ABCs of Sleep || Gastroesophageal Reflux Disease (GERD)

Gastroesophageal Reflux Disease (GERD) is a condition in which acid rises from the stomach and breaches the valve separating the bottom of the esophagus from the top of the stomach. This valve, also known as a sphincter, is meant to keep stomach acid out. If it comes into contact with the stomach acid on a regular basis, it can become damaged and no longer prevent the “reflux” of stomach acid from rising back into the esophagus and even into the trachea and other parts of the upper airway. 

The highly corrosive nature of stomach acid means it will wreak havoc on other parts of the body outside the stomach as they are not lined with the heavy mucosal barrier like the stomach. If allowed to enter the airways, stomach acid reflux can lead to, trigger or aggravate respiratory disorders like chronic cough, wheezing and asthma. 

Other common complaints of GERD include chest pain; problems with the ears, nose and throat, such as postnasal drip, vocal cord damage, upper airway resistance and congestion; and inflammatory diseases like bronchitis and pneumonia, in which particles of stomach acid are accidentally aspirated (inhaled) into the lungs. 

Researchers are also looking into relationships between GERD and obesity as well as obstructive sleep apnea (OSA) as each of these conditions relates to physiologically challenged upper airways.

GERD can happen at any time of day and to nearly anyone at any age and of any size. But at nighttime, it can be especially troublesome. People laying completely flat (and especially while supine) are most susceptible to the creeping up of stomach acid. 

This can make bedtime frustrating because GERD leads to frequent awakening, requiring its sufferers to rise out of bed, take an antacid, and even sit in a chair in order to fall asleep again, as the gravity of a vertical position can help pull the acid back into the stomach where it belongs. 

However, sleeping is hardly easy or comfortable to achieve in an upright position. GERD may be a key reason why many older people sleep in reclining chairs, as they have the flexibility of raising and lowering the back of the chair to suit their issues with GERD. 

There are several things a person with GERD can do to help prevent their condition from interrupting with their nightly sleep. 

Elevate the head of the bed by 3 inches. This increases the angle of the bed enough to help use gravity to one’s advantage without being too noticeable for people sleeping in bed. Individuals might consider sleeping in a reclining chair or using a wedge pillow that helps them sleep more upright. 

Quit smoking. Smoking exacerbates any issues with asthma or other pulmonary conditions that could develop as a result of GERD.

Dietary changes. Eating a low-fat diet, avoiding high acid foods, eating lighter meals at dinner and eating at least two hours before bedtime can help alleviate GERD and improve sleep quality.

Avoid alcohol. Alcohol relaxes the body’s muscles, which increases the chance that the sphincter which serves to keep stomach acid out of the esophagus will lose its ability to seal. 

Sleep on your left side. This sleeping position is most likely to support the closure of the sphincter between the esophagus and the stomach; sleeping on the right side is more likely to break that important seal.

Treat GERD. There are a number of approaches to managing reflux disease; some are over-the-counter, while others are more aggressive prescription approaches that should be monitored by a healthcare professional.

About Tamara Kaye Sellman (621 Articles)

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