Beyond Tired-Sleep issues and GERDby Jan Gambino Patient Expert
So tired. So tired of waking up night after night, hour after hour. So tired my whole body aches and my brain doesn't work. So tired of feeling tired.
One thing is certain, Gastroesophageal Reflux Disease (GERD) and sleep problems go hand in hand. If you have an infant or child with GERD, it is likely you are struggling to get your little one to sleep at night and you are feeling some level of sleep deprivation ranging from mild to mind-altering.
When I was pregnant with my first daughter, I knew that she would wake up every few hours for a feeding. Yet after sleeping through the night for 30 years, it was still a jarring experience to be on the night shift. I didn't really know what it meant to be sleep deprived until my little girl taught me how exhausting it was to wake up several times a night. But like everything else in parenting, night waking was a stage and she quickly moved on to other things to keep my hands and my brain engaged.
While many babies with reflux are poor sleepers, most begin to feel better during the first year and eventually start sleeping through the night. A few babies, like my refluxers never caught on to sleeping and continued to wake up at night well past a year of age.
My reflux baby had silent reflux so being reclined caused painful backwashing. It was difficult for her to learn to self soothe and go to sleep or sleep for more than a few hours at a time. Most nights she woke up at least once but some nights, she woke up every hour or two. I ended up propping myself up on pillows in bed or on the couch so she could sleep upright over my shoulder. At times, I resorted to co sleeping. She definitely slept longer in my bed than in her crib but I tossed and turned, sleeping lightly and waking up exhausted.
Parents of infants and children with GERD often mention poor eating and poor sleep as their greatest caretaking challenges. While most infants with GERD have a prolonged period of night waking past the newborn stage, parents of toddlers and children express frustration when sleep issues persist, especially when all of the usual medical treatments for GERD are in place. Could it be that GERD causes more long term sleep issues than any other chronic childhood health condition?
It isn't surprising that a pH probe showed that my daughter had prolonged reflux events at night. She managed to sleep through some of these episodes but reflux was waking her night after night even while she slept on an elevated surface and took medication every day. I am forever grateful to the pediatric gastroenterologist who helped us develop a successful treatment plan, including a high dose of acid suppression medicine so she could finally sleep through the night.
Every child is different so the GERD treatment plan that leads to better sleeping will be different for each child. It is important to give detailed information to the doctor about the quality of life issues you are facing, including sleep issues. It really helps to document the amount of night waking for a few days or weeks to give the doctor a clear picture of the problem. I also think it is important to help your baby or child develop new ways of self soothing. Your baby should not be expected to deal with the pain and discomfort of reflux alone in her crib night after night. However, as the treatment begins to address the underlying pain and she is feeling better, she can begin to learn age appropriate ways of calming herself and going to sleep.
She wanted to nurse every time she woke up. Over time, I weaned her to one or less feeding per night. I knew she was nursing just for comfort and I knew nursing was a guaranteed way to get her back to sleep. At the same time, I helped her to associate nursing with holding her favorite stuffed toy so that I wasn't the "medicine" or the only source of soothing. As the pain of reflux decreased, she gradually became less dependent on nursing to go back to sleep and I was able to wean her from night nursing. It took a long time but eventually we both mastered the art of sleeping through the night in our own beds