Disclosure: I am compensated for purchases made through some links on this site. Click for details.
Do you ever have heartburn at night when trying to sleep?
Elevation therapy (sleeping on an incline) through the use of a wedge pillow, under-mattress wedge, or adjustable bed can prevent heartburn at night.
Let’s look at why acid reflux is worse at night and the different sleep solutions used for naturally eliminating acid reflux when you lie down.
Symptoms of Acid Reflux Are More
than Just Heartburn
Be aware of these acid reflux symptoms:
- Bitter Taste
- Dental Erosion
- Bad Breath
- Sore Throat
- Excessive Saliva
- Trouble Swallowing
- Weight Loss
Related Content: 19 Acid Reflux Symptoms You Need To Know
What Causes Acid Reflux?
The general cause of acid reflux is a weakening of the lower esophageal sphincter (LES). It’s the closure that separates the esophagus from the stomach. The LES is designed to open when you swallow food or drink and close after to keep the contents in your stomach.
The following can cause the LES to weaken and allow acid to reflux. If you want to eliminate acid reflux, these are causes to address:
- Heartburn Trigger Foods
- Low Dietary Fiber
- High Salt Intake
- Eating Large Meals
- Eating Before Bedtime
- Hiatal Hernia
- Being Overweight
- Being Pregnant
- Stress Levels
- Posture and Position
- Bending Over at the Waist
- Physical Exercise
- Tight Clothing
- Nicotine Use
- Gas and Burping
- Body pH
- Food Allergies and Intolerances
If you have chronic acid reflux or questions about your heartburn, please see your doctor to determine the underlining cause of your acid reflux. Prevention is always better than any treatment method.
Related Content: What Causes Acid Reflux?
Acid Reflux is Worse at Night
To understand why acid reflux is worse at night, we first need to understand a tiny bit about human anatomy.
Human Anatomy and Acid Reflux
When you swallow, the contents travel down your esophagus to your stomach. Between your esophagus and stomach is a ring of muscle called the lower esophageal sphincter (LES). When the LES operates properly, it opens when you swallow to let food into the stomach and then closes to keep your stomach contents in the stomach. The LES needs to maintain a tight closure to keep acid reflux from occurring.
Acid reflux occurs when the closer of the LES is weakened in some way. Certain food and drink, overeating, medications, and body positions are a few things that can weaken the LES closure. We have a list of acid reflux causes in the section above.
Why is Acid Reflux Worse at Night?
There are three main reasons why acid reflux is worse when lying down to sleep.
- Sleep Position: Your sleep position can put extra pressure on the LES causing the closure to weaken and can place your stomach higher than your esophagus allowing acid to leak into your esophagus, throat, vocal cords, lungs, mouth, sinuses, ears, and nose.
- Saliva: Saliva helps to neutralize acids and also washes acid back into the stomach when swallowed, but when you sleep your saliva production and swallowing slows.1,2 This means stomach acid isn’t neutralized or washed back into the stomach as quickly as it might be during the day.
- Gravity: When you’re lying flat on your back, side, or stomach gravity isn’t helping to return refluxed contents back to the stomach. It sits in your esophagus.
Note: Saliva contains bicarbonate, the same component found in baking soda that neutralizes stomach antacid.
Dangers of Acid Reflux at Night
Not only is there a greater risk of acid reflux at night but the extended exposure to refluxed acid causes a greater risk of tissue damage.
The stomach has a special lining that protects against the corrosive effects of stomach acid but the esophagus lacks the same protection. Horrible complications can occur when the lining of tissues outside the stomach are damaged by refluxed acid.
Repeat exposure to stomach acid can cause ulcers, scarring, esophageal strictures, and in more severe cases Barrett’s Esophagus, which is a precancerous condition, and even esophageal cancer.3
Don’t Reduce Stomach Acid
We have stomach acid for a reason. It digests our food and kills harmful bacteria that we ingest.
Many people including doctors and pharmacists go for the quick fix… acid reflux medication.
Heartburn Medicines Don’t Stop Reflux
Heartburn medicine reduces your stomach acid level thus reducing or preventing the pain caused by heartburn, the pain from acid burning your throat. The medication doesn’t prevent acid reflux from occurring.
You’re still having acid reflux when you take heartburn medicines! It’s just masked. Acid reflux symptoms other than heartburn still occur.
Heartburn medicine isn’t always effective anyway especially at night when acid reflux symptoms are at their worst.
Sleep Position and Acid Reflux at Night
Let’s look at common sleep positions to see which ones cause or prevent acid reflux. Then we’ll look at a way to modify your sleep position to reduce the likelihood of acid reflux at night.
3 Flat Sleep Positions to Avoid for Preventing Acid Reflux at Night
Human anatomy and gravity play a great role in acid reflux frequency, the episode’s length, and the severity of symptoms.
Most people sleep flat as opposed to an incline so let’s look at these sleep positions.
#1 Sleep Position to Avoid for Preventing Acid Reflux at Night
The worst position for acid reflux is sleeping flat on your stomach.
In this position, acid can flow freely into the esophagus when the LES closure is weakened which is likely due to pressure on the stomach.
Pressure on the abdomen increases pressure on the LES causing stomach contents to reflux.
Do not sleep on your stomach if you’re prone to acid reflux.
#2 Sleep Position to Avoid for Preventing Acid Reflux at Night
The second worst position for acid reflux is to sleep flat on your back.
Acid reflux frequency and duration is great for back sleepers.4 In this position, stomach contents can flow freely into the esophagus.
To reduce chances of heartburn at night and decrease the likelihood of damage from prolonged exposure to acid, avoid sleeping flat on your back especially if you’re overweight. The pressure on your stomach can cause acid to reflux into your esophagus.
#3 Sleep Position to Avoid for Preventing Acid Reflux at Night
The third worst position for nighttime acid reflux is sleeping flat on your right side.
When sleeping flat on your right side:
- Acid reflux frequency is less than sleeping flat on your back or stomach.
- The refluxed stomach contents tend to be more liquidy in composition due to the position of the LES in relation to stomach contents.5
- Exposure time to stomach acid is much longer.4 There is an uphill battle when lying on your right side. Gravity can not return refluxed contents to your stomach in this position.
Avoid lying flat on your right side if you have heartburn at night.
Related Content: Positions You Should Avoid to Prevent Nighttime Heartburn
The Best Flat Sleep Position for Acid Reflux at Night
Your left side is the best flat sleeping position for avoiding acid reflux at night.
In this position your, LES typically stays above your stomach contents thus lowering the likelihood of acid reflux.
If reflux occurs when lying flat on your left side, gravity works with you to return contents to your stomach. Also, your reflux is typically more gaseous in nature.5
The combined benefits of sleeping on your left side…
- Decrease the likelihood of acid reflux.
- Decrease exposure time to acid.
- Decrease the possibility of damage from acid exposure.
Acid reflux symptoms are less frequent and less severe when sleeping flat on your left side as compared to on your right side, back, or stomach.4 This makes your left side the most desirable flat sleep position.
Elevation Therapy – Sleeping on an Incline to Prevent Acid Reflux at Night
Finally! We get to the good part! Elevation therapy for acid reflux.
Sleeping on an incline can prevent acid reflux! You want to sleep on an angle with your head and torso raised. That’s elevation therapy in a nutshell.
Imagine sleeping without heartburn or any of the other nightmarish acid reflux symptoms! Elevation therapy is simple and it works! It’s the best natural remedy for nighttime acid reflux.
Clinical studies prove that sleeping on an incline with your head and torso raised reduces the chances of acid reflux and if you happen to experience reflux it returns to your stomach at a faster rate.6 Being at an angle allows gravity to keep stomach contents where it belongs!
How awesome is that?! An incline reduces acid reflux no matter what your sleep position. But still, don’t sleep on your stomach. It’s the worst!
Sleep Solutions Used in Elevation Therapy for Heartburn at Night
Not every form of elevation therapy for heartburn at night is equal. Some ways of raising your head and torso are better than others.
Let’s look at some of the common elevation therapy solutions to discover your best options.
Keep in mind that the height of elevation needs to be 6–8 inches (15–20 cm) or greater to prevent acid reflux. Greater the angle, the better the results. You do, however, need to consider sleep comfort when choosing the height of your sleep therapy device. Sitting straight up would provide great results but what a super uncomfortable sleep position! I sure can’t do it.
Wedge Pillows for Elevation Therapy
A wedge pillow is a short, narrow, wedge-shaped pillow made of moderately firm foam. In elevation therapy, they are used at the head of the bed to attain a better sleep position for the improvement of acid reflux, neck and back pain, snoring, sleep apnea, allergies, and coughing.
Wedge pillows can be used for both back and side sleepers and they can be used alone or in combination with standard pillows for added comfort.
A wedge pillow may also be referred to as a bed wedge, bed wedge pillow, sleeping wedge pillow, sleeping wedge, foam wedge, triangle pillow, pregnancy wedge pillow, incline pillow, back wedge pillow, or elevated pillow and for the specific use of acid reflux prevention, it may also be called a reflux pillow, acid reflux pillow, or GERD pillow.
To save money, people will sometimes try to stack their regular pillows at an angle to achieve the same effect as a wedge pillow. This doesn’t work well. It’s best to go ahead and invest in a wedge pillow.
When it comes to wedge pillows, you have two awesome options. The standard wedge pillow which comes in different angles/heights or the MedCline Reflux Relief System.
Note for Side Sleepers:
While wedge pillows can be used for both back and side sleepers, those with back and hip problems like herniated discs, bulging discs, spinal cord compression, scoliosis, fused vertebrae, lumbar damage, arthritic hips, hip bursitis, or hip injuries may find it difficult to tolerate the angles of many wedge pillows. This is particularly true for side sleepers.
If you suffer from any of these back or hip conditions, speak to a doctor or physical therapist about your options. An under-mattress wedge or adjustable bed may be a far better solution for you.
Standard Wedge Pillow
Standard wedge pillows are very affordable elevation therapy solutions that come in a variety of different heights and a variety of different foam options.
The wedge pillow pictured is made of memory foam which will conform to your back neck and/or shoulders for a comfortable night’s sleep. It measures 24 x 28 x 7.5 inches which provides an acceptable height/angle for preventing acid reflux.
Tip: When looking for a wedge pillow look for one with a removable cover you can wash.
This pillow at a height of 7.5 inches is a good place to start. If you think you can sleep at a greater angle or want to work up to a larger angle, you might consider a wedge pillow with a height of 12 inches.
MedCline Reflux Relief System
I highly recommend the MedCline Reflux Relief System!
Better than a Standard Wedge Pillow
So what makes the MedCline Reflux Relief System better than a standard wedge pillow? Its design has some amazing advanced features and the medical-grade memory foam makes it far more comfortable. Take a look at the design!
Keeps You on Your Left Side
Clinical studies show that the effect of sleeping on an incline and on your left side combined make acid reflux almost impossible!7,8 The combination places your LES well above your stomach contents. If you do happen to experience reflux in this position gravity is able to quickly return the content to your stomach.
The MedCline Reflux Relief System is a wedge pillow that can keep you at the ideal incline and on your left side in comfort. The pillow can be used on your right side too but remember from the sleep positions above, sleeping on your left side is best.
Prevents Sliding while sleeping on an Incline
Have you ever used a standard wedge pillow only to find yourself sliding down it during the night? That defeats the purpose of using a wedge pillow for relief from heartburn at night. Well, you won’t slide down the MedCline when your arms in place. Neat feature, huh?
And here’s another bonus feature that I love!…
Prevents Shoulder Pain while Sleeping
If you have shoulder pain while sleeping, it’s another reason to pick the MedCline. It’s specifically designed to prevent shoulder pain at night! After multiple rotator cuff injuries, this feature is a huge bonus for me. They even sell a version of the wedge pillow for people with shoulder issues and no reflux problems, the MedCline LP Shoulder Relief System.
For Comfort Make Sure You Get the Therapeutic Body Pillow
There are a few wedge pillow setups over at MedCline. The MedCline Reflux Relief System is the best for the relief of nighttime acid reflux. The reflux relief system includes the Advanced Positioning Wedge and their Therapeutic Body Pillow which I prefer over the Advanced Positioning Wedge pillow alone. The combination makes the experience of sleeping on a wedge pillow far more comfortable!
The MedCline Reflux Relief System does cost a bit more than a standard wedge pillow but it does come with a 100-night trial. If the MedCline isn’t working out, you can return it for the purchase price minus a 10% recycling fee.
Under-Mattress Wedges for Elevation Therapy
Under-mattress wedges are longer foam wedges that are placed under your mattress to raise the head of your bed. This aids gravity in keeping stomach contents from refluxing when you sleep.
Under-mattress wedges are far more comfortable for side sleepers than wedge pillows but won’t lock you into sleeping on your left side like the MedCline Reflux Relief System.
Let’s face it. Most of us have a tendency to move around when we sleep. The MedCline can keep you on your left side, the best sleep position for those with acid reflux. But maybe you want the ability to roll around some. I get that. When I sleep in the same position too long I start to ache.
A big advantage of having a mattress wedge is that you’re sleeping on your mattress and not some other piece of foam that you may or may not find so comfortable.
The Reflux Guard is 60 inches long and comes in width to fit twin, full, queen, king, California king, 30-inch beds, 36-inch beds, and 48-inch beds.
Unlike other under-mattress wedges, the Reflux Guard is shorter than your mattress length. This helps keep your mattress from sliding down the wedge, a problem found with many under-mattress wedges that are full mattress length.
At 60 inches in length, the Reflux Guard gives you the ability to adjust its placement under the mattress for higher or lower incline. You should be able to raise the head of your bed around 6 to 7 inches.
Having an under-mattress wedge is extremely helpful if you and your partner both suffer from acid reflux at night. But if your partner doesn’t like sleeping on an incline, you might be better off with a wedge pillow or an adjustable bed that will allow each person to raise or lower their side of the bed as they see fit.
Well, it’s more expensive initially. You don’t sleep on the Reflux Guard directly so you don’t have to wash its cover or buy new ones over time and it typically won’t wear out as fast as a wedge pillow. Maybe this is one of the reasons why they offer a 10-year warranty. Something the wedge pillows don’t have. Over time you may save money by going with the Reflux Guard.
Adjustable Beds for Elevation Therapy
Adjustable beds are the best long-term solution for elevating the head and torso to prevent acid reflux and heartburn at night. They are one of the most comfortable options and they’re especially beneficial for those with back pain and acid reflux symptoms.
A bonus to the adjustable bed over the standard wedge pillow and under-mattress wedge is that you’re less likely to slide down the incline. The foot of an adjustable bed can be adjusted to combat sliding.
There are many different adjustable beds on the market. Tempur-Pedic is one of the best brands out there that you have probably heard of. It’s top on my list!
I have back problems (a herniated disc and sciatica) and I suffered from GERD until I found ways to naturally overcoming it. My wife has back pain different than mine and usually needs a softer mattress than I do.
Because of our different sleeping needs, the split type adjustable bed is a perfect option for us. We have our eye on the TEMPUR-Ergo Premier-Grey Adjustable Base, Twin XL which would allow each of us to have a twin mattress to our liking. I want the Tempur-Pedic TEMPUR-ProAdapt 12-Inch Firm Cooling Foam Mattress where my wife may opt for the medium firmness of the TEMPUR-ProAdapt. It’s a really great product for preventing acid reflux at night.
You might prefer one of the other Tempur-Pedic mattresses though. We all have different sleeping needs. No matter what your mattress type Tempur-Pedic has you covered.
If you already own a Tempur-Pedic, I’d love to hear your thoughts in the comments below. How has it helped your heartburn at night?
Bed Risers for Elevation Therapy
Bed risers are available for raising the head of your bed but I no longer recommend them.
Placing these blocks under the head of your bed isn’t particularly safe and they don’t work for all bed frames. The elevation therapy solutions I previously mentioned are much better options.
If you try bed risers, do so as a temporary measure.
Which Sleep Solution is Best in Elevation Therapy for Heartburn at Night?
Well, that’s hard to say. It depends on your health situation, personal preference, and your preferred sleep position. You may have to try a few of the options before finding the right one for you.
Best Sleep Position
The absolute best sleep position for preventing acid reflux at night is the combination of being on your left side and on an incline. This position makes nighttime reflux almost impossible.
My Choice, Experience, Desired Solution for Elevation Therapy
I used the MedCline when I had GERD (chronic acid reflux). I didn’t buy the Reflux Guard. My wife doesn’t have acid reflux issues and doesn’t like sleeping on an incline. So the Reflux Guard was out. I prefer the Tempur-Pedic adjustable bed, my wife likes this idea too, for her back, but the cost… Yep, it’s expensive. Expensive but worth it according to many people who have chronic acid reflux or worse.
Weigh your options and speak with your health professionals. They help steer you to your best choice.
Elevation Therapy Conclusion
Nighttime sleep solutions used in elevation therapy can help you take advantage of the human anatomy and gravity to naturally prevent acid reflux at night.
When stomach acid repeatedly leaks through your LES, serious and irreversible damage can occur. Take the steps you need to protect yourself!
Think of it! No more heartburn and insomnia from those unbearable acid reflux symptoms that torture you at night!
Elevation therapy has worked for me and the millions of others who’ve used this simple technique that’s recommended by doctors all over the world.
I hope you try one of the sleep solutions I’ve mentioned.
Related Content: 10 Ways to Eliminate Nighttime Heartburn
1) Thie NM, Kato T, Bader G, Montplaisir JY, and Lavigne GJ. (2002). The significance of saliva during sleep and the relevance of oromotor movements. Sleep Medicine Reviews. 2002 Jun;6(3):213-27.
2) Jay W. Marks, MD. GERD (Acid Reflux, Heartburn). MedicineNet.
3) Lagergren J, Bergström R, Lindgren A, and Nyrén O. (1999) Symptomatic gastroesophageal reflux as a risk factor for esophageal adenocarcinoma. The New England Journal of Medicine. 1999 Mar 18;340(11):825-31.
4) 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.
5) 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.
6) C Stanciu, and JR Bennett. (1977). Effects of posture on gastro-oesophageal reflux. Digestion. 1977 Feb;15(2):104-9.
7) 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.
8) 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.