Waking Up with Heartburn

Waking up with heartburn puts a different spin on the old saying “Waking up on the wrong side of the bed”. What is a heartburn anyway? To those who are new to it, a heartburn is a painful and burning sensation you get in your chest or throat. The official term for it is acid reflux. Sometimes it happens when you burp. It is due to stomach acid flowing back to your esophagus and reaching your throat. If you get heartburn occasionally, then that is normal, and you do not have to worry about it. But if you get it more than twice in a week, then you may have a condition called gastroesophageal reflux disease or GERD.

 

GERD

In the US, weekly GERD occurs in around 20% of people while monthly GERD occurs in around 44%.  Acid reflux in general does more than just give you an annoying burning feeling in your throat and chest. The acids can damage the tissues in your esophagus and lead to inflammation or esophagitis. The acids can even change the cells on your esophagus and give you Barrett’s esophagus. This condition increases your risk of esophageal cancer.  If the acids reach your throat, they can damage your vocal cords. You can end up with a hoarse voice and chronic dry coughs. GERD can even give you adult-onset asthma.

 

Causes

When you swallow, muscles around the bottom of your esophagus called the lower esophageal sphincter (LES) relax to allow food and liquid to flow down into your stomach. After the food and liquid pass, the LES retightens. If the LES relaxes abnormally or is weak, the stomach acid can back flow.  Why the LES acts abnormally can be due to several reasons.

  • Hiatal hernia is a condition wherein a part of the stomach moves above the diaphragm. A hiatal hernia may lower the LES pressure necessary to maintain the anti-reflux barrier.
  • Large meals where you pretty much stuff yourself, like in the holidays, can enlarge the upper portion of your stomach. As a consequence, the LES may not have enough pressure to prevent reflux.
  • Even pregnancy increases your risk of GERD. More than 50% of women can experience GERD symptoms at some point during pregnancy. Hormonal changes during pregnancy can cause the muscles in the esophagus to relax more frequently. A growing fetus can also place pressure on the stomach and interfere with LES functions.2, 3

 

Waking Up with Heartburn

waking up with heartburn

Heartburns commonly occur after eating, but they can also occur in the morning. A study referred to waking up with heartburn as “riser’s reflux”. The researchers took participants with GERD and found that 48.7% of them get heartburns within 20 minutes of waking up. The participants would have 32 to 60 acid reflux events within those 20 minutes!

  • If you do not wake up with the pain, then you may wake up with the taste. People with GERD also complain about waking up with a sour or bitter taste in their mouth as the acids and stomach contents go beyond their throats and reach their mouth, almost like regurgitating.
  • The heartburns can also happen in the middle of the night. As you sleep, your stomach acid can back flow, and the pain from the heartburn can wake you up. Thus, besides the usual risks of GERD, it can also disrupt your sleep and affect the rest of your day.
  • Another study found that 40% of patients experienced heartburn symptoms when they wake up in morning. Another 29% were awakened at night by coughing or choking because of fluid or an acid or bitter taste or food in throat.4

 

Sleep Disorders and Acid Reflux

Sleep has four stages, and studies have found that acid reflux tends to occur in Stage 2 and rarely in the deepest stage of sleep called rapid eye movement (REM). Deep sleep also appears to suppress the reflux. Thus, if you are suffering from sleep disorders that keep you from reaching the deeper stages of sleep, you may be more likely to suffer from acid reflux episodes. You can even say GERD itself as a “pseudo-sleep disorder” if the heartburns wake you up at night since sleep disorders are anything that disrupt your sleep.

 

How to Get Some Relief

Thankfully, there are plenty of methods to help you with your heartburns that range from medications to lifestyle changes.

 

Medications

Most physicians prescribe medications called proton-pump inhibitors (PPIs) to people suffering from severe acid reflux or GERD. PPIs are medications that lower the acid production in the stomach. Other common medications include antacids and H2 blockers. H2 blockers also lower the acid production in the stomach. H2 blockers specifically lower the acid production at night, which can help people waking up with heartburn.

 

Diet

For some people, certain foods and beverages trigger acid reflux. These foods and beverages can include:

  • high-fat foods
  • spicy foods
  • chocolate
  • citrus fruit
  • pineapple
  • tomato
  • onion
  • garlic
  • mint
  • alcohol

So, if you find yourself waking up with heartburn, try reducing or even avoiding these foods, especially when near bedtime. Keep yourself from having a large last meal too. As you read from above, having a stuffed stomach can interfere with the LES functions and lead to acid reflux.

waking up with heartburn helps

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Lifestyle

Below are just some of the lifestyle changes you can do to help reduce acid reflux:

  • quit smoking
  • lose excess weight
  • eat smaller meals
  • chew gum after eating
  • avoid lying down after eating
  • avoid foods and drinks that trigger your symptoms
  • avoid wearing tight clothing
  • practice relaxation techniques

If you have several episodes of acid reflux when sleeping, you can also try inclined bed therapy. As the name suggests, you lie on an inclined bed. If you lie flat, your esophagus is on the same plane as your stomach, so it is easier for the acids to flow back. If you lie on an incline, gravity can help prevent the backflow. Several studies show that an incline of between 20 to 28 cm has beneficial effects.5

 

Conclusion

Getting a good night’s rest is essential for optimal health. While it is uncommon to associate acid reflux with sleep, those who suffer from it at night are all too familiar with waking up with heartburn and an acidic or bitter taste in the morning. Besides increasing your chances for other diseases like asthma and cancer, the pain alone from the acid reflux can wake you up at night. Thus, take the necessary medical and lifestyle steps if you find your days and nights suffering from regular acid reflux.

 

References

https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2982.2009.01446.x

https://www.healthline.com/health/gerd#pregnancy

https://bmcgastroenterol.biomedcentral.com/articles/10.1186/1471-230X-12-131

https://pubmed.ncbi.nlm.nih.gov/11146697/

https://pubmed.ncbi.nlm.nih.gov/27250962/

 

Jesse Crow
Jesse Crow graduated with a bachelor’s degree from the University of Texas at Arlington. As a life-long participant in sports and motocross, he suffered considerably from joint and back pain. It wasn’t until he purchased his first quality mattress that he found any relief. After having studied and tested hundreds of sleep products, as well as visiting manufacturers both overseas and in the U.S., Jesse established Rest Right Mattress. His approach is based on assessing the individual needs of each customer, and meeting those needs through expert knowledge of sleep products.