What Is Causing You To Wake Up With Heartburn?

Waking up feeling well-rested and ready to take on the day is one of life's simple pleasures. But for people who struggle with acid reflux, that little victory can be hard to come by.

More than 50 million adults in the U.S. are affected by gastroesophageal reflux disease (GERD), a condition characterized by the backflow — or reflux — of stomach acid into the esophagus, which is the tube that moves food from the throat to the stomach.

When everything's working properly, a ring of muscle called the lower esophageal sphincter (LES) acts as a barrier to prevent backflow from the stomach to the esophagus. But for people with GERD, this muscle is often weakened or relaxed, allowing irritating acid to pass into the esophagus.

GERD can be the catalyst for a number of uncomfortable symptoms — one of the most common being heartburn. While most people with GERD experience more heartburn at night, many people may notice that they wake up with heartburn, too. Talk about a rude awakening! So, what causes heartburn in the morning? Let's take a closer look.

Heartburn can happen at any time, but thanks to our good friend gravity, it happens most commonly around bedtime. That's because when we lay down, it becomes easier for the stomach acid to push past the lazy LES muscle and settle in the esophagus. It's not terribly surprising then that a 2010 study published in Neurogastroenterology and Motility found that 48.7% of participants with GERD were also experiencing acid reflux within the first 20 minutes after waking up — a phenomenon aptly named "riser's reflux".

Nature — always the expert planner — seemed to have a solution for acid reflux, though. A 1982 study published in Gastroenterology discovered that our saliva acts as a base against stomach acid. This means that when stomach acid makes its way into the esophagus, swallowing our own saliva can have a neutralizing effect.

However, the Sleep Foundation points out that as we progress into deeper stages of sleep, our saliva production decreases. Coupling that with the fact that we naturally swallow less during sleep, stomach acid that would typically be pushed down by swallowing and neutralized by saliva remains in the esophagus instead. And thus "riser's reflux" was born.

Waking up with heartburn is no way to start the day. To get your GERD under wraps so that you can wake up on the right side of the bed, Sepalika says you should start by paying attention to when you eat dinner and how much you're consuming. Reducing your portion size and eating at least three hours before bed ensures that you will have digested everything before bed, taking the pressure off your LES.

Head elevation can also be an excellent weapon against morning heartburn. By propping your head up with a wedge pillow during sleep, you can recruit the help of gravity to keep stomach acid from moving up your esophagus.

See your doctor if your GERD symptoms are frequent, severe, or cause you to take over-the-counter medications more than twice per week. Chronic acid reflux doesn't only affect your quality of life — it can also be damaging to your health.

If left untreated, GERD can lead to dangerous complications like esophageal ulcers, damaged esophageal tissues, and a condition called Barrett esophagus, which is a primary risk factor for esophageal cancer. Obesity, smoking, drinking alcohol, poor diet, and certain medications can increase the occurrence of GERD.