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If you’re like the millions of people suffering from heartburn at night, you probably dread laying down each night fearing what your night will bring. Nighttime heartburn can also be accompanied by other painful symptoms, such as coughing, choking, regurgitation, sore throat and even chronic sinus issues.
People searching for relief from nighttime acid reflux often turn to OTC or prescription heartburn medicine. These medications work for some but not for others. With the recent research linking PPIs to serious side effects, such as bone fractures, kidney failure, heart disease, pneumonia, Clostridium difficile, dementia, Alzheimer’s, and increased mortality risk, many people are searching for natural remedies for nighttime reflux.
Natural Remedies for Heartburn at Night
The only two clinically validated natural remedies for GERD are weight loss and sleep positioning. Though weight loss can be effective, it is often a longer-term solution that, depending on how much weight you need to lose, can take months before relief is felt. Sleep positioning, on the other hand, can make a huge difference for those suffering from nighttime GERD and relief can be often experienced almost immediately.
Sleeping Positions for Natural Heartburn Relief
Many people don’t realize that how you sleep directly affects how you reflux at the night as anatomy and gravity play a big role in heartburn symptom frequency, length and severity.
First, a quick anatomy lesson. What you eat travels down your esophagus through your lower esophageal sphincter (LES) and into your stomach where digestion begins.
Your LES is essentially a ring of muscles that act as a valve to control the flow of contents between your esophagus and your stomach and vice versa. If your LES functions correctly, what you eat will stay in your stomach with the occasional release of gas, also known as a burp.
Problems arise when your LES doesn’t function properly allowing your stomach contents to escape back up into your esophagus. Commonly referred to as acid reflux, the acidic nature of what comes back up can cause damage to the delicate lining of your esophagus leading to serious health complications, such as erosive esophagitis, peptic stricture, esophageal ulcerations, Barrett’s esophagus, and adenocarcinoma of the esophagus.1
If reflux occurs when you are standing up, gravity and saliva quickly return the acidic content to your stomach. This quick return typically makes your symptoms shorter, as well as minimizes the potential acid damage to the delicate lining of your esophagus from acid exposure. (Figure 1)
Things get more complicated when you lay down to sleep at night as saliva and swallowing slow making the return of reflux to the stomach more difficult.2 Let’s take a look at common sleep positions and you will quickly see which ones you will want to avoid!
Sleep Position 1 to Avoid for Preventing Acid Reflux at Night
Nighttime heartburn can be tough for back sleepers making it position #1 to avoid at night.
When laying flat on your back, a poorly functioning LES can allow acidic stomach contents to flow freely into the esophagus.
Studies have shown that in this position, symptoms are often more frequent and tend to last longer.3
The severity of your symptoms may also increase if you have stomach fat, which pushes down on your stomach and LES and can “force” contents back up into the esophagus and beyond. To reduce your nighttime heartburn and decrease the risks associated with prolonged acid exposure, try to stay off your back at night. (Figure 2)
Sleep Position 2 to Avoid for Preventing Acid Reflux at Night
Position #2 to avoid at night is…sleeping flat on your right side.
Though reflux episodes may be less frequent on your right when compared to flat on your back, the episodes are more liquidy in nature because your LES is often submerged in the acidic stomach content.4
This position potentially creates a leaky faucet spouting stomach acid into the delicate lining of your esophagus.
While liquid reflux can be very distressing, it can also be dangerous as when flat on your right side, the amount of time acid lingers in your esophagus is much longer.3 Gravity is fighting an uphill battle as it is unable to effectively return refluxed content to your stomach.
If you suffer from nighttime heartburn, avoid lying flat on your right side. (Figure 3)
Best Flat Sleep Position for Preventing Acid Reflux at Night
You may have heard that sleeping flat on your left side provides heartburn relief, which is true!
In this position, your LES typically stays above “sea level” or above the level of gastric contents making refluxing more difficult.
Should reflux escape, gravity is able to return it to your stomach quicker than when on your right side. Also, reflux on your left side tends to be more gaseous in nature,4 which decreases potential damage from acid exposure.
Studies have shown that symptoms are less frequent and less severe when on your left side as compared to on your right side or on your back3 making it the most desirable flat sleep position. (Figure 4)
#1 Best Sleep Position for Preventing Acid Reflux at Night
Finally, what about sleeping on an incline?
Has your doctor recommended that you sleep at an incline using a bed wedge or putting blocks under your bed frame? Studies have shown that sleeping at an incline decreases the frequency of reflux episodes and allows your body to clear reflux at a quicker rate.5
As long as your entire torso is elevated, the incline gives gravity a little boost in its power to return reflux to your stomach.
So, what if you take the best flat sleeping position, aka the left side, and add an incline?
Could the benefits be more than the sum of its parts?
Recent studies have shown that this is indeed the case!6,7 These studies show that this compound inclined, left-side sleeping position makes refluxing virtually impossible because your LES is now positioned well above the level of stomach contents, even if your stomach is really full. And, if you do reflux, gravity is able to quickly return the contents to your stomach.
This ideal nighttime acid relief position provides a double whammy of decreasing your heartburn symptoms and providing protection from prolonged acid exposure to your esophagus, throat, lungs, and sinuses. (Figure 5)
If you want to experience the power of this compound position, try an Acid Reflux Pillow System by MedCline, specifically designed to create and maintain the position clinically proven to be the most effective for natural relief from nighttime heartburn and the other distressing symptoms of acid reflux/GERD. Sweet dreams!
Pros and Cons of the MedCline Acid Reflux Pillow System
I highly recommend the MedCline Acid Reflux Pillow System for anyone with nighttime acid reflux. From my personal experience, I found it to be a great natural remedy for nighttime reflux symptoms like heartburn, regurgitation, coughing, sore throat, nausea, and all those other horrible symptoms that go along with acid reflux and GERD.
The Acid Reflux Pillow System is the best of the MedCline products for those suffering from nighttime acid reflux symptoms. The system comes with the MedCline Therapeutic Body Pillow which I prefer over the Advanced Positioning Wedge pillow alone.
PROS of the MedCline Acid Reflux Pillow System:
- It works! The MedCline Acid Reflux Pillow System puts you on an incline and locks you in on your left side to stop nighttime reflux.
- Proven clinical studies that the MedCline wedge pillow system works.
- It’s comfortable once you get used to sleeping in the new position.
- It also helps with snoring, sleep apnea, and shoulder pain. Unfortunately, I suffer from all of these.
- The MedCline Therapeutic Body Pillow that comes with the Acid Reflux Pillow System helped with my lower back pain.
- They give you 100 nights to try it out. If you aren’t happy they will refund your purchase price minus a 10% disposal fee.
- Machine washable covers. They even have extra covers for sale.
CONS of the MedCline Acid Reflux Pillow System:
- I toss and turn a lot because of lower back and neck issues. Staying in one position isn’t comfortable for me. Do you have back problems too? MedCline does not recommend the Advanced Positioning Wedge pillow for people with lower back or hip injuries.
- It’s big! It’s not possible for me to sleep on mine all night because of my back issues. The MedCline can get me past the hours when my acid reflux is at its worst then the bulky system hits the floor leaving no room beside the bed and making it difficult to get up in the night. (Not as bad as the reflux symptoms though.)
- Again, it’s big. It took up half our queen size bed. I felt like I was crowding my wife.
- Takes some time to get used to.
- Pricey though mine was given to me by MedCline to see what I thought.
1) J Lagergren, R Bergström, ALindgren, and O Nyrén. (1999). Symptomatic gastroesophageal reflux as a risk factor for esophageal adenocarcinoma. The New England Journal of Medicine. 1999 Mar 18;340(11):825-31.
2) Jay W. Marks, MD. GERD (Acid Reflux, Heartburn). MedicineNet.
3) Ramez MKhoury M.D., Luciana Camacho-Lobato M.D., Philip OKatz M.D., Muhammad A Mohiuddin M.D., and Donald O Castell M.D. (1999). Influence of spontaneous sleep positions on nighttime recumbent reflux in patients with gastroesophageal reflux disease. The American Journal of Gastroenterology. Volume 94, Issue 8, August 1999, Pages 2069-2073.
4) SS Shay, DL Conwell, V Mehindru, and B Hertz. (1996). The effect of posture on gastroesophageal reflux event frequency and composition during fasting. The American Journal of Gastroenterology. 1996 Jan;91(1):54-60.
5) C Stanciu, and JR Bennett. (1977). Effects of posture on gastro-oesophageal reflux. Digestion. 1977 Feb;15(2):104-9.
6) Erik Person MD, Christopher Rife MD, Janice Freeman RN, Aaron Clark, and Donald O. Castell MD. (2015). A Novel Sleep Positioning Device Reduces Gastroesophageal Reflux. Journal of Clinical Gastroenterology. September 2015 Volume 49, Issue 8, Page 655–659.
7) Sanath Allampati, Rocio Lopez, Prashanthi N. Thota, Monica Ray, Sigurbjorn Birgisson, and Scott L. Gabbard. (2015). Use of a Sleep Positioning Device Significantly Improves Nocturnal Gastroesophageal Reflux Symptoms. Gastroenterology. April 2015 Volume 148, Issue 4, Supplement 1, Page S-617.