Acid reflux is more dangerous at night than in the day. When we lie down, the lack of gravity allows the reflux material from the stomach to travel higher and stay longer in the esophagus, which in turn can do more damage (Khan et al., 2012). There are several things you can do to reduce nighttime acid reflux symptoms.
1. Tilt the head of your bed
Bed tilting has been shown to be an effective therapy to reduce nighttime acid reflux symptoms. According to a study reported in the May 2015 issue of the Journal of Allergy and Clinical Immunology, tilting the head of the bed six inches significantly improved reflux symptoms in some of the participants. Tilting the bed involves raising the head of the bed six to eight inches above the foot of the bed. This can be accomplished by putting blocks under the bedposts, sleeping on a medical wedge pillow or folding a blanket under the upper part of the mattress and box spring.
2. Reduce night eating
According to multiple studies, large meals and late night eating are known to increase reflux symptoms. This makes sense in that going to bed on a full stomach will create more nighttime acid production and put more pressure on the stomach. However, for some people, either work schedules or eating time preferences make the elimination of late night meals difficult. In these cases, it is better to choose easily digestible and lighter fare such as a half of a nut butter sandwich, a bowl of rice or a baked potato with a light topping for an evening meal or snack. The goal is quick digestion and stomach emptying before lying down for the night.
3. Talk to your doctor about adjusting your medication
Some reflux medications are prescribed for once or twice a day and some are recommended to take immediately when symptoms arise, depending on the type of medication. There are some medications that are known to better control nighttime reflux. For example, in one study, it was determined that a once-daily dose of a special PPI with sodium bicarbonate helped nighttime acid reflux symptoms (Orbelo, et al., 2015). There are other reflux medications that if taken in the morning, may not last through the night. If you suspect that you have nighttime acid reflux symptoms and you have already tried tilting your bed and reducing your late eating, you should talk to your doctor about reflux medications that may be available to help through the night.