Why You Get Heartburn at Night and How to Stop It

Heartburn is a common condition, but when it strikes at night, it can become more than just uncomfortable—it can disrupt your sleep, affect your quality of life, and even impact your long-term health. If you find yourself waking up with a burning sensation in your chest, a sour taste in your mouth, or frequent coughing, you're not alone. Nighttime heartburn is a well-documented problem with clear causes and solutions.

In this article, we'll explain why heartburn often worsens at night and provide effective strategies to help you prevent it, manage it, and sleep better.

What Is Heartburn?

Heartburn is a symptom of acid reflux, a condition where stomach acid flows backward into the oesophagus. It creates a burning sensation in the chest or throat, often after eating or when lying down. When acid reflux happens frequently—two or more times per week—it is considered gastroesophageal reflux disease (GERD).

At night, gravity is no longer helping to keep stomach contents down, which makes heartburn more likely to occur. That’s why many people who are fine during the day find their symptoms intensify after they go to bed.

Why Heartburn Gets Worse at Night

Several factors make nighttime a prime time for heartburn symptoms:

1. Lying Down After Eating

When you lie down, gravity is no longer helping to keep acid in your stomach. This makes it easier for acid to rise into your esophagus, especially if your lower oesophageal sphincter (LES)—the muscle that keeps acid from escaping—is weak or relaxed.

2. Eating Late Dinners or Snacks

Eating close to bedtime doesn’t give your stomach enough time to digest before you lie down. This increases pressure in the stomach, which can force acid upward into the oesophagus.

3. Slower Digestion at Night

Your body naturally slows down digestion in the evening and while sleeping. This means food and acid stay in your stomach longer, increasing the chances of reflux.

4. Obstructive Sleep Apnea and GERD

There’s a strong link between sleep apnea and acid reflux. Interrupted breathing can create pressure changes in the chest that push stomach contents back into the oesophagus, worsening nighttime reflux.

5. Relaxed Muscles During Sleep

During sleep, all muscles—including the LES—tend to relax. If your LES is already weak, it’s more likely to allow acid to escape while you're asleep.

Symptoms of Nighttime Heartburn

Nighttime heartburn may present differently than daytime reflux. Common symptoms include:

• Burning sensation in the chest, especially after lying down
• Sour or bitter taste in the mouth
• Coughing or choking at night
• Waking up with chest discomfort or a sore throat
• Hoarseness in the morning
• Difficulty sleeping or frequent waking
• Feeling of a lump in the throat

If these symptoms occur regularly, you may be dealing with GERD and should consult a doctor.

Risks of Untreated Nighttime Reflux

Chronic nighttime reflux does more than ruin your sleep. It can lead to serious complications if left untreated:

• Esophagitis: Inflammation of the esophageal lining
• Strictures: Narrowing of the esophagus due to scar tissue
• Barrett’s Esophagus: A precancerous condition from repeated acid exposure
• Poor sleep quality, fatigue, and reduced mental alertness

That’s why addressing nighttime reflux isn’t just about comfort - it’s important for your overall health.

How to Prevent and Stop Nighttime Heartburn

The good news is that there are effective steps you can take to reduce or eliminate heartburn at night. These involve both lifestyle changes and, if necessary, medical treatment.

1. Avoid Eating Close to Bedtime

Stop eating at least 2 to 3 hours before you lie down. This gives your stomach enough time to empty and reduces pressure on the LES.

2. Elevate the Head of Your Bed

Raising the head of your bed by about 15 to 20 centimeters allows gravity to keep acid down. You can use a wedge pillow or place blocks under the bed legs.

Avoid propping your head with extra pillows alone, as this may bend your body in a way that actually worsens reflux.

3. Avoid Trigger Foods and Drinks

Common triggers include:

• Spicy foods
• Chocolate
• Coffee and caffeinated drinks
• Alcohol
• Citrus fruits
• Tomatoes
• Fried or fatty foods
• Carbonated beverages

Everyone’s triggers are different, so keeping a food diary can help identify yours.

4. Maintain a Healthy Weight

Excess abdominal fat increases pressure on the stomach and LES. Losing even a small amount of weight can make a big difference in reflux symptoms.

5. Sleep on Your Left Side

Research shows that sleeping on your left side can reduce reflux episodes. This position helps the stomach remain lower than the esophagus, limiting the chance of acid backup.

6. Wear Loose Clothing

Tight clothing around the waist or abdomen can put pressure on your stomach and worsen reflux symptoms. Choose loose-fitting sleepwear and avoid belts or elastic bands at night.

7. Manage Stress

Stress doesn’t directly cause reflux but can worsen symptoms. Practice relaxation techniques like deep breathing, meditation, or gentle stretching before bed.

Heartburn Medication Singapore

If lifestyle changes aren’t enough, over-the-counter or prescription medications may be needed.

Antacids

These neutralise stomach acid and provide fast, temporary relief. However, they are not effective for long-term management.

H2 Blockers

These reduce acid production and are useful for moderate symptoms, especially if taken before bed.

Proton Pump Inhibitors (PPIs)

These are stronger acid blockers and are typically prescribed for more severe or chronic GERD. PPIs should be used under medical supervision, particularly for long-term treatment.

When to See a Doctor for Heartburn

Consult an experienced acid reflux specialist if:

• Nighttime heartburn occurs more than twice a week
• Symptoms persist despite lifestyle changes and medications
• You experience difficulty swallowing or unexplained weight loss
• You wake up choking or coughing regularly

Your doctor may order tests such as endoscopy, pH monitoring, or esophageal manometry to determine the severity of your condition.

Nighttime heartburn is more than just a nuisance—it can significantly affect your quality of sleep and lead to long-term health issues if ignored. Fortunately, with the right combination of lifestyle changes, dietary adjustments, and medical treatment, most people can gain control over their symptoms and enjoy a good night’s sleep again.