As a health writer and PhD-trained scientist, I often hear about people struggling with heartburn that wakes them up, followed by coughing or choking. 

This is nighttime acid reflux, and it’s one of the most prevalent and troublesome complaints among many people. Out of all the people in the U.S. who suffer from heartburn, 70-75% experience it at night once a week. However, if you’re experiencing these symptoms more frequently, it could be gastroesophageal reflux disease (GERD) or laryngopharyngeal reflux (LPR).

Many fail to understand why it’s happening to them and are scared to take the pills due to the side effects. Don’t worry, you are not alone in this. 

If you know what triggers your reflux at night, your reflux type, and which safer alternatives are available, you can manage your symptoms. I wrote this guide to help lead you toward a calm, relaxing sleep.

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• Heartburn that wakes you up at night is more common due to slower digestion, reduced swallowing, lack of gravity, and the relaxed lower esophageal sphincter during sleep.
• Certain trigger foods or drinks and sleeping in a flat position can cause acid reflux and heartburn and even coughing or choking.
• Elevating your head position and some quick relief options, like alginate therapy, can alleviate your symptoms and provide you with relief.
• For long-term prevention of heartburn, you need to address the cause with lifestyle changes, not just reduce stomach acids with medications.
• Products like Reflux Gourmet’s alginates form a mechanical barrier to block reflux at night, while their Reflux Pillow supports optimum elevation for a more restful sleep.

Why Does Your Heartburn Get Worse at Night?

After you swallow food, the esophageal muscles contract and move the food from your throat to your stomach by primary peristalsis. The leftover food material (including stomach acid) is then cleared by the esophagus through secondary peristalsis. The remaining stomach acid is neutralized by the bicarbonate present in our saliva.

When we sleep, primary peristalsis doesn’t occur. Instead, we depend on secondary peristalsis to clear stomach acid and refluxed material. If you have  gastroesophageal reflux disease (GERD), the secondary peristalsis is dysfunctional. Studies also show that impaired esophageal activity and slow stomach acid clearance are associated with nighttime acid reflux.

When we lie down to sleep at night, gravity is reduced, and the clearance by the esophagus is further slowed down. Additionally, reduced saliva due to the absence of swallowing further inhibits the neutralization of your stomach acids. 

The lower esophageal sphincter (LES) in the stomach opens and shuts to control the flow of stomach contents in the right direction. LES can become weak or open too often due to hiatal hernia, pregnancy, obesity, smoking, birth defects, or past abdominal surgery, causing acid reflux.

All of these contribute to nighttime acid reflux, which exposes your esophageal lining to stomach acid for a longer time, causing mucosal damage.

Common Nighttime Reflux Triggers 

Even careful eaters and diligent sleepers can wake up with heartburn or reflux. Understanding the common triggers can help you pinpoint what’s causing discomfort at night:

‘I eat my usual food, but I’m still getting heartburn at midnight.’

Overeating, especially spicy and citrus foods (as well as chocolate, caffeine, and alcohol) are common triggers that everyone knows about. But eating dinner late can also lead to heartburn when you’re asleep. 

‘I get reflux as soon as I lie down.’

Impaired peristaltic movement, reduced saliva production, and your sleeping position can trigger acid reflux as soon as you sleep. When you lie flat, on your back or on your right side, gravity is lacking, which can trigger heartburn or reflux.

‘My reflux makes me choke and cough.’

You may have a form of reflux called LPR, or laryngopharyngeal reflux. While in GERD, reflux reaches your esophagus and causes heartburn; in LPR, reflux reaches your throat and voice box, causing coughing and choking.  

‘I am taking medications, so why am I still getting it?’

Common medications, such as H2 blockers and PPIs, reduce stomach acid, but don’t prevent the stomach contents from flowing back into the esophagus. These meds are not effective for LPR, nighttime acid reflux, or reflux caused by bile salts and pepsin.

How Can Reflux Gourmet Help? 

You can fight your heartburn with the help of multiple defenses in the form of sleeping position and targeting your symptoms. Reflux Gourmet gives you both.

Reflux Gourmet Pillow

Lack of gravity is one of the main reasons for nighttime acid reflux, so adjusting your sleep position is the first thing you can do when heartburn occurs.

Reflux Gourmet has designed their pillows with a seven-inch elevation. This height is clinically proven to give you optimum chest elevation for easing reflux while providing you with maximum comfort. Made entirely from organic cotton, it is breathable, sustainable, and pesticide-free.

Alginate Therapy

You can pop antacids when you have heartburn, but they don’t provide long-term relief and make you feel nauseated and bloated. H2 blockers can work, but they lose efficacy over time. 

PPIs are the most effective solution for chronic acid reflux, nighttime reflux, and GERD, but if you take them for a long time, you might get intestinal infections, vitamin and mineral deficiencies, gastric cancer, and bone fractures in rare cases. Moreover, they don’t work for non-acidic reflux or reflux caused by bile salts or pepsin.

Reflux Gourmet’s alginates are derived from seaweed, so it’s a natural and safer option for heartburn that forms a barrier and prevents stomach acids from reaching your esophagus. Alginates are most suitable for nighttime heartburn because they address the root cause (stop the acid from coming up), instead of just suppressing the acids like H2 blockers or PPIs.

Reflux Gourmet offers alginates that are sodium and potassium-free, so they are suitable for patients with high blood pressure and kidney issues. They are also clinically proven to be more effective than antacids and work effectively for LPR and non-acidic reflux. 

The best part is that it can be taken with or after your meals, so it gives you instant relief at night when heartburn occurs. Alginates from Reflux Gourmet come in the form of gels and gums with natural flavors, so you can choose what works for you.

How To Get Instant Relief From Heartburn?

Quick Relief Checklist:

• Sit upright: Let gravity help keep acid down.
• Sip water: Small amounts can dilute stomach acids.
• Stay upright: Avoid lying down for 30 to 45 minutes.
• Loosen up: Wear comfortable clothes to reduce abdominal pressure.

Symptom-Focused Relief Checklist:

• Antacids: Neutralize stomach acid for short-term relief.
• Alginate therapy: Forms a barrier to keep acid from rising while you sleep.

How to Prevent Heartburn?

Start by identifying what triggers your heartburn. 

The usual culprits are fatty, spicy, and citrus foods, chocolate, caffeine, and alcohol. Avoiding these for a while, or cutting down any excess can be a great place to start. By changing your eating habits, such as early dinners, small portion sizes, and avoiding late-night snacking, you can create a healthier lifestyle for your gut.

It’s also good to stay upright for a while after meals, and to keep your head raised while sleeping to let gravity prevent stomach acids from coming up. Also, make sure to include fiber-rich and alkaline foods in your diet to neutralize too much stomach acid.

Keeping your weight in check to reduce pressure on your abdomen will help ease your symptoms. It’s also a good idea to talk to your physician to find out your reflux type and explore suitable medication options, such as H2 blockers, PPIs, alginate therapy, or a combination of them.

Seek Medical Help for Heartburn When:

• Heartburn is frequent or persistent.
• Lifestyle changes and over-the-counter medications provide no relief.
• Symptoms are severe.
• You are losing weight or frequently feeling ill.
• You experience pain radiating to the arm or jaw (to rule out possible cardiac issues).
• You have difficulty breathing.

My Final Thoughts

Heartburn doesn’t always need to be something serious. If you’re having heartburn in response to some specific triggers at some specific times, and it gets worse at night, then it can be managed with a few lifestyle changes. But you have to be consistent.

Trying an elevated sleeping position with the Reflux Gourmet pillow can help you with your heartburn. Look for a natural, safer, and trusted alternative like alginate therapy from Reflux Gourmet. Alginates have no side effects and can be taken alone or combined with PPIs. 

Personally, I feel everyone is different, and so are their reflux symptoms and heartburn issues. Try what works for you, listen to your body’s signals, and check in with an expert when you’re not sure about things related to your health.