People who experience heartburn at night may find that it is painful and disrupts their sleep.
There are a few common causes of heartburn at night, which include consuming particular foods, eating too close to bedtime, and taking certain prescription medications.
Heartburn at night or worsening heartburn symptoms may be a sign of gastroesophageal reflux disease (GERD).
Many simple home remedies can help ease the symptoms while a person works with a doctor to find a more permanent solution.
In this article, learn about the possible causes of heartburn at night, as well as how to treat them.
Heartburn occurs as a result of food and acid leaking from the stomach up into the food pipe, or esophagus. Experiencing heartburn at night may mean that a person ate too soon before going to bed.
As a person swallows their food, it passes through the esophagus and into the stomach through a band of muscle called the esophageal sphincter. The esophageal sphincter acts as a valve to the stomach, keeping food from moving back into the esophagus.
Sometimes, the esophageal sphincter may fail to close completely, allowing acid and food to leak from the stomach up into the esophagus. When this occurs, it causes the burning sensation that people call heartburn.
Heartburn at night can occur as the person lies down to sleep or while they are sleeping.
When someone eats while either sitting or standing, the force of gravity helps keep acid and food inside the stomach during digestion, making symptoms less likely.
However, when the person lies down, their position can make it easier for the stomach contents to leak back up through the esophageal sphincter.
Several other risk factors contribute to heartburn at night, including:
- dietary triggers, such as spicy food
- having obesity
- high stress levels
- smoking or drinking alcohol
- wearing tight fitting clothing
- eating very large meals
- eating too close to bedtime
It is common for women to experience heartburn during pregnancy, even if they did not frequently experience it before becoming pregnant.
Research from 2015 notes that 17–45% of women experience heartburn during pregnancy. It can occur for many reasons, including the added pressure inside the body, weight gain, and changes in hormones and stress levels.
Most of the time, dietary and lifestyle changes can help control heartburn symptoms.
However, if home remedies prove ineffective for pregnant women, or they cannot take certain medications, they should speak to a doctor about other options.
Many home remedies and nonprescription medications may help people deal with heartburn at night.
Over-the-counter (OTC) medications, such as antacids or acid reducers, may help treat occasional digestive upsets and heartburn.
Antacids work by neutralizing the acid in the stomach, providing relief from symptoms. There are a few different OTC antacids to choose from, including:
- calcium carbonate (Tums)
- magnesium hydroxide (Milk of Magnesia)
- sodium bicarbonate (baking soda, Alka-Seltzer)
- bismuth subsalicylate (Pepto-Bismol)
Acid reducers work to decrease the production of acid in the stomach. There are two main types of acid reducers: proton pump inhibitors (PPIs) and histamine antagonists (H2 antagonists).
A few different OTC acid reducers are available, including:
- famotidine (Pepcid AC)
- omeprazole (Prilosec OTC)
- esomeprazole (Nexium 24HR)
Similar medications may be available with a doctor’s prescription.
These OTC medications can help relieve heartburn, but they are not long-term solutions. Anyone using OTC medications for heartburn relief should talk to a doctor if the symptoms last for more than 2 weeks.
If heartburn at night is becoming a regular issue, it is best to see a doctor for a diagnosis and to discuss long-term treatment options.
Some home remedies can relieve symptoms in the meantime. These include:
Sleeping on the left side of the body
People may notice that their symptoms get better if they sleep on their left side. Some believe that this helps relieve pressure on the stomach, making it less likely that stomach acid will leak into the esophagus.
Elevating the head and chest
For people who sleep on their back, heartburn may occur if stomach acid leaks from the stomach back into the esophagus as they lie down.
In these cases, the person can try to reduce their symptoms by using gravity and elevating the head and chest higher than the lower abdomen.
Specially designed wedge pillows are one way to keep the upper body more upright during the night. Alternatively, a person can try raising the upper half of the bed slightly. Safely placing cinder blocks, bricks, or wood beams under the head of the bed can help.
The National Institute of Diabetes and Digestive and Kidney Diseases note that simply placing extra pillows under the head will not help. The goal is to raise the entire upper abdomen to allow the force of gravity to keep stomach acid down.
Excess weight puts more pressure on the abdomen and can increase the risk of heartburn.
Losing weight, if necessary, may help relieve symptoms. Pregnant women should not usually try to lose weight, however, so they should speak to a doctor about other options.
Avoiding tight clothing
Sometimes, wearing tight, restrictive clothing puts pressure on the abdomen, making heartburn more likely.
People may find it beneficial to wear loose fitting pajamas to bed rather than restrictive clothing, such as bras, compression shirts, or items with tight waistbands.
Avoiding late night snacking
Eating too late in the night may also cause symptoms to flare up. It takes time for foods to pass through the stomach and further into the digestive system after eating.
People who eat closer to bedtime and experience heartburn may wish to try ending their last meal at least 2–3 hours before they go to bed.
Eating smaller meals
Eating a large or high fat meal in the evening may mean that the body is still trying to digest the food by bedtime.
Switching to smaller or lighter meals later in the day may help reduce the risk of heartburn in some people.
The authors of a 2014 study recommend that people eat no fewer than three meals each day but aim for four or five. They reason that people who eat more frequently will have smaller meals.
Avoiding trigger foods
Some foods may be more likely than others to trigger heartburn. Common food triggers for heartburn include:
- tomatoes and tomato products, such as pasta sauce and ketchup
- citrus fruits, including oranges and lemons
- spicy foods
- greasy foods
- carbonated beverages, such as soda or sparkling water
- coffee, tea, or other caffeinated beverages
Keeping a food journal and noting which foods cause heartburn can help people eliminate problematic foods from their diet or avoid eating them in the evening.
Smoking may contribute to heartburn. Smoking irritates the esophagus, and it may also relax the esophageal sphincter and increase stomach acid.
Smoking can also cause forceful coughing, which may aggravate heartburn in some cases.
Checking medication side effects
Heartburn is a common side effect of many different medications. If a person starts getting heartburn at night soon after they begin taking a new medication, the drug could be the cause.
Anyone who suspects that their symptoms are a side effect of a medication should talk to their doctor. It is essential not to stop taking any medication without consulting a doctor first.
Experiencing heartburn at night is common, especially if a person eats too late in the evening.
People can treat occasional bouts of heartburn by using OTC antacids or making simple lifestyle changes.
Anyone who regularly experiences heartburn at night or notices the symptoms getting worse over time should see a doctor. The doctor can help identify any underlying conditions, such as GERD.