Imagine you’re all settled into bed for the night, snug as a bug in a rug, about to drift off to sleep, when all of a sudden you feel it: that burning sensation in your chest you’ve come to dread.

If you experience heartburn frequently, you might suffer from chronic acid reflux, or gastroesophageal reflux disease (GERD). GERD is a digestive disorder that affects the muscle between the esophagus and your stomach, otherwise known as the lower esophageal sphincter (LES). GERD can affect the quality of your sleep, but with a few tips, you may be able to alleviate the worst of the symptoms. First, let’s talk about what exactly those symptoms are so you can figure out how to treat them.

What are the symptoms of acid reflux?

Acid reflux occurs when acid travels from the stomach to the esophagus, inflaming it. While common, acid reflux is often misunderstood. Many cases even go undiagnosed, or are misdiagnosed as heartburn, which is in fact the main symptom of acid reflux and not the condition itself.

Heartburn is a burning sensation in your chest or throat that, in some cases, can even extend to the back.

Here are some other symptoms to look out for:

• Asthma and/or shortness of breath
• Difficulty swallowing and/or sore throat
• Dry cough
• Dyspepsia or indigestion (recurring pain or discomfort in the upper part of your abdomen)
• Nausea
• Regurgitation, burping, or vomiting
• Sour or bitter taste at the back of your throat (sometimes accompanied by bad breath)

You can read more about the symptoms of acid reflux here to better understand them if you’re recognizing yourself in a lot of them.

So, why is acid reflux worse at night?

Don’t be surprised if you experience more noticeable symptoms at night. It’s common to have symptoms of acid reflux, such as heartburn, at night because the amount of acid in your stomach is highest during this time. The culprit? Gravity—which is why the position you sleep in can have a major effect on whether you spend the night contending with acid reflux.

What’s the best sleeping position for GERD?

If you usually experience acid reflux when you’re trying to sleep, you might wonder: Does lying down make my heartburn worse? The short answer is: Yes. Reclining can often worsen your symptoms because gravity is working against you by allowing stomach acid to travel to the esophagus.

That’s why certain sleep positions are better than others. If you’re sleeping on your back and acid is released from your stomach, it can more easily flow into and harm your esophagus.

You should also avoid right-side sleeping, because in this position, your esophagus is below your stomach and more susceptible to catching loose acid that’s dripping downward.

With that in mind, left-side sleeping is the best option to fall asleep and stay asleep. And that’s because your esophagus is above your stomach so gravity can help keep acid from spilling upwards into the esophagus.

If left-side sleeping does not bring relief from heartburn symptoms then you should try elevating the head of your bed by six to eight inches (about 30 degrees) with either a foam wedge pillow or some wood blocks. This angle of elevation will support natural gravity and hinder the stomach contents from refluxing up into the esophagus.

What gets rid of heartburn at night?

As anyone who’s spent years sleeping in the same position can attest, it can be tricky to train your body to fall asleep in a new one. Fortunately, there are many other lifestyle choices, both big and small, you can make if left-side sleeping doesn’t come easily to you

• Eat smaller meals throughout the day and make sure you chew your food thoroughly.
• Do your best to maintain a healthy body weight for your body.
• You already know this, but quit smoking in general. It can harm the LES and make it more susceptible to damage.
• While you want to cut down on fatty, fried, spicy, or salty foods, you also might want to avoid less well-known triggers from your dinner, like: seafood, cheese, alcohol, coffee, chocolate, peppermint, and ice cream. (Confused by what you’ll eat if you cut all of this out? Try removing one trigger at a time to better understand what your body is OK with and what it isn’t.)
• Do your best to eat at least 2-3 hours before you go to bed so your body has time to digest.
• Avoid tight-fitting pajamas, which can put pressure on your abdomen and LES.

If these tips don’t help, it might be worth talking to a doctor to see whether you should try one or more of the following medical treatments:

• Over-the-counter antacids: Chewable tablets can neutralize your stomach acid and can stop symptoms within 20 minutes.
• H2 blockers: H2 blockers not only decrease the amount of acid released by your stomach, but also help protect your esophageal lining. They can be taken to combat symptoms as they happen, and/or preventatively. Like the antacids, H2 blockers are available over-the-counter in lower doses, but if you find yourself taking them more than twice a week, you should talk to your healthcare provider about possibly getting a prescription.
• Proton pump inhibitors (PPIs): PPIs protect and heal your esophageal lining. They go a step further, however, by actually preventing your body from producing acid in the first place. Some PPIs are also available over-the-counter, though others can only be obtained through a doctor’s prescription.

For people who suffer from acid reflux, a good night’s sleep might not come easy, but relief is possible with the right strategies (and knowledge). The more informed you are, the more easily you can effectively prevent and treat GERD.

The information provided in this article is not a substitute for professional medical advice, diagnosis, or treatment. You should not rely upon the content provided in this article for specific medical advice. If you have any questions or concerns, please talk to your doctor.

Esomeprazole, omeprazole, pantoprazole, and rabeprazole are oral medications used to treat gastroesophageal reflux disease (GERD; acid reflux). Tell your doctor if you are allergic to any drugs like this one, any other drugs, foods, or other substances. Tell your doctor about the allergy and what signs you had, like rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs. Tell your doctor if you are taking any of these drugs: atazanavir, clopidogrel, nelfinavir, rifampin, rilpivirine, or St. John's wort. Do not start, stop, or change the dose of any drug without checking with your doctor. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away: headache, falling asleep, abdominal pain, diarrhea, constipation, gas, dry mouth, upset stomach. Full prescribing information for esomeprazole is available here. Full prescribing information for omeprazole is available here. Full prescribing information for pantoprazole is available here. Full prescribing information for rabeprazole is available here. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit MedWatch or call 1-800-FDA-1088.

Photo by Ray Kang via Death to Stock