Best Sleeping Position For Acid Reflux: Sleeping with GERD

By: SleepScore Labs  |  April 22nd, 2019

What Is the Best Sleeping Position for Acid Reflux? Sleeping With GERD 

Do you experience burning in your throat, regurgitation, choking, coughing, or heartburn during sleep? All of these may disturb your sleep throughout the night. But what could be the cause? Short answer: Stomach acid, when it escapes out of your stomach to the esophagus and sometimes even up into your lungs, throat, and sinuses.  

People with acid reflux, or gastroesophageal reflux disease (GERD), usually experience these symptoms at night. If you’re one of them, know that you’re not alone. It’s more common than you may expect. GERD affects up to 13% of the global population at least once a week. And, 25% of people with GERD experience poor sleep, which could be from nocturnal gastroesophageal reflux (GER), a type of GERD, with the other being upright or daytime GERD.   

Supine or nocturnal gastroesophageal reflux usually occurs when acid moves back up to a person’s esophagus while lying down and mostly happens at night before or during sleep. This condition may cause sleep issues and prevent a person from getting a good night’s rest. 

Let’s take a look into the sleep positions that may reduce your GERD symptoms and help you get a better night’s sleep, as well as the sleep positions to avoid because they may aggravate your symptoms at night.

What is GERD? 

Gastroesophageal reflux disease (GERD) is a common chronic gastrointestinal condition that happens when the contents in the stomach escape out of it into the esophagus. The most common symptom of GERD is heartburn, which may come with a sour taste in the mouth. A person with GERD may also experience acid regurgitation, bloating, nausea, and belching. 

What Causes Acid Reflux at Night? 

Acid reflux happens when the muscles at the lower part of the esophagus (called the lower esophageal sphincter), which stop food from leaving the stomach, become weak or relaxed. However, gravity and anatomy play a massive role in the occurrence of nocturnal GERD symptoms.  

During the day, you are more likely to be upright—standing or sitting up. So when stomach acid escapes, gravity and saliva quickly return the content to the stomach. You’re also more likely to manage GERD symptoms by staying upright, swallowing saliva, or taking antacids when you’re awake.  

Plus, when upright, your esophagus naturally flows down into your stomach. This quick return of acid to your stomach typically makes your symptoms shorter and minimizes the potential harm acid can cause to the delicate lining of your esophagus. 

Evidence shows that acid reflux usually happens in the first two or three hours of sleep. It usually occurs when a person lays down soon after consuming heavy meals. Studies suggest that those with GERD are more likely to experience acid reflux when they consume heavy meals late at night (about two hours before bedtime). 

Other factors that may trigger acid reflux include 

  1. Consuming fatty foods, spicy foods, alcohol, and caffeine 
  2. Smoking tobacco 
  3. Stress 
  4. Pregnancy 
  5. Weight gain 
  6. Taking drugs that affect the functioning of the esophagus like anticholinergic drugs (e.g., antidepressants and muscle relaxants) and anti-inflammatory drugs (like diclofenac and ibuprofen)

Acid reflux sleeping positions  

You don’t have to sleep sitting upright to take advantage of the effects of gravity and anatomy on the occurrence of GERD. Still, how you sleep can directly affect how often you feel symptoms, how severe those symptoms are, and how long the acid sits in your esophagus.  

The good news is that you can drastically change your nights by changing the way you sleep. But first, consult with your doctor if you suspect you have GERD or any other condition that may be disturbing your sleep.  

Left Side 

Sleep on your left side. Gravity will work in your favor on your left side as your stomach now stays below your esophagus, making reflux more difficult. 

Should stomach acid escape, gravity can return it to your stomach quicker than when on your right side or on your back which is why the left is usually the best side to sleep on to avoid acid reflux. Plus, lying down on your left side produces reflux symptoms that tend to be more gaseous, which may be annoying but much less distressing than liquid reflux that comes with lying down on your right side.  

Studies show that symptoms are less frequent and less severe when a person sleeps on their left side rather than their right side or back, making it a more desirable sleep position for people with GERD. 

Talk to your doctor if you’re experiencing any symptoms that are affecting your sleep.   

Benefits of Sleeping at an Incline 

Sleeping at an incline means sleeping with your head elevated 6 to 8 inches off your body by putting extra pillows under your head and upper back.  

According to an article published in the journal ​​Missouri medicine, head of bed elevation (sleeping at an incline) is proven to manage GERD. It limits how often stomach acid escapes to the esophagus, allows your body to get stomach acid back to your stomach quicker, and reduces the symptoms of GERD. Likewise, a 2012 study suggests that elevating the head while lying down may reduce nighttime acid reflux and help manage heartburn and poor sleep from nocturnal gastroesophageal reflux.  

As long as your entire torso is raised (not just your head and neck), sleeping at an incline gives gravity a power boost to return stomach acid to your stomach and keep it there. 

Speak with your doctor if you think you have GERD or any other sleep disorder so they can prescribe interventions appropriate for your case.  

Sides to Avoid Sleeping on for Acid Reflux 

What may be the best sleeping position for some could aggravate GERD symptoms and impair sleep in people with GERD.  

Here are two sleeping positions people with GERD should avoid. 

Back Sleeping: Avoid Whenever Possible 

Sleeping on the back increases how often acid reflux happens at night.  

When you sleep flat on your back and acid escapes from your stomach, it can flow freely into your esophagus and remain there.  

Studies show that symptoms are often more frequent in this position and tend to last longer because the acid cannot flow back to the stomach.  

Your symptoms may also be more severe if you have stomach fat—which pushes down on your stomach forcing contents to escape. Back sleeping should be the #1 position to avoid at night if you suffer from nighttime acid reflux. 

Right Side: It’s Not Right for Acid Reflux 

Position #2 to avoid at night is sleeping on your right side.  

When lying on your right side, your stomach is actually above your esophagus, creating a leaky faucet spouting stomach acid into the delicate lining of your esophagus. This is especially true when your stomach is full.  

Interestingly, when lying flat on your right side, your reflux symptoms tend to be more liquid, leading to regurgitation, coughing, and choking, which can be very devastating in the middle of the night. Since gravity is doing nothing for you in this position, the amount of time acid lingers in your esophagus is much longer.  

study showed that people who sleep on their right side get an earlier diagnosis of GERD when they have it than those who sleep on their left, which is telling on how severe nocturnal GERD symptoms are when a person sleeps on their right side.  

Best Sleep Position for Acid Reflux: Incline + Left-Side 

Sleeping on your back is generally not recommended for most people with GERD. You may also want to avoid sleeping on your right side. So what’s the best way to sleep to reduce nighttime acid reflux? 

What if you take the best sleeping position, the left side, and add an incline? Could the benefits be more than the sum of its parts? 

2015 study suggests that this is indeed the case.  

The compound inclined, the left-side sleeping position makes acid reflux at night virtually impossible because your esophagus is now positioned well above the level of stomach contents, even if your stomach is full.  

And, if you do reflux, gravity can quickly return the contents to your stomach. This sleep position may decrease your GERD symptoms and protect you from prolonged acid exposure to your esophagus, throat, lungs, and sinuses. 

So, what’s the secret to controlling your acid reflux symptoms at night and finally getting good, quality sleep? Proper sleep positioning. 

Find relief with the ideal position that maximizes the power of gravity and anatomy. Choose the  MedCline Reflux Relief System, specifically designed to create and maintain the inclined, left-side position, clinically proven to be effective for natural relief from nighttime acid reflux or GERD.

Consider talking to your doctor if you experience symptoms that may be disturbing your sleep, who can best recommend treatment appropriate for your case.  

Additional Tips to Control Acid Reflux at Night 

You can also make some lifestyle changes that may help you manage the occurrence of acid reflux at night and promote a well-rested night. 

Some of these lifestyle recommendations include: 

  1. Limiting alcohol intake, heavy meals, fatty meals, and nighttime snacks
  2. Eating in the early hours of evening time
  3. Managing bodyweight if you’re overweight or obese 
  4. Quitting smoking  
  5. Avoiding drugs that may limit the functioning of the esophagus like non-steroidal anti-inflammatory drugs (NSAIDs)

A doctor may also prescribe medications or recommend surgery to treat GERD when appropriate. Talk with your doctor about your symptoms so they can prescribe treatment or lifestyle recommendations to manage your condition and improve your sleep health.  

If you have GERD, you’re not sentenced to a lifetime of sleepless nights from acid reflux at night. By making simple tweaks to your sleeping position—choosing the Incline + Left-Side sleepingyou can take control of your symptoms and get the recovery sleep everyone deserves.  


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