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Acid reflux and sleep disorders: Both can be hidden

19 Nov
Posted by: sleepapnea.org
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What is acid reflux?

Acid reflux, more commonly referred to as heartburn, occurs when stomach contents repeatedly flow backward into the esophagus. This can happen at any time of day.

A muscle known as the lower esophageal sphincter (LES) attaches at the lower end of the esophagus where it drains into the stomach.

The chief role of the LES is to provide a one-way valve between the throat and the stomach; it opens up as you swallow food to allow it to enter the stomach for digestion.

In healthy individuals, this valve remains shut except for the purposes of driving digestion during mealtime.

However, when the LES doesn’t close properly or tightly enough, a reflux (or regurgitation) of digestive juices and stomach contents can rise back into the esophagus. This leads to the usual acidic sensation and taste that characterizes heartburn.

When does acid reflux become GERD?

Those with an ongoing condition (symptoms occur at least twice weekly) are typically diagnosed with Gastroesophageal Reflux Disease (GERD).

GERD is considered a chronic form of acid reflux. It may require a more proactive treatment strategy than those who experience heartburn less frequently.

GERD can have a dramatic impact on sleep, leading to risks of:

  • aspirating (breathing in) stomach acid while asleep
  • aggravating or contributing to obstructive sleep apnea (OSA), and
  • experiencing sleep fragmentation caused by the discomfort of heartburn symptoms

These chronic symptoms may signal something more serious than occasional distress caused by overeating.

Signs of acid reflux

Acid reflux is one of those medical concerns that may not be apparent for some. For them, acid reflux may not result in the usual burning sensations it causes in the stomach, chest, or throat, or the sour or acidic taste in the mouth after a meal. For them, the only indication they have acid reflux may be a problem with swallowing, a dry nagging cough, the development of asthma, or the repeated loss of one’s voice (laryngitis).

Like many sleep disorders, acid reflux may be a hidden problem. What makes it even more complicated is its overall prevalence. People of the 1 last update 2020/07/13 all ages, from infancy to the golden years, may experience and suffer from acid reflux, and many don’t know it.Like many sleep disorders, acid reflux may be a hidden problem. What makes it even more complicated is its overall prevalence. People of all ages, from infancy to the golden years, may experience and suffer from acid reflux, and many don’t know it.

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During sleep, a case of reflux may actually allow stomach contents to rise as far as the back of the mouth. This is due to the (usually) horizontal position of sleeping.

While upright and awake during the day, gravity can help limit the impact of reflux to the stomach and mid-chest. However, in a reclining position, gravity can no longer “push down” stomach acid. If the LES is faulty, it may easily fail at its task.

For those who experience reflux during sleep, this means rude awakenings with a sour, burning sensation in the back of the throat. Falling back asleep may require reintroducing gravity at night, either by:

  • sitting partially upright in a reclining chair
  • using a wedge pillow to elevate the upper body, or
  • raising the head of the bed by 3 inches (usually by adding risers to the legs beneath the headboard).

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  • use of over-the-counter acid neutralizing medications
  • sleeping on the left side, as a right-, back-, or stomach sleeping position typically encourages more reflux

GERD and sleep apnea

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When OSA occurs, changes in pressures within the diaphragm and the chest cavity make conditions favorable for acid reflux. It is also thought that an episode of apnea could alter digestive processes in a way that disrupts the function of the LES.  Apneas also cause more “respiratory effort” during sleep. This might force a change in pressure in the esophagus that leads to an increased chance for reflux.

It’s beneficial to know that treatment of OSA by positive airway pressure (PAP) therapy has been consistently shown to result in an improvement to the symptoms of GERD.

To learn more about the relationship between reflux and all sleep disorders, check out this article published by the National Institutes of Health (NIH). 

Don’t ignore acid reflux

It makes sense to consult a doctor if you struggle with long-term and ongoing problems with heartburn. This means you experience it more than once a week, or have a condition that worsens and is continuous over time.

It’s also important to be honest about any problems you have with sleep (diagnosed or not) or about any of the silent symptoms listed above. Reflux, for instance, could be the reason you have problems with insomnia.

An accurate diagnosis may identify an undetected sleep breathing disorder as well. This knowledge can help you proactively seek appropriate treatment so you can sleep comfortably again.

Author: sleepapnea.org

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  • […] post Acid reflux and sleep disorders: Both can be hidden appeared first on […]

    • Sophie

      Since I started this program https://sites.google.com/view/hearthburngone/home, my acid reflux symptoms seem to finally be on the run. I have no chest pain or burning sensation after a meal (even a heavy one) and I have tossed away all those expensive pills that have never dealt with the underlying cause anyway. This book is very digestible and the program is quite practical if you take it one step at a time. Moreover, I am no longer constipated as I was prior to starting the Heartburn No More. I highly recommend it to all sufferers out there!

  • […] two of the possible symptoms of nocturnal GERD. For some helpful info on what to look for, this article on sleep apnea and GERD at sleepapnea.com can help you determine if your (or a family member’s) unexplained issues might […]

    • Mack Donald

      Waking up gasping for air. I have noticed i have alot of gas and feel acid in my throat- and have to use the bathroom. My stomach makes noises (gas?). No typical gas pains. Sometimes my nose is abit congested. I wake up freeked out and worried.  After i wake up this way it takes awhile for me to regain my normal breathing pattern. That is, i gasp for a deep breath for at least an hour or two. I am terrified to go back to sleep. I cannot continue this way. My job is physically demanding- and i am very active on a daily basis. I am about 20 lbs over weight. BP average is high normal- about 130/75. This happens on and off a few times a month. I usually do not have any shortness of breath durring the day- unless i have had a bad episode the night before then maybe abit.  I do sleep with a mandibular advancement device which has helped me greatly- but i am still sufferring.  I am writting this at 230 am after having an episode at 1 am. I have a big day at work tomorrow and have no idea how i am going to make it. I have my theories but I am not 100% sure. Have been to dr before and they think I am fine. I dont feel fine. I need sleep!!! I cannot function this way!!! Please any words of advice? I feel like i’m dying. Earlier in the day i got so much work done- cut grass, made a coffee table even grilled some ribs. Maybe the piggie had something to do with it. I am sure there are others dealing with this. In no way do I think I am unique. What have you done to get better? Anything, please!

      • MD

        Well, I am sorry to hear what you are going through. Please know my prayers and thoughts are with you tonight. Have faith! You shall be the 1 last update 2020/07/13 healed by his stripes. I ask for supernatural healing & restoration over your body & mind. May you sleep peacefully and rest well without any interruptions and fear. MDWell, I am sorry to hear what you are going through. Please know my prayers and thoughts are with you tonight. Have faith! You shall be healed by his stripes. I ask for supernatural healing & restoration over your body & mind. May you sleep peacefully and rest well without any interruptions and fear. MD

      • Arya

        @mack that happened to me I have inhaler for that

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  • Bruce Nicol

    Occasionally my wife starts choking at night (around 2:30am) on what appears to be phlegm. She does not wake up and cannot be woken. She is a dead weight and appears almost unconcious. I have to raise her to a sitting position (with great difficulty) and it then takes about 5 to 10 minutes for the choking to stop and she then carries on sleeping. Other than muscle pain the following morning she has no memory whatsoever of the choking episode. Very scary and I would appreciate any advice as the local doctors are confused and cannot seem to offer any advice.

  • Kristeen

    Sometimes I awake in middle of night thinking I’ve been sick. Awful taste in mouth and severe burning in back of throat. Quite scarey. Not sure what it is or how I can stop it happening. Lately been happening once twice a week started about month ago. Thank you very much.

  • Esther Villarreal

    The burping is constant, no regurgitation, no heartburn, just the burping and gas in stomach, how do I treat it?

  • Lid

    Does anyone know where I can find research about the affects of GERD on sleep apnea?

  • Steve

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    This sucks and is weird.

    • Rebecca Brotherston

      My son died from this. He went to sleep after eating a large meal and aspirated sometime in the middle of the night.

  • Sophie

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  • Tori Raddison

    I didn’t know that heartburn was when stomach contents go back into the esophagus but now I can see why it’s so painful. What causes the valve to not close properly? I think my mom may have GERD because it happens to her quite a lot. http://midstategastroct.com/barrx-procedure-for-barretts-esophagus-treatment-in-connecticut-midstategastroct/

  • Carol

    I have been experiencing waking up probably every 2 hours with a choking sensation, it lasts a second, but is very scary, if I go back to sleep it will happen again seems like every 2 hours or so, this has been going on for a month now, no symptoms when awake. Please help I can’t stand this, does anyone else know what this could be, I am awaiting an appt with a sleep specialist, but the appt is so far away.

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