What is 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.
When reflux strikes at bedtime
GERD, also referred to as reflux, can happen at any time of day, and it can be unpleasant at any time of day. GERD can be so severe that the contents of the stomach may even enter the windpipe (trachea) and other parts of the upper airway.
During sleep, this is especially problematic, as you may be at risk for breathing in the highly corrosive contents of your stomach. If they enter your lungs, they can damage the tissues there and trigger or aggravate other respiratory disorders like chronic cough, COPD (chronic obstructive pulmonary disease), wheezing, and asthma.
Other common complaints of GERD include:
- chest pain (angina)
- problems with the ears, nose and throat, such as postnasal drip, vocal cord damage, upper airway resistance, laryngitis, and congestion
- inflammatory diseases like bronchitis and pneumonia, in which particles of stomach acid are accidentally aspirated (inhaled) into the lungs
Other ways reflux can affect sleep
Researchers also note relationships between GERD and obesity as well as obstructive sleep apnea (OSA), as each of these conditions relates to physiologically challenged upper airways and what happens if these problems are left untreated.
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.
What to do about 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.
- Recline or sleep upright. 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 (including carbonated beverages), 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 or on the back or face down is more likely to compromise 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.
- Nibble on saltine crackers. It’s thought that the sodium and magnesium in a saltine cracker can help adjust the pH of the stomach contents while giving the system something light to digest. This might reduce the burning sensation in the throat caused by reflux.
7 links related to sleep and GERD in SleepyHeadCentral:
- Adventures in Sleep for the Pregnant Woman, Part Three: The Third Trimester
- How overeating at bedtime affects sleep
- 10 foods to avoid eating right before bed
- The calming powers of magnesium
- Upper airway resistance. It’s a thing. And it matters.
- How do misaligned circadian rhythms affect the body?
- Circadian Rhythm Disorders in the Elderly
Links to learn more:
- GERD || Mayo Clinic
- “Gastroesophageal Reflux Disease and Sleep Disorders: Evidence for a Causal Link and Therapeutic Implications” || Journal of Neuroenterogastrology & Motility
- “Treating Sleep Apnea May Ease GERD” || GI Society: Canadian Society of Intestinal Research
- “Study finds that CPAP therapy reduces acid reflux in people with sleep apnea” || American Academy of Sleep Medicine