This question haunts every GERD sufferer, especially those who are battling insomnia caused by acid reflux. One of life’s great certainties, many of us take SLEEP for granted. While those who are blessed with the ability to fall off to sleep any time anywhere don’t give it a second thought, sleep can seem like an elusive mistress for many others….especially those who suffer from night-time acid reflux.
Insomnia is a broad term used to describe a variety of sleeping problems. In essence, a person has insomnia if he/she is either unable to fall asleep or remain asleep for sufficient periods of time to awake refreshed. Acid Reflux adversely affects sleep quality by awakening the patient from sleep during the night. While insomnia and acid reflux are two different medical problems, they often co-exist together to throw in a double whammy.
Studies have found a significant association between disturbed sleep and GERD, and this may be bidirectional. Sleep disturbances induce gastrointestinal (GI) distress, while at the same time GI symptoms only worsen sleep patterns. According to research done by Mayo Clinic College of Medicine “Nighttime reflux can lead to sleep disturbance and sleep disturbance may further aggravate GERD by prolonged acid contact time and heightened sensory perception. This may facilitate the occurrence of complicated GERD and decreased quality of life. The interplay between sleep problems and GERD is complex.”
Many patients with GERD experience sleep fragmentation. What’s worse, sleep deprivation can adversely affect GERD severity by enhancing the perception of acid in the esophagus causing esophageal hypersensitivity, and potentially by increasing esophageal acid exposure time. In a nutshell – Heartburn makes it difficult to sleep, inadvertently causing insomnia. You can remedy this by addressing the heartburn, not the insomnia.
Sometimes when patients complain about their relentless insomnia, physicians don’t always consider GERD as a contributing factor. As a result, many treatments focus on prescribing sleeping pills to help regulate sleep cycle, which only worsens GERD. In a study conducted at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, researchers found that GERD patients taking popular sleep aid zolpidem (also popularly known as Ambien) suffered from increased duration of each esophageal acid reflux event. Since nocturnal acid exposure was prolonged, scientists believe that hypnotic use by patients with GERD could lead to increased risk for complicated disease.
So if you often reach for sleeping pills to help you sleep because you’re worried that staying awake will worsen GERD, it’s time to take lifestyle changes and diet modifications more seriously.
If your insomnia is caused by acid reflux, you may suffer from daytime tiredness or sleepiness. You could also have difficulty paying attention, focusing on tasks or remembering things. All this can add extra stress to your life, resulting in irritability, depression or anxiety.
As we have discussed above, the best way to minimize acid reflux causing insomnia is to address the reflux, and the insomnia will resolve on its own. By learning ways to avoid night time heartburn, you can improve your sleep too.
With a few lifestyle adjustments, you can save yourself a lot of the discomfort that comes from the dual problems of acid reflux and insomnia. For more details, read our article on tips to avoid night-time heartburn.
Stress is at the heart of both night time acid reflux and insomnia. Stress and GERD are deeply linked, as are stress and sleep disturbances.
When stressed, you become extra-sensitive to smaller amounts of acid in the esophagus – the bane of life as a GERD sufferer. In fact, a study found that reflux patients under stress reported more painful symptoms related to acid reflux, but none of the patients showed an increase in gastric acid. So it’s not that you’re producing more gastric acids when you’re stressed….you’re only more sensitive to acid exposure in periods of stress. To top that, stress coupled with exhaustion will also make it harder for you to fall asleep. Stress causes hyperarousal, which disrupts the balance between sleep and wakefulness.
Leave all worries of your job where they belong – in the office. A stress-free bed time routine will help keep acid reflux at bay and ensure that you go to bed in a calm, peaceful state of mind. This is why it is also important to avoid any confrontations and arguments with your partner or other family members at night; somethings are best done in the morning. If you are unable to shake off stress even after a relaxing bath and bedtime tea, we recommend deep breathing exercise to help you relax. We’ll go a step further and also recommend that you don’t watch movies and TV shows with violence, gore and horror before bedtime to keep your stress levels down.
Since sleeping pills will only worsen your GERD symptoms in the long run, what can you take to help sleep peacefully? Some dietary supplements can provide relief from acid reflux and improve sleep quality at the same time. These don’t come with undesirable side-effects and help symptoms of heartburn naturally.
Magnesium deficiency has been associated with acid reflux. Magnesium aids in the functioning of LES (lower esophageal sphincter) that works as a lid between the esophagus and the stomach to keep stomach contents from coming back up the esophagus. Magnesium is also vital for the function of GABA receptors, which are calming neurotransmitters that the brain requires to switch off and go to sleep. In simpler words – magnesium supplements improve sleep quality and can also help with acid reflux. Try 200 to 400 mg of magnesium citrate or glycinate twice a day, but be aware that excessive magnesium supplementation may result in diarrhea, nausea, and stomach cramping for some people.
Melatonin has long been used as a sleep aid, but is also effective in inhibiting gastric acid secretion and seems to control the lower esophageal sphincter. Melatonin is naturally produced by pineal gland to regulate the wake/sleep cycle and other daily biorhythms. Low levels of melatonin can lead to insomnia as well as worsen GERD. Start with 500 mcg to 5 mg at night.