news about sleep debt is you can lower it. Here’s how: 

  • Take naps: If acid reflux keeps you up at night, try catching up on sleep during the day. Check RISE for the best time to take a nap. 
  • Go to bed a little earlier. 
  • Sleep in a little later: Keep this to an hour or two to avoid messing up your circadian rhythm (more on that soon). 
  • Improve your sleep hygiene: Focus on sleep hygiene habits that can help you fall asleep faster and wake up less often, helping you get more sleep overall. More on what to do soon.

The RISE app can work out how much sleep debt you have and keep track of it as you pay it back. We recommend keeping your sleep debt below five hours to maximize your energy levels and overall health and well-being.

RISE users on iOS 1.202 and above can click here to view their sleep debt.

5. Live in Sync with Your Circadian Rhythm 

As we briefly covered above, your circadian rhythm is your body’s roughly 24-hour biological clock. You have one master clock in your brain and what’s known as peripheral clocks in almost every tissue and organ system, including in your digestive system.

Living in sync with these circadian rhythms helps improve everything from your energy levels to your gut health and overall digestive health. And it may reduce reflux symptoms, too. 

For example, those who work night shifts are more likely to develop GERD than day-shift workers. It’s not entirely clear why, but this could be due to lowered melatonin production in those with circadian misalignment. This could cause more stomach acid production and esophageal sphincter dysfunction. Another theory is that being out of sync may promote esophageal damage as your body can’t create and repair cells as well. 

Even if you don’t work night shifts, you may be out of sync with your circadian rhythms if you sleep and eat at odd times. 

You can live in sync by: 

  • Keeping a consistent sleep pattern: Find a sleep schedule that works for you and stick to it, even on your days off. This will keep the master clock in your brain in check, which communicates with all your peripheral clocks, keeping them more in line, too.  
  • Eating meals at roughly the same times and during the day: Eating can change the timing of your circadian rhythm and throw off your peripheral clocks. Avoid eating at night and eat at roughly the same times each day. 
  • Going to bed during your Melatonin Window: This is what we call the roughly one-hour window of time when your body’s rate of melatonin production is at its highest. As melatonin primes your body for sleep, going to bed during this window can help you fall and stay asleep.

The RISE app predicts your circadian rhythm each day and shows you when your body naturally wants to wake up, wind down for bed, and go to sleep. You can then sync up your sleep and meal times to it. 

RISE users on iOS 1.202 and above can click here to see their circadian rhythm on the Energy screen.

6. Improve Your Sleep Hygiene 

Sleep hygiene is the name for the set of daily habits you can do to help you fall and stay asleep at night. 

You may find you wake up during the night, and this is when you feel heartburn. Or it may take you a long time to fall asleep because of reflux symptoms, and ill-timed caffeine each day is adding to the problem.

When your sleep hygiene is on point, you’re more likely to have an easier time falling asleep, and minor reflux will be less likely to wake you up.

Here’s how to improve your sleep hygiene: 

  • Get bright light first thing: This will reset your circadian rhythm, helping you feel sleepy come bedtime. Get at least 10 minutes of light as soon as possible after waking up. And aim for 15 to 20 minutes if it's overcast or you’re getting light through a window. 
  • Avoid light close to bedtime: Bright light suppresses melatonin. About 90 minutes before bed, dim the lights and put on blue-light blocking glasses to stop light from keeping you up. 
  • Avoid caffeine, large meals, intense exercise, and alcohol too late in the day: All four can keep you up or wake you up during the night, and all four can trigger acid reflux, too. 
  • Keep your bedroom dark, cool, and quiet: Set your thermostat to 65 to 68 degrees Fahrenheit, invest in blackout curtains, and wear earplugs and an eye mask to make sure nothing in your bedroom keeps or wakes you up. 

To stay on top of sleep hygiene, the RISE app can guide you through 20+ habits each day and tell you the ideal time to do each one to make them more effective.

RISE users on iOS 1.202 and above can click here to set up their 20+ in-app habit notifications.

7. Lower Stress 

RISE app screenshot showing guided relaxation techniques
The RISE app can guide you through relaxation techniques.

Stress can cause and aggravate acid reflux. It can also keep you up at night, which means sleep debt from stress can add to the worsening of your reflux symptoms. 

Lower stress by: 

  • Doing a calming bedtime routine: Lower stress before bed by doing a relaxing activity in the run-up to bedtime. Try reading, listening to music, or practicing yoga. 
  • Doing a brain dump: Write down what you’re worrying about or write a to-do list for tomorrow (research shows this can help you fall asleep faster compared to journaling about other things before bed). RISE’s brain dump feature will remind you of everything you wrote down the next day. 
  • Trying relaxation techniques: Relaxation techniques like progressive muscle relaxation and diaphragmatic breathing can calm your mind and body. RISE can walk you through science-backed relaxation techniques for better sleep
  • Asking for help: If stress is seriously impacting your life, speak to friends and family, ask for help at work or with childcare or caretaking responsibilities, or reach out to a therapist or doctor. 

Anxious thoughts keeping you awake? You can learn more about how to sleep with anxiety here.

RISE users on iOS 1.202 and above can click here to go right to their relaxation audio guide homepage and get started.

RISE users on iOS 1.202 and above can click here to set up their Brain Dump Habit notification

8. Lose Weight 

GERD has been linked to being overweight and obese. In fact, the prevalence of GERD increases as body mass index (BMI) increases. Excess weight may put pressure on your stomach and esophageal sphincter. 

If you’re overweight, losing weight can help reduce your acid reflux, and it may even cure it altogether. Research has found weight loss over a six-month period can help 81% of people reduce their GERD symptoms and 65% eliminate reflux symptoms entirely. 

Being overweight also ups your odds of sleep apnea and losing weight can reduce symptoms.

We’ve covered the best way to lose weight here and the best sleeping positions to lose weight here.

9. Quit Smoking

If you’re a smoker, consider quitting. Your esophagus will thank you. 

Research shows quitting smoking can reduce how often those with GERD experience acid reflux.  

10. Consider Medication 

You can buy over-the-counter medications (OTC medications) to get some heartburn relief. 

OTC medications include antacids, which neutralize stomach acid, H2 blockers like Pepcid AC and proton pump inhibitors (PPIs), which reduce the amount of stomach acid you make. You can also get prescription-strength versions of these medications.

Research shows PPIs can reduce nighttime heartburn symptoms in up to 53% of people and help to reduce sleep disturbances.  

Speak to your healthcare provider if you regularly get acid reflux and think PPIs would help. 

If you take medication for other health issues, talk to a doctor about whether these could be causing or making acid reflux worse. Drugs like blood pressure meds, NSAIDs, antidepressants, and asthma medications may do this.

Heads-up: When considering medication, avoid sleep aids. While it’s tempting to reach for a sleep aid when you can’t sleep, research shows benzodiazepine usage is a predictor of heartburn during sleep. 

11. Get Treatment for Sleep Apnea 

As we mentioned above, many people have both obstructive sleep apnea and GERD, and the two conditions may be linked. 

Sleep apnea treatments have been shown to not only help the sleep disorder, they can reduce reflux symptoms, too. 

Sleeping with a continuous positive airway pressure (CPAP) machine is a common sleep apnea treatment. The machine pushes air into your airways to keep them open at night. It’s been shown to reduce sleep apnea episodes, daytime sleepiness, and nighttime acid reflux

We’ve covered how to know if you have sleep apnea here and how to get rid of sleep apnea here.

As high sleep debt can make acid reflux worse, you should also seek treatment for other sleep disorders you may have that are causing sleep deprivation.

12. Speak to a Doctor 

If acid reflux is a common occurrence for you or it’s seriously impacting your sleep and daily life, get medical advice. A doctor can prescribe medication or supplements, recommend the best heartburn treatment options for you, and surgery may also be recommended in rare cases. 

Heads-up: GERD and acid reflux are common in pregnant people, but the symptoms may clear up when the baby arrives. In the meantime, we’ve covered how to get sleep when pregnant and how to get energy when pregnant here. 

Stop Acid Reflux Before Bedtime 

If you’re laying in bed with acid reflux, try sleeping on your left or with your head elevated. To stop symptoms before they start, aim to finish dinner two to three hours before bed, limit trigger foods, and go for a post-dinner walk. 

Lowering your sleep debt and living in sync with your circadian rhythm can also help. The RISE app can tell you how much sleep debt you have and it can predict your circadian rhythm each day to help you sync up to it. 

RISE can also remind you when to do 20+ Acid reflux is worse at night because when you’re horizontal, it’s easier for stomach acid to travel up into your esophagus. You also produce more stomach acid and less saliva (to neutralize the stomach acid), and have fewer esophageal movements (to clear the acid) at night.sleep hygiene habits to make it easier to get a good night’s sleep, even when you have acid reflux. 

FAQs

Why is acid reflux worse at night?

Acid reflux is worse at night because when you’re horizontal, it’s easier for stomach acid to travel up into your esophagus. You also produce more stomach acid and less saliva (to neutralize the stomach acid), and have fewer esophageal movements (to clear the acid) at night.

How do I stop acid reflux while sleeping?

To stop acid reflux while sleeping, try sleeping on your left side or with your head elevated. Finishing dinner two to three hours before bed, lowering sleep debt, living in sync with your circadian rhythm, and improving sleep hygiene can also help.

How to get rid of heartburn at night fast

Get rid of heartburn at night fast by laying on your left side or sleeping with your head and upper body elevated. Changing into looser clothing may also help.

Waking up with heartburn in the middle of the night

Waking up with heartburn in the middle of the night isn’t serious if it is irregular. If it happens often, though, it could be a sign of GERD. To stop heartburn from waking you up, try eating dinner two to three hours before going to bed, sleeping on your left or with your head elevated, lowering your sleep debt, living in sync with your circadian rhythm, and improving your sleep hygiene.

What helps indigestion while sleeping?

Sleeping on your left side or with your head elevated can help with indigestion while sleeping. Eating two to three hours before bed, lowering your sleep debt, getting in sync with your circadian rhythm, and improving your sleep hygiene can also reduce indigestion.

Can sleeping cause indigestion?

Sleeping can cause indigestion if you go to bed shortly after a large meal. You’re more likely to get acid reflux when horizontal and digestive problems if you eat late at night when your body isn’t expecting you to. Give yourself two to three hours after dinner before going to bed and keep meal times to earlier in the day.

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