The Relationship Between Gastroesophageal Reflux Disease (GERD) and Insomnia

Gastroesophageal reflux disease (GERD) affects about 20 percent of the population. People with GERD regularly experience heartburn. Heartburn is a burning sensation in the chest area. It is caused by acid reflux.^1,2

Acid reflux is when the acid from the stomach starts to come up the esophagus. The esophagus is the tube that connects the stomach to the throat. Over time, heartburn can cause serious damage to the esophagus.^1,2

Some research studies show that there might be a link between GERD and sleep. Many people experience GERD-related symptoms at night. These symptoms can have a negative effect on sleep. And not sleeping well can make the symptoms of GERD worse. So, it makes a cycle that can be hard to break.^2,3

How does GERD affect sleep?

People with GERD regularly experience heartburn caused by acid reflux. Having heartburn at night can make it harder to sleep. As a result, people with GERD are more likely to have sleep problems, including:^3,4

1. Insomnia
2. Having trouble falling asleep
3. Waking up in the middle of the night

You may also experience worse GERD symptoms at night because of the way your body is positioned when you are trying to sleep. When you are lying down, it is easier for acid from the stomach to come into the esophagus. Also, during sleep we do not swallow as much. And your body produces less spit (saliva) when you are sleeping.^3,4

All of these factors make it easier for the stomach acid to stay in the esophagus. This causes damage to the esophagus.^3,4

So, having GERD may make it difficult to fall asleep. And laying down to fall asleep and other changes during sleep can make the symptoms of GERD worse. This can create a loop which can be difficult to get out of.³

Can sleep problems affect GERD?

Research suggests that not getting enough sleep can also make the symptoms of GERD worse. We do not exactly know how lack of sleep affects GERD. But there are a few different possibilities.^2,3

One possibility is that having difficulty sleeping and GERD share common risk factors. A risk factor is something about you that makes it more likely you will have a problem such as a health condition. For example, stress can cause sleep problems. Stress is also linked to GERD. So, for some people who have both sleep problems and GERD, the conditions may both be caused because of high stress in their life.^3,5,6

Another possibility is that lack of sleep can make you feel hungry late at night. Eating right before bed can make GERD worse.³

Also, people with GERD may experience worse symptoms because lack of sleep can make you more sensitive to pain.³

What can I do about GERD?

One thing that can help reduce GERD's effect on your sleep is adjusting your sleeping position. Research shows that people with GERD who sleep on their left side get better sleep compared to those who sleep on their right side. Raising your head so that it rests higher than the rest of your body during sleep can also help with acid reflux.²

If GERD is causing sleep problems for you, then treating GERD could also improve your sleep. Talk to your doctor about what you are experiencing. They may be able to help guide you toward the best treatment for you.^2,3

Here are a few things that can help reduce the symptoms of GERD:^2,3

• Changes in lifestyle like diet and physical activity can help reduce the symptoms of GERD.
• Medicines such as antacids or proton pump inhibitors can help manage acid reflux.
• Adjust your sleeping position. Sleep on your left side and use a pillow to raise your head.
• Avoid alcohol, bubbly (carbonated) drinks, and any other foods you have noticed make your GERD symptoms worse.
• Benzodiazepines are a group of drugs that are sometimes used to treat insomnia. But they can make the symptoms of GERD worse. So you may want to talk to your doctor if they have you taking a benzodiazepine to help with your insomnia.
• Do not eat right before you sleep. Try to eat at least 4 hours before you lie down to sleep.

To summarize, GERD can have a negative effect on sleep and not getting enough sleep can make GERD worse. Knowing how sleep and GERD affect each other can help you and your doctor come up with a better treatment plan.^2,3