Nighttime Heartburn Can Make You Lose Sleep

If you regularly have heartburn, it could be robbing you of sleep and make getting up in the morning and staying alert at work a problem.

Nighttime heartburn not only disrupts your sleep, but it may lead to other health risks such as raising your risk of cancer or aggravating asthma, according to a study in the New England Journal of Medicine. The report shows people who experience nighttime heartburn are 11 times more likely to develop cancer of the esophagus than those who do not.

“Heartburn has been making headlines lately, but most of the focus has been on daytime symptoms,” says Donald Castell, M.D., chairman of the department of medicine at the Graduate Hospital in Philadelphia. “Nighttime acid reflux is a serious, widespread and often undertreated health problem that warrants attention by patients and physicians alike.”

Castell is chairman of the Nighttime Heartburn Relief Effort, a heartburn education campaign launched by the American Gastroenterological Association to alert people about the dangers associated with nighttime heartburn.

Heartburn and asthma

Gastroesophageal reflux disease (GERD) is also extremely common among people who suffer from asthma and both conditions can get worse at night. It’s estimated that as much as 80 percent of asthmatics have GERD. Asthma can get worse at night even if there is no reflux. But can one condition aggravate the other?

“Asthma can aggravate reflux, yes, but I see it from the other way around. GERD makes asthma worse,” says Ronald Ferdman, M.D., an attending physician in the Division of Clinical Immunology and Allergy at the Children’s Hospital in Los Angeles.

If you have asthma and GERD, then you would take medications to control each, Ferdman says. He says studies have shown that reflux medications can also improve a person’s asthma.

Ferdman says just as asthmatics can be helped by environmental controls to avoid triggers, such as dust mites or dog dangers, those who suffer from heartburn can make some lifestyle modifications that can make a difference. “You should go for the easy stuff first,” Ferdman says.

What is heartburn?

More than 60 million Americans suffer from heartburn. In a Gallup survey of 1,000 adults with heartburn, nearly eight in 10 reported experiencing heartburn at night. Based on the survey, about 80 percent of heartburn sufferers, or nearly 50 million people, have nighttime heartburn.

Heartburn is the common term for GERD. It occurs when digestive juices in the stomach are going the wrong way – backing up into your throat. Normally these digestive chemicals remain in your stomach until they pass downward into the intestines. But when the valve at the top of your stomach (called the lower esophageal sphincter, or LES) doesn’t close, digestive juices can flow into your esophagus.

Unlike the stomach lining, the lower esophagus is not protected from the corrosive effects of the acid, so the result is a burning sensation in the throat. It’s called heartburn because it feels as if it’s coming from your heart.

Most of us get occasional heartburn, perhaps from eating too much or having something too spicy. That’s no reason to run to the doctor. However, if you get heartburn more than twice a week or still have symptoms after two weeks of taking an antacid, then it may be serious.

Tips for controlling heartburn

The American Gastroenterological Association has advice for preventing nighttime heartburn:

  • Do not lie down for three hours after eating.
  • Avoid foods, beverages and medicines that can aggravate heartburn, such as fried or fatty foods, chocolate, coffee, carbonated beverages, citrus fruits, tomato products and alcoholic beverages.
  • Decrease the size of portions at mealtimes.
  • Avoid tight-fitting clothing.
  • Lose weight if you’re overweight.
  • Stop smoking.

Elevating the head of the bed by putting blocks under the legs of the bed can also help. The elevation is more effective than just using pillows.

Antacids usually provide temporary or partial relief from GERD, although they don’t completely control heartburn symptoms and long-term use can lead to side effects, such as diarrhea.

For chronic reflux and heartburn, your doctor may prescribe medications to reduce acid in the stomach. These medications include H2 blockers, which inhibit acid secretion in the stomach, and another group of drugs called a proton pump (or acid pump) inhibitors (PPI’s), which inhibits the enzyme necessary for acid production.

Long-term GERD can lead to a serious condition called Barrett’s esophagus, named for the doctor who discovered it. The constant damage to the esophagus from stomach acid refluxing can lead to changes in the esophagus lining that can become cancerous. Esophageal cancer is still quite rare in America, but the incidence of it is increasing at a faster rate than any other cancer.

External Resources

The American Gastroenterological Association
American Medical Association
The National Institute of Diabetes and Digestive and Kidney Diseases