GERD and sleep – How are they related?

GERD, which stands for gastroesophageal reflux disease, is a chronic condition that occurs when stomach acid flows back into the esophagus, leading to irritation and discomfort. GERD primarily affects digestion. But its impact on sleep shouldn’t be overlooked. 

Many people with GERD experience disruptions in their sleep patterns due to the condition’s symptoms. Understanding the relationship between GERD and sleep is crucial for managing both aspects of your health. 

GERD symptoms often cause sleep disturbances

The hallmark symptoms of GERD include the following: 

• Heartburn
• Difficulty swallowing
• Regurgitation of stomach acid or bitter-tasting fluids in the mouth

When GERD-related discomfort disrupts sleep, it can result in fragmented and poor-quality sleep. In turn, this leads to various issues with daytime functioning, including daytime fatigue, irritability, and decreased cognitive function. 

Nighttime heartburn

Nighttime heartburn is a common symptom of GERD. It’s a burning sensation in the chest, usually behind the breastbone, that occurs when stomach acid backs up into the esophagus.

This happens when the lower esophageal sphincter (LES), a ring of muscle between the esophagus and stomach, doesn’t close properly or relaxes too frequently. The stomach acid irritates the lining of the esophagus, leading to the burning sensation of heartburn. GERD-related heartburn often worsens when you lie down, especially after eating or drinking. The discomfort can make it challenging to fall asleep or stay asleep throughout the night.

To better manage nighttime heartburn, try these tips: 

Avoid eating close to bedtime: Don’t eat large meals or heavy snacks close to bedtime, as this can increase the likelihood of experiencing heartburn during the night. Instead, have your last meal or snack at least two to three hours before going to bed.

Stay upright after eating: Additionally, after eating, remain upright for at least two to three hours before lying down. This allows gravity to keep your stomach contents where they belong, reducing the likelihood of reflux.

Sleep disorders

Chronic GERD can contribute to the development of sleep disorders such as…

• Insomnia
• Sleep apnea
• Restless legs syndrome (RLS)

These conditions can further disrupt sleep patterns and significantly impact your health. For example, untreated sleep apnea and chronic insomnia can impair memory and focus. Plus, they can lead to mood disorders and increase the risk of conditions like hypertension, stroke, and diabetes. 

Managing GERD for better sleep

Fortunately, several strategies can help manage GERD symptoms and improve your sleep quality:

Changing your sleep position

Certain sleep positions can exacerbate GERD symptoms. Sleeping on your back allows stomach acid to flow more easily into the esophagus, which can disrupt your sleep as you may need to adjust your position frequently to find relief. Instead, try sleeping on your left side, as this position can reduce acid reflux.

Modifying your diet 

Certain foods and beverages can trigger or worsen heartburn. Common triggers include the following: 

• Spicy foods
• Citrus fruits
• Tomatoes
• Chocolate
• Caffeine
• Alcohol
• Fatty or fried foods

Avoiding these triggers, especially in the evening, may reduce nighttime heartburn. Making dietary adjustments can be an important part of managing GERD symptoms and improving your sleep.

Elevating the head of your bed

Elevating the head of your bed by about six to eight inches can help prevent stomach acid from flowing back into your esophagus while you sleep. When you elevate your upper body, gravity helps keep the acid in your stomach, reducing the likelihood of it traveling up into your esophagus.

Taking medication

Over-the-counter and prescription medications are available to help manage GERD symptoms by reducing stomach acid production.

Here are some common types of medications used for this purpose:

Antacids: These medications work by neutralizing stomach acid to provide short-term relief from heartburn and indigestion. They are available over the counter and often taken as needed after meals or at bedtime.

H2 blockers (histamine-2 receptor antagonists): H2 blockers reduce the production of stomach acid by blocking the action of histamine, a chemical that stimulates acid secretion in the stomach. These medications can provide longer-lasting relief than antacids and are available over the counter or by prescription.

Proton pump inhibitors (PPIs): PPIs are powerful medications that work by blocking the enzyme responsible for producing stomach acid. They are highly effective at reducing acid production and can provide long-term relief for GERD symptoms. PPIs are available by prescription and, in some cases, over the counter at lower doses.

You can use medications alone or in combination, depending on the severity of your symptoms and how you respond. You should use these (and all) medications as directed by your healthcare professional. You should also be aware of potential side effects and interactions with other medications.

Changing your lifestyle

Lifestyle changes, such as maintaining a healthy weight and quitting smoking, can help manage GERD symptoms and improve sleep.

Excess weight puts pressure on your abdomen, causing acid to back up into your esophagus. By maintaining a healthy weight through diet and exercise, you can reduce this pressure and lessen the severity of GERD symptoms, thus improving your sleep quality.

Additionally, smoking can weaken the lower esophageal sphincter (LES), the muscle that normally prevents acid reflux. Smoking can also increase acid production in the stomach and irritate the lining of the esophagus, making GERD symptoms more severe. Quitting smoking can improve GERD symptoms and contribute to better sleep.

Practicing better sleep hygiene

Practicing good sleep hygiene can promote better sleep despite GERD symptoms. Good sleep hygiene includes the following: 

• Establishing a regular sleep schedule (going to bed and waking up at the same time each night and day)
• Creating a comfortable sleep environment (your sleep space should be cool, dark, and quiet)
• Practicing relaxation techniques, such as yoga, deep breathing, or mindful meditation

Consulting a healthcare professional is essential for anyone experiencing persistent GERD symptoms. A healthcare provider can offer personalized recommendations and treatment options to address GERD and its impact on your sleep.

GERD and sleep are closely intertwined. GERD symptoms often lead to disrupted sleep patterns and sleep-related issues. By addressing symptoms of both GERD and sleep disturbances, you can achieve better health and more restful sleep.

Dr. Meghna Dassani has practiced dentistry for over two decades and is passionate about the role dentists play in whole-body health. You can learn more at her website: MeghnaDassani.com.