Prevention of acid reflux during sleep
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An acid reflux patient suffers from sleep difficulties due to an increase in symptoms during sleep, resulting in difficulties in performing daily activities.

Which may ultimately lead to a deterioration in the patient’s psychological condition, which is often affected by lack of sleep. What is acid reflux and methods of treatment and prevention?

What is acid reflux?

Gastroesophageal reflux can be defined as the return of acids secreted from the stomach during digestion into the esophagus. (1).

This pathology stems from many reasons, perhaps the most important of which is weakness in the lower esophageal muscle (the esophageal valve), which is responsible for preventing the return of acid from the stomach to the esophagus.

A large percentage of people suffer from acid reflux, where it is estimated that the rate of acid reflux may be as high as 33% in some communities. However, patients may not complain of any symptoms.

While others complain of symptoms such as burning in the chest area and the return of poorly digested food residues to the mouth. In addition to vomiting, nausea and hoarseness at other times (2).

All this may prompt the patient to visit a specialist doctor, who may conduct several tests and analyzes to arrive at a diagnosis and develop the necessary treatment plan. In addition to guiding the patient to life and natural ways that will reduce the symptoms of the disease and prevent complications.

What makes acid reflux symptoms worse at night?

The symptoms of reflux are characterized by the fact that most patients worsen during sleep, and several explanations can be offered for this, including:

• When lying down, the role of gravity in preventing stomach acids from returning to the esophagus decreases, so these acids can easily return when lying down, and this is how symptoms appear.
• During sleep, the swallowing movements that a person usually makes during the day decrease, and this has a role in reducing the force that pushes the acids down.
• A decrease in saliva during sleep, as saliva naturally reduces the acidity of gastric secretions. Therefore, this decrease in the amount of saliva secreted will increase the acidity of the stomach.

These factors usually combine in acid reflux patients, which increases the symptoms of the disease. The patient’s condition is much worse if he goes to sleep shortly after eating a heavy meal. He might not even be able to sleep (3).

Positions that may reduce reflux during sleep

Changing sleeping positions can play an important role in reducing the frequency of reflux symptoms during the night (4). Because it is not necessary for the person to sleep sitting upright in order to relieve the symptoms. Studies indicate that some positions reduce and others increase acid reflux into the esophagus, and these positions include:

1- Sleeping on the left side

In this position, the effect of gravity on preventing reflux is stronger, and the stomach remains lower than the esophagus, which reduces reflux.

So if some of the stomach acid leaks up, gravity will pull it down faster than if the patient is lying on their right side or back.

Recent studies indicate that the symptoms experienced by the patient are less on this side, which makes sleeping in this way desirable.

2- Sleep at an angle

Sleeping at an angle by elevating your head 6 to 8 inches can reduce reflux, by using more than one pillow under your head or upper back.

This has a role in reducing the number of times acids leak into the esophagus, and in increasing the force of gravity’s effect on these acids. Especially when the entire upper body is lifted diagonally, not just the neck or head.

3- Sleeping diagonally and on the left side together

This position is definitely the best in preventing reflux, since the esophagus is much higher than the stomach.

The effect of gravity is also strong, so it is able to return all the acids that may leak into the esophagus.

Sleeping positions that increase symptoms

1- Sleeping on the back

Acids while sleeping on the back leak freely into the esophagus, and the symptoms increase, and worsen in people suffering from obesity, due to the pressure of the fat on the abdomen while lying on the back.

Therefore, all patients should avoid this condition in patients with acid reflux.

2- Sleeping on the right side

The stomach is in this position almost above the esophagus, and the role of gravity in preventing acids from returning to the esophagus is reduced. All this leads to advise patients with acid reflux to avoid this position while sleeping.

Tips to reduce the situation

There are now several recommendations for some foods and drinks that the patient can eat before going to bed to relieve the symptoms of acid reflux. (5). Among these foods:

• The banana: Bananas are very useful because they contain large amounts of fiber, which increase the activity of the digestive system, and help it get rid of food residues. Banana also increases the secretion of a substance that changes the strength of stomach acid.
• cold milk: Milk contains large amounts of calcium, which maintains the acidity level in the stomach well, by reducing the acids by absorbing excess.
• Fennel seeds: These seeds contain a substance useful in calming the stomach and reducing abdominal cramps and swelling. In addition to a group of vitamins and elements that improve the digestive process.
• drink juices: There is evidence that suggests the role of drinking seedless juices in improving digestion.
• Eat meals containing ginger.

Tips for improving sleep reflux symptoms

There are a collection of tips that can help relieve the symptoms of acid reflux during sleep, in addition to improving nutrition, such as:

• Go to bed at regular times.
• Avoid drinking caffeinated items about eight hours before bed.
• Avoid drinking alcohol before bed.
• Avoid eating large meals before bed to prevent nocturnal reflux.
• Do not lie down after eating for at least three hours.
• Eat a large meal for lunch, and a small meal for dinner.
• Wear loose and comfortable clothes while sleeping to avoid pressure on the stomach.

By following these tips, the patient will be able to reduce the reflux symptoms, which are greatly increased during sleep at night (6).

Please note that a doctor should always be consulted when the symptoms worsen and the patient is unable to tolerate them.