Nighttime heartburn is one of the many reasons for sleeping problems. And it is more common than most people think. But often the symptoms are not well understood and you spend an entire night looking at the ceiling trying to pinpoint the cause of your insomnia. Heartburn is a symptom and not a disease. It occurs when your stomach acid flows backward from your stomach (where it is produced) to your oesophagus (food pipe). And while it may worsen after a meal or with specific foods and drinks, most people do not know that heartburn worsens at night when the stomach acid production peaks even if you have not eaten .
Chronic heartburn is not simply a problem of how much acid your stomach produces. It is much more complicated. Much of it has to do with a group of muscles that form the lower oesophageal sphincter – a gateway between the oesophagus (food pipe) and stomach. Normally your lower oesophogeal sphincter opens when you eat or drink. This allows food and beverages to move downwards from your oesophagus (food pipe) to your stomach. But this sphincter stays closed most of the time. It prevents the acidic stomach contents from moving upwards into the oesophagus. In this way the sphincter protects the oesophagus against the corrosive action of stomach acid.
How To Stop Heartburn?
There are many ways to remedy heartburn. But remember that heartburn is only a symptom. The cause of heartburn should be targetted and that is the acid reflux. Weakening of the lower oesophageal sphincter tends to occur over years and becomes permanent in many cases. When severe it can only be corrected with surgery like Nissen fundoplication. However, for most people, simpler measures like lifestyle and dietary changes as well as medication may suffice.
Antacids are the most commonly used remedy for heartburn. It works by neutralising the stomach acid in the oesophagus and stomach. Some antacids also coat the oesophagus to protect it for a short while from the action of stomach acid. Antacids are often taken once the heartburn starts.
The other commonly used group of medication is acid-suppressing drugs like proton pump inhibitors (PPI) e.g. omeprazole and lansoprazole. This medication acts by blocking the acid-producing mechanism in the stomach. It is one of the most effective ways of managing acid reflux on a chronic basis. Some PPIs are available over-the-counter while others need a doctor’s prescription.
Despite the effectiveness of these drugs, changing your diet and lifestyle is an important part of managing heartburn and acid reflux.
Avoid Caffeine And Alcohol
Caffeinated and alcoholic drinks are two types of beverages that worsen heartburn. Avoiding that evening cup of coffee or nightcap can make all the difference with nighttime heartburn and your quality of sleep. Try not to drink coffee or alcohol for at least 3 hours before bedtime. Chocolate can also be a problem as it contains small amounts of caffeine and may also exacerbate your condition. Rather drink a glass of water or milk.
Do Not Eat Before Bedtime
Your stomach acid production increases when you eat a meal and continues for a short while thereafter. If you suffer with heartburn then you should try not to eat a meal for at least 2 to 3 hours before bedtime. No nighttime snacking either. Always stand or sit up after eating a meal and a short walk can also help with emptying the stomach of food. Lying down after eating, even if you are not sleeping, can make heartburn worse by sustaining stomach acid secretion and slowing gastric emptying.
Small Meals Better Then Large Meals
Generally the larger the meal the more likely that you will suffer with acid reflux. Very large meals or overeating are the worst. But an empty stomach can be just as much of a problem if you do not eat for several hours. Try to have many smaller meals throughout the day rather than a few large meals. Opt for foods that do not trigger heartburn. You may find that certain foods are worse for you than others and it may be helpful to keep a food diary of foods to avoid.
Sleep With Your Head Side Elevated
If you suffer with severe nighttime heartburn despite following the other measures above then you may have also reconsider your sleeping position. By slightly elevating your upper chest and head, the acid will be drawn downwards into the stomach by gravity. It does not mean that you will have to sit up and sleep. A gentle incline can be achieved by placing a brick under the head end of your bed to make it slightly higher than the foot end. Specially designed wedges are also available for this purpose.
Take Medication Before Bedtime
Always consult with a doctor about your heartburn even though it may seem like such a minor ailment. Your doctor can assess your condition properly and prescribe the necessary treatment. You may find it helpful to take antacids and acid-suppressing drugs at night before bedtime even if you do not have any symptoms. Remember that when acid secretion increases during the course of the night, you may not be aware of it. Instead you may find that you wake up in the morning with a mild sore throat, bitter taste in your mouth and have experienced poor quality sleep yet you do not know why.