Have you ever thought that your acid reflux or acidity can also occur when you are asleep? Yes, it can happen and you may not even realise that you are constantly disturbed from having a good night sleep due to acidity.
Acidity or acid reflux can happen at any time and not just right after your meal. Let us learn about acidity, how sleep and acidity are connected and different ways to manage acid reflux so that you can have a sound sleep.
Why do you get acidity in the first place?
Before knowing about acidity, it is better to have some knowledge about our stomach so that it will help you in understanding acidity and how it occurs. The food we eat has to pass through a food pipe called the oesophagus and then it reaches the stomach. Note that it is a one-way passage, there is a valve at the junction of the oesophagus and stomach called the Lower Oesophageal Sphincter (LES). It is a band of tissue that opens when the food has to enter the stomach and closes as soon as food reaches the stomach.
When the muscles of the LES are relaxed, the acid produced in the stomach for digestion purpose escapes or travels backwards into the oesophagus. The acid in the oesophagus irritates the lining of the oesophagus causing an array of symptoms. Sometimes this acid along with undigested food also reaches the mouth leaving a bad taste in the mouth.
Each person experiences at least one of the symptoms when suffering from acidity. Some people refer to acidity as acid reflux.
Symptoms of acidity:
- Acid regurgitation
- Discomfort in the stomach
When the symptoms of acidity are severe and occurring more than twice a week, it is called Gastro-esophageal Reflux Disease (GERD).
How does GERD impact your quality of sleep?
When you are suffering from acidity over a period of time irrespective of dietary factors, it results in GERD. GERD not only disrupts the quality of life but can also cause various complications such as –
Causing or aggravating Obstructive Sleep Apnea (OSA):
OSA is a sleep disorder characterised by obstruction of the airway, as a result, the person stops breathing for some time (10- 20 secs) during sleep. When the muscles of the throat relax, the airway narrows or closes, thus breathing stops. When the oxygen supply to the brain is reduced it wakes the person up and again the person starts breathing. This pattern repeats throughout the sleep about 20 times or so and is called sleep apnea. The person may not be aware of this condition. This is a dangerous condition that needs medical attention.
How GERD causes or aggravates sleep apnea?
Research has established a relationship between GERD and obstructive sleep apnea as 60% of patients with sleep apnea also experience GERD. It is to be noted that obesity is a common factor in both GERD and OSA. But the exact mechanism is not yet established. It is believed that when an episode of sleep apnea occurs, the pressure in the chest varies making things favourable for acid reflux like relaxing of the oesophagal muscles and LES, thus facilitating the backward flow of acids causing acid reflux.
Aspiration of stomach acid while asleep:
Often due to acid reflux, the gastric acid may travel backwards from the stomach and if you are awake, it reaches your mouth but when you are asleep, it may reach your lungs, which is also called chocking.
Insomnia or lack of complete sleep:
Trouble falling asleep and disturbed sleep over a period of time is called insomnia. Insomnia leads to severe fatigue and lethargy throughout the day.
The person suffering from acid reflux often awakes at night with a cough or choking or with a weird taste in the mouth. This happens as a person with acid reflux sleep in a horizontal position as this facilitates the contents of the stomach to reach up to the mouth. But during the day time, the same reflux won’t cause the contents of the stomach to reach your mouth as the gravity helps in confining the contents only to the stomach or mid-chest. Thus acid reflux causes disturbance in sleep and makes it difficult for the person to fall asleep until they sit in a reclining position or stand to help gravity do its job.
Management of acid reflux:
You can ease your symptoms with simple strategies at home as mentioned below –
- Maintain a healthy weight
- Do not sleep immediately after having your meal
- Have a stroll after dinner
- Incorporate exercise into your daily life
- Avoid triggering foods like spicy, oily, and citrus food that can aggravate acid reflux
- Do not have large meals for dinner
- Raise your bed by at least 6 inches near the head with the help of pillows
Many medicines can treat acid reflux but your doctor is the person to assess the severity of your condition and treat accordingly with prescription medicines as mentioned below.
Antacids like Sucralfate provide symptomatic relief by neutralising the acids and decreasing the acid penetration in the oesophagus or food pipe. This provides only interim relief but not useful for prolonged management of acid reflux.
HISTAMINE H2-RECEPTOR ANTAGONISTS:
H2 receptor blockers like cimetidine, famotidine, nizatidine, and ranitidine reduce acid production. They are more effective than antacids but they do not act as quickly as antacids in providing relief.
Proton pump inhibitors (PPIs):
PPIs include lansoprazole, omeprazole, pantoprazole and rabeprazole. They are considered to be more effective than H2 receptor blockers as they not only reduce acid production but also help in healing the injured lining of the stomach and oesophagus.
Don’t underestimate acidity:
If you are suffering from the symptoms of acid reflux often then it is always better to consult a doctor and get diagnosed and treated for GERD, rather than ignoring the symptoms. If you ignore them for a very long time it may lead to future complications. And also inadequate sleep has many deleterious effects on both your health and the quality of your life. Both sleep issues and GERD are interrelated and influence one another thus forming a vicious cycle. Your doctor upon assessing your symptoms will determine the management of both your sleep issues and acid reflux.
Disclaimer: The information included at this site is for educational purposes only and is not intended to be a substitute for medical treatment by a healthcare professional. Because of unique individual needs, the reader should consult their physician to determine the appropriateness of the information for the reader’s situation.