The most common upper gastrointestinal disorder in Western countries is acid reflux disease. With multiple studies increasingly indicating risks associated with proton pump inhibitors (PPIs), the most common medication for the disease, looking for non-pharmaceutical options, is more important than ever. One of the “oldies but goodies” in coping with acid reflux is simply elevating the head of the bed at night.
What does the research say?
Research on elevating the head of one’s bed for acid reflux is overwhelmingly positive, and the simple tactic is a frequent recommendation of specialists to their reflux patients. In 2012, a study published in the Journal of Gastroenterology and Hepatology found that elevating the head of the bed by about eight inches (20 cm) decreased the esophageal exposure to acid and increased the clearance of acid from the esophagus.
More recently, in 2016, a systematic review of the literature on the subject found that an elevation of 8 to 11 inches (20 to 28 cm) reduced esophageal exposure to acid and improved symptoms such as regurgitation and heartburn. This benefit was noted in patients who were not taking medications, and in others relieved symptoms better than taking medication alone. As there are no medicinal side effects associated with elevating the head of the bed, adding it to an acid reflux patient’s treatment plan seems a reasonable measure to put in place.
How to elevate correctly
Elevating the head of the bed can be confusing because there are so many products out there that claim to be the best way to elevate for reflux. That being said, you can effectively elevate the head of your bed quite simply and inexpensively. It’s really up to personal preference, but bed risers or a wedge pillow are the most common ways to reach optimal minimal elevation of approximately 8 inches.
Some ways to raise the head of the bed include:
Use blocks, books, or bricks under the feet at the head of the bed (ensure whatever method you use is secure before sleeping on the bed).
Invest in plastic or wooden bed risers to raise the head of the bed if damage to wooden floors is a concern.
Buy bed wedges that go between the mattress and box spring or on the mattress under the sheets.
Invest in a wedge pillow that simulates elevating the head of the bed. (My daughter loves her wedge pillow.)
Quick fixes for difficulties elevating the bed.
People who have attempted to elevate the head of their bed without success sometimes find the results of their efforts uncomfortable, or that they slide off the wedge.
For the first problem, it can help to elevate gradually. Starting on low end and raising the elevation an inch at a time until you find relief from symptoms can help acclimate you to the new sleeping position. Sometimes you have to experiment with different ways of elevating the bed to find what is most comfortable. Some people swear by wedge pillows, while others find the pillows cause neck pain. It doesn’t matter how you do it — just find what works for you, and do it consistently.
The problem of sliding down the bed can often be resolved by placing a body pillow at the foot of the bed in a “U shape” to limit any sliding. It can also be helpful not to use sheets that increase the likelihood of sliding. For example, flannel sheets are harder to slide down than silk.
Elevating the head of the bed is a fairly simple concept with no side effects that can provide huge benefits for people dealing with acid reflux. If your acid reflux is out of control, talk to your doctor about this simple fix to see if it might be right for you.
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Jennifer has a bachelor’s degree in dietetics as well as graduate work in public health and nutrition. She has worked with families dealing with digestive disease, asthma and food allergies for the past 12 years. Jennifer also serves on the Board of Directors for the Pediatric Adolescent Gastroesophageal Reflux Association (PAGER).