3 Things to Do If Heartburn at Night Is Wrecking Your Sleep

You’re just about to doze off into a restful slumber when it starts: the nausea, fiery chest pains, and scorching burps that jolt you wide awake. When heartburn hits at night, it can seriously ruin your shut-eye (and probably your partner’s too), making it hard to nod off in the first place—or tricky to fall back asleep after a bout.

While the timing may seem…inopportune to say the least, it isn’t random. During sleep, you’re lying down rather than standing up, so food and stomach acid are more likely to reverse course and creep back up into your esophagus because they don’t have to fight against those G-forces, Craig Gluckman, MD, an assistant professor of medicine at UCLA Health with a focus on esophageal and gastrointestinal motility disorders, tells SELF. Cue all those symptoms we associate with heartburn, including, yep, burping fire, which we do to “relieve the uncomfortable sensation that this acid reflux causes,” Dr. Gluckman says. While these burps shouldn’t be painful, he says, the acid itself can be: It’s the source of that nasty burning sensation that gives heartburn its fiery name.

Heartburn can be aggravated by many external factors, including stress, smoking, constipation, and certain medications (and, ironically, poor sleep). Nearly everyone experiences it at some point, but frequent spells might point to a chronic issue known as gastroesophageal reflux disease (GERD). Thankfully, certain lifestyle adjustments can help quench the fire. Before you turn to meds, you might want to try making these three simple doctor-approved tweaks to your sleeping and eating patterns first.

1. Move up dinner—and maybe make a few tweaks to it.

Reining in those late dinners and midnight snacks could provide some relief. In fact, that’s “the number-one [tip],” Lisa Ganjhu, DO, a gastroenterologist at NYU Langone Health, tells SELF. Try to eat your last meal or snack of the day at least three hours before you lie down, according to Cynthia Cohen, MD, a clinical assistant professor at New York Medical College. Gastric emptying—the process by which the contents of your stomach move into the small intestine—typically takes about four hours, so by sticking to this cutoff time, you’ll “minimize the amount of stomach contents that could potentially reflux,” Dr. Cohen says. Otherwise, the heightened digestive activity means there will be more stuff available to flow back up the pipes.

For the same reason, how much you eat at once might also be worth reevaluating. Larger meals are harder on the digestive tract due to their sheer volume, so reducing your portion size could also help ease acid reflux symptoms, according to Dr. Ganjhu. One thing to note: Water is a different story. In fact, you should drink more H2O if you frequently experience reflux, Amy Burkhart, MD, RD, a physician and registered dietitian who specializes in gut health, tells SELF. “Dehydration, even mild dehydration that doesn’t result in thirst, can worsen acid reflux symptoms,” she says. Fluids can help dilute that stomach acid, though you’ll still want to cap your bottle a few hours before bed to curb any nocturnal pee breaks.

But sometimes your best dinner-planning efforts can’t stave off those hunger pangs. Life “is life, and the reality is it just doesn’t always happen,” Dr. Burkhart says of the three-hour rule. If your stomach is growling close to bedtime, Dr. Burkhart recommends eating something light and easy to digest, like a banana with soy milk or even a small amount of soup. Better yet, follow that with 1src minutes of light movement, “such as walking around the block or the house if going out isn’t an option,” she says. This helps move food along and speeds up gastric emptying, as SELF reported previously.

2. Keep a food journal to tease out patterns.

When it comes to acid reflux, when you eat isn’t the only potential contributing factor: What you eat can also play a role. There are no blanket foods everyone should avoid—we all react differently—so jotting down your meals and your symptoms can help you ID the potential culprits. “You may need to keep a food log to determine the foods that worsen your acid reflux,” Dr. Burkhart says. Try to track for at least three weeks to see what patterns emerge.

Still, there are some foods that tend to stoke the fire more than others. Think: chocolate and alcohol, Dr. Burkhart says, or spicy foods, fatty foods, caffeine, and peppermint, according to Dr. Cohen. (Acidic options like mint, orange juice, and tomatoes can also be a problem, per Dr. Ganjhu.) That’s because your lower esophageal sphincter—the “door” between your stomach and your esophagus—is more prone to opening “in response to particular dietary triggers,” Dr. Burkhart says. Basically, “that little muscle just relaxes a little bit more,” Dr. Ganjhu explains.

3. Change up your sleeping position.

Sorry, back and stomach sleepers: Your posture could be worsening your symptoms. “People who lay flat on their backs or their stomachs are more likely to experience acid reflux at night,” Dr. Burkhart says, particularly if they have other risk factors for it. Instead, try sleeping on your left side, according to Dr. Ganjhu. There’s a reason for that specificity: “Because of the way the esophagus is positioned in the stomach,” she explains, this “[prevents] the acid from washing up.”

You may also want to try propping up your body slightly during sleep, either by elevating the head of your bed six to eight inches—bed blocks beneath the legs of your bed or pillows between your boxspring and mattress can do this—or investing in a specially designed “wedge pillow” (yes, they’re out there!). Similarly, this “puts you in a position to take advantage of gravity and keep stomach contents down where they belong,” Dr. Cohen says. Per Dr. Ganjhu, shoot for a 3src-to-45-degree angle.

Even if you follow each of these three suggestions to the letter, there’s always a chance that heartburn at night might persist despite lifestyle changes. In that case, see a health professional, according to Dr. Cohen—especially because GERD can have serious health consequences if left untreated, like esophageal damage and even cancer. Your primary care doctor or a gastroenterologist will be able to help you figure out whether your symptoms are caused by an underlying issue and weigh your options as far as meds like antacids or H2 blockers—and hopefully get your sleep schedule back on track.