What Causes Acid Reflux at Night & How to Treat It

Acid reflux at night affects millions of Americans, interrupting crucial sleep with a distinctive burning sensation in the chest and throat.^[1] This nighttime discomfort is a health concern that can impact sleep quality, daytime functioning, and long-term well-being. GERD symptoms at night affect up to 4 in 5 GERD patients^[2], making it one of the most prevalent sleep disorders nationwide.

This guide will examine what causes acid reflux at night and discuss its symptoms and solutions to help you achieve the restorative sleep essential for optimal health.

• Key Takeaways
• What Is Acid Reflux?
• What Causes Acid Reflux at Night?
• What Are the Symptoms of Acid Reflux at Night?
• How Do You Prevent and Treat Acid Reflux at Night?
• Nighttime Acid Reflux FAQs
• Understanding and Controlling Acid Reflux at Night

Key Takeaways

• Sleeping on your left side helps reduce nightly acid reflux symptoms by keeping stomach contents away from your esophagus.
• Avoid eating within a few hours of bedtime to give your body time to digest before lying down.
• Raising the head of your bed or using the right number of pillows can prevent stomach acid from flowing upward while you sleep.
• Managing your weight, reducing alcohol intake, and avoiding trigger foods can make a significant difference in nighttime reflux episodes.
• From over-the-counter antacids to prescription medications, various treatment options are available if lifestyle changes aren’t enough to prevent GERD at night.

What Is Acid Reflux?

Acid reflux occurs when acid makes its way from the stomach back into the esophagus, which connects the mouth and stomach. Normally, the lower esophageal sphincter muscle opens to let food into the stomach for digestion and then closes again to prevent stomach acid from coming back up. When this muscle weakens or relaxes inappropriately, acid reflux can take place.^[3]

Gastroesophageal reflux disease (GERD) occurs when reflux episodes become chronic with more severe symptoms. While occasional reflux is common and generally not concerning, GERD at night can lead to complications if left untreated.^[3]

Your stomach naturally produces acid to break down food and kill bacteria. This highly acidic substance is much stronger than the neutral environment your esophagus is designed to handle. When this acid enters the esophagus, it irritates the lining, causing the characteristic burning sensation.^[3]

What Causes Acid Reflux at Night?

Many people who rarely experience reflux during the day find themselves particularly vulnerable at night. What causes acid reflux at night specifically? Several factors contribute to this nighttime nuisance:^[4]

Lying flat when sleeping

While technically the best sleeping position, there are many pros and cons of sleeping on your back. While sleeping on your back helps keep your spine in alignment, those with GERD can experience heightened acid reflux episodes. When you lie horizontally, gravity no longer keeps stomach acid where it belongs. This flat position makes it easier for acid to flow back into your esophagus, which explains why symptoms can intensify shortly after lying down.

Eating too close to bedtime

Your stomach takes several hours to empty after a meal. Lying down with a full stomach creates pressure that can force acid upward, leading to heartburn at night. It’s recommended to eat at least two to three hours before bedtime to allow your stomach to digest your meal.

Weak or relaxed lower esophageal sphincter

The lower esophageal sphincter (LES) naturally weakens with age or can become damaged due to various factors. Certain foods and beverages, including chocolate, peppermint, and fatty foods, can worsen symptoms. Caffeine and sleep are closely linked, as stimulants like coffee can temporarily relax this muscle, increasing the risk of acid reflux at night.

Spicy, fatty, or acidic foods

These foods stimulate acid production and can irritate an already sensitive esophagus. Consuming them in the evening can trigger nighttime acid reflux episodes. Tomatoes, citrus fruits, and vinegar-based dressings are common culprits.

Obesity

Additional weight puts more pressure on the body and can force acid upward. People with higher BMIs are more likely to develop GERD compared to those at healthy weights, as increased abdominal pressure can overwhelm the lower esophageal sphincter.

Pregnancy

Pregnancy comes with hormonal changes that can relax the lower esophageal sphincter, and an increase in progestogen is known to relax muscles throughout the body, including the LES. Additionally, as the baby grows, additional pressure on the stomach from the expanding uterus can push acid upward toward the esophagus.

Smoking and alcohol use

Both smoking and alcohol consumption weaken the lower esophageal sphincter and stimulate acid production. Alcohol can affect sleep quality in multiple ways, and triggering acid reflux is just one example, as it can weaken or relax the LES and stimulate acid production in the stomach. Smokers have a 23% higher risk of acid reflux than non-smokers, as it’s also known for relaxing the LES, as well as reducing saliva production that’s needed for neutralizing stomach acid.^[5]

Hiatal hernia

This type of hernia occurs when the stomach begins pushing through the diaphragm into the chest cavity. A hiatal hernia is a structural abnormality that disrupts the barrier, pulling part of the stomach and the LES above the diaphragm, which can make it difficult for the LES to close. This can make nighttime acid reflux symptoms more likely, as acid trapped in the hernia pocket can flow upward when lying down.

What Are the Symptoms of Acid Reflux at Night?

GERD symptoms at night can differ from daytime symptoms and may even be confused with other conditions. Knowing when you’re having acid reflux symptoms at night can help you determine when it’s time to get proper treatment. The most common signs of acid reflux at night are:^[3]

• Heartburn: The most recognizable symptom is a burning sensation that starts behind the breastbone and may radiate upward toward the throat. At night, this discomfort can be intense enough to wake you from sleep.
• Chest discomfort or tightness: Some people experience pressure or discomfort in the chest rather than burning. This can sometimes be mistaken for heart problems, especially when it occurs at night.

• Coughing, sore throat, or hoarseness: When acid reaches the throat and larynx, it can irritate these sensitive tissues. Many people with nighttime reflux wake up with a chronic cough, scratchy voice, or sore throat, even if they didn’t experience typical heartburn during the night.

• Regurgitation or sour taste in the mouth: The backflow of stomach contents can bring a bitter or sour taste to the mouth. Some people may even experience actual regurgitation of food or liquid while lying down.

• Trouble sleeping: Beyond the direct discomfort, acid reflux at night disrupts sleep architecture. People with nighttime GERD may experience poorer sleep quality, more awakenings, and reduced REM sleep.

How Do You Prevent and Treat Acid Reflux at Night?

Fortunately, there are many effective ways to prevent and treat nighttime reflux. Here’s how to stop acid reflux at night through lifestyle changes and medical interventions:^[4]

• Avoid eating close to bedtime: Give your body time to digest before lying down by finishing your last meal at least a few hours before bed. This simple timing adjustment often produces dramatic improvement in nighttime symptoms.
• Maintain a healthy weight: Losing weight can reduce pressure on your stomach, which may decrease reflux episodes.
• Elevate your head: Gravity is your ally against acid reflux. Raising the head of your bed by a few inches can reduce nighttime symptoms. An adjustable bed base can give you the perfect incline to minimize acid reflux while maintaining proper spinal alignment. You can also play around to find the right number of pillows to sleep on to elevate your head. In most cases, two to three pillows offer enough height to keep your throat above your stomach to prevent acid from flowing up.
• Sleep on your left side: Sleeping on your left side reduces reflux episodes because the position keeps the area between the stomach and esophagus above the level of gastric acid.
• Eat reflux-friendly foods: Eat a diet of low-acid, easy-to-digest foods, especially at night. Good choices include bananas, melons, lean proteins, vegetables, and whole grains. Keeping a food diary may also help you figure out your personal trigger foods.
• Reduce stress: Stress increases stomach acid production and can trigger reflux episodes. Try relaxation techniques like meditation for sleep, deep breathing, or gentle yoga before bed. Remember that exercise before bed should be calming rather than vigorous; save intense workouts for earlier in the day.
• Try medications: Medications can help manage acid reflux. Antacids like Tums and Rolaids offer quick, temporary relief by neutralizing stomach acid. H2 receptor blockers like Pepcid reduce acid production and work for several hours. Meanwhile, proton pump inhibitors like Prilosec block acid production and promote healing of the esophagus. Prescription-strength versions of these medications are also available for severe cases. Before taking any medications, always consult your doctor or healthcare provider to ensure safe use.^[6]

Nighttime Acid Reflux FAQs

What sleeping position is best for acid reflux?

Sleeping on your left side is generally considered best for acid reflux. This position uses gravity to keep stomach contents away from the esophagus. Elevating your upper body can also help. Choose a few firm pillows to put under your head and shoulders, or discover the benefits of an adjustable bed base, which makes it easy to ensure your head is elevated throughout the night.

What can happen if you don’t treat acid reflux?

If you don’t treat acid reflux and GERD, they can turn into potentially serious complications. These include:[3]

What can happen if you don’t treat acid reflux?

If you don’t treat acid reflux and GERD, they can turn into potentially serious complications. These include:[3]

• Esophagitis: This condition involves inflammation and erosion of the esophageal lining due to repeated acid exposure, causing pain, bleeding, and difficulty swallowing.
• Ulcers: Prolonged exposure to stomach acid can create painful sores or ulcers in the esophagus that may bleed and cause discomfort, especially when eating or drinking.
• Esophageal stricture: Over time, repeated damage and inflammation can cause scar tissue to form, which narrows the esophagus and creates a stricture that makes swallowing difficult or painful.
• Barrett’s esophagus: This more serious condition occurs when constant acid exposure causes the cells lining the esophagus to change into a type that more closely resembles intestinal cells, creating a precancerous condition that needs to be monitored.
• Esophageal cancer: In very rare but serious cases, chronic, untreated acid reflux may contribute to the development of esophageal cancer.

It’s important to see a doctor if you experience any of these warning signs:^[3]

• Symptoms that occur more than twice a week.
• Difficulty swallowing.
• Persistent nausea or vomiting.
• Weight loss due to eating difficulties.
• Nighttime choking episodes.
• Symptoms that persist despite over-the-counter medications.

Does acid reflux cause sleep apnea?

While acid reflux doesn’t directly cause sleep apnea, the two conditions frequently coexist and can worsen each other. Reflux can cause inflammation in the throat that may aggravate sleep apnea symptoms, while the negative pressure in the chest during apnea events can pull stomach contents upward.

Understanding and Controlling Acid Reflux at Night

Managing acid reflux at night comes down to a few strategies. Sleep on your left side and elevate your head and upper body. Avoid eating within a few hours of bedtime, and steer clear of trigger foods. If symptoms persist, over-the-counter medications can help, but see your doctor if you’re not finding relief.

The right mattress and bed setup can make a big difference for acid reflux sufferers. A memory foam mattress keeps your body properly aligned while you sleep on your side, while a hybrid mattress offers both support and comfort for easy position changes. When paired with an adjustable bed base, you can find the perfect elevated position to prevent acid reflux at night. Browse Layla’s collection to find the right sleep system for your needs.

References

1. Clarrett, Danisa M, and Christine Hachem. “Gastroesophageal Reflux Disease (GERD).” Missouri Medicine, vol. 115, no. 3, May 2018, p. 214, pmc.ncbi.nlm.nih.gov/articles/PMC6140167/.
2. “Sleep & GERD – about GERD.” About GERD, 24 Feb. 2021, aboutgerd.org/signs-and-symptoms/sleep-gerd/.
3. “Gastroesophageal Reflux Disease (GERD) – Symptoms and Causes.” Mayo Clinic, 2025, www.mayoclinic.org/diseases-conditions/gerd/symptoms-causes/syc-20361940
4. Roland, James. “What Causes Acid Reflux at Night and What to Do.” Healthline, Healthline Media, 25 Nov. 2019, www.healthline.com/health/acid-reflux-at-night/.
5. Sepehr Sadafi, et al. “Risk Factors for Gastroesophageal Reflux Disease: A Population-Based Study.” BMC Gastroenterology, vol. 24, no. 1, 5 Feb. 2024, pmc.ncbi.nlm.nih.gov/articles/PMC10840240/, https://doi.org/10.1186/s12876-024-03143-9.
6. “Gastroesophageal Reflux Disease (GERD) – Diagnosis and Treatment – Mayo Clinic.” Mayoclinic.org, 2025, www.mayoclinic.org/diseases-conditions/gerd/diagnosis-treatment/drc-20361959.