What Causes Heartburn at Night?
During the day, when you’re more likely to be sitting or standing, your stomach acid tends to stay in your stomach where it belongs. It’s more difficult for the acid to travel upward into your esophagus (the tube that links your mouth to your stomach)3.
When you lie down at night just after eating, on the other hand, your stomach acid doesn’t have to fight gravity to travel back into your esophagus or throat. This phenomenon, called acid reflux, can leave you with burning heartburn pains or a feeling like you’ve regurgitated food3. Lying down too soon after eating dinner or late night snacks can trigger or worsen heartburn5.
Why Heartburn May Be Worse at Night?
Heartburn may be worse at night because certain heartburn-causing factors occur more often in the evening. For example, alcohol can trigger heartburn, and people more often drink in the evenings than other times of day5. Studies have found that heartburn can also be triggered by certain foods, including fatty, greasy, salty, or acidic foods5,6. You may also realize that other items such as chocolate, spicy food, or carbonated beverages worsen your heartburn symptoms5,6. Consuming these foods in the evening may be a cause of heartburn at night.
Tight-fitting clothing may also worsen heartburn by putting extra pressure on the abdomen, which can force stomach acid into your esophagus4. You may want to change your sleepwear if you tend to wear pajamas or undergarments that are form-fitting, snug, or contain a tight elastic waistband.
Certain medications, including sedatives, can also cause nighttime heartburn4. If you are taking sleep medications that are triggering heartburn or making your heartburn worse, talk to your doctor.
How to Treat Nighttime Heartburn Symptoms
If you tend to get heartburn at night, there’s a good chance you’re experiencing evening discomfort and may have trouble getting to sleep and staying asleep because of that discomfort7. Fortunately, there are several ways you can help prevent or stop acid reflux at night.
Eat a Smaller, Earlier Dinner
Having food in your stomach when you lie down for bed increases your chances of experiencing heartburn symptoms at night.
Eating several smaller meals rather than a couple of large meals can help control heartburn throughout the day and night. In particular, decreasing the size of your dinner may lead to less heartburn in the evening and nighttime hours5.
You can also help prevent heartburn at night by having dinner at least three to four hours before you plan to go bed. This gives your stomach time to completely empty before you lie down to sleep4.
Elevate Your Head When You Lie Down
You can keep gravity working in your favor while you sleep. Propping up your head and neck when you lie down helps keep more of your stomach acid from traveling up your esophagus, helping to you to get rid of or reduce acid reflux at night6.
Use extra pillows under your upper body to lift your head so that it lies 6 to 8 inches higher than your abdomen. Alternatively, get a wedge pillow that naturally props up your head. You can also try to elevate your bed with bricks so that your head is slightly higher than your feet6.
Improve Your Sleep Hygiene
If you suffer from occasional sleeplessness in addition to nighttime heartburn, try correcting any problems with your sleep hygiene — the set of behaviors and habits that helps you get higher-quality sleep. Try staying away from screens in the evenings, blocking light from your bedroom, keeping your sleeping environment cool and quiet, and going to sleep and waking up at the same times each day5,8.
If you have occasional heartburn symptoms, you can also try over-the-counter (OTC) medications such as PEPCID®. PEPCID® is a histamine-2 (H2) blocker, with the active ingredient famotidine, which can help relieve heartburn by reducing the amount of acid in the stomach. It works fast and will help to control acid all night*. If you do not have OTC heartburn medications readily available, learn more about easy ways to manage with at-home heartburn remedies.
When Should I See a Doctor?
Occasional heartburn is common and can often be self-treated with OTC medications and lifestyle changes. However, frequent heartburn at night may be a sign of a more serious disease, so talk to your doctor if your symptoms persist.
If your nighttime heartburn symptoms worsen, or occur two or more times a week, it may be a sign of gastroesophageal reflux disease (GERD). While GERD is not life threatening, you should talk to a doctor if your symptoms persist for more than a couple of weeks. Some individuals are able to manage the discomfort of GERD on their own, but in some cases stronger medications or surgery may be needed to ease symptoms.
*Based on 12-hour acid control studies during the night. Acid control does not imply symptom relief.
- 1Definition and Facts for GER & GERD. National Institute of Diabetes and Digestive and Kidney Diseases. Reviewed July 2020. Accessed October 17, 2022.
- 2Orr WC. Management of nighttime gastroesophageal reflux disease. Gastroenterol Hepatol (N Y). 2007;3(8):605-606.
- 3Why Does Your Heartburn Always Seem Worse at Night? Cleveland Clinic. Published September 9, 2020. Accessed October 17, 2020.
- 4Heartburn. MedlinePlus. Reviewed January 14, 2021. Accessed October 17, 2022.
- 5Sethi S, Richter JE. Diet and gastroesophageal reflux disease: role in pathogenesis and management. Curr Opin Gastroenterol. 2017;33(2):107-111.
- 6Dağlı Ü, Kalkan İH. The role of lifestyle changes in gastroesophageal reflux diseases treatment. Turk J Gastroenterol. 2017;28(Suppl 1):S33-S37.
- 7Fass R. (2009). Functional heartburn: what it is and how to treat it. Gastrointestinal endoscopy clinics of North America, 19(1), 23–v.
- 8Tips for Better Sleep. Centers for Disease Control and Prevention. Reviewed September 13, 2022. Accessed October 17, 2020.