person sleeping on their side on a Putnams bed wedge to combat acid reflux

Acid Reflux at Night: Why Lying Flat Makes It Worse

Feb 27, 2026

For many people, the shift from a productive day to a peaceful night is disrupted by an all-too-familiar burning sensation. If you find that night time heartburn flares up the moment your head touches the pillow, you're far from alone. Research shows that gastroesophageal reflux disease (GERD) affects roughly 20% of adults, yet the night presents a particular challenge: up to 79% of GERD sufferers report experiencing symptoms during sleep.

But why does acid reflux intensify after dark? The answer lies in a combination of physics, anatomy, and the body's internal rhythms.

Why Reflux Increases When You Lie Down

During the day, gravity acts as your digestive system's natural ally, anchoring gastric acid down in your stomach where it belongs. When you lie flat to sleep, however, you lose this gravitational advantage, and reflux becomes far more likely.

The Loss of Gravity

In a horizontal position, your stomach and oesophagus sit at the same level. Without gravity to keep stomach contents in place, acid can flow freely backwards into the oesophagus.

This is why heartburn lying down feels significantly more intense than it does during waking hours.

A study published in the Journal of Neurogastroenterology and Motility found that while reflux events are less frequent during sleep than during the day, they last considerably longer because the body's natural clearing mechanisms are suppressed.

Reduced Protective Mechanisms

At night, your body's defences against acid reflux weaken in two key ways:

Decreased salivation: Saliva is a natural acid buffer. During deep sleep, saliva production drops significantly, meaning any acid that escapes the stomach lingers in the oesophagus for longer.

Lower swallowing frequency: Swallowing helps push acid back down into the stomach. This reflex is substantially reduced during sleep, leading to prolonged "acid contact time" and greater tissue irritation.

Delayed Gastric Emptying and Meal Timing

During sleep, your digestive system slows down. Food stays in the stomach longer, increasing gastric pressure. If you've eaten a large meal close to bedtime, this pressure pushes against the lower oesophageal sphincter (LOS), the muscular valve between your oesophagus and stomach, making it far more likely for acid to escape upward.

Research from Michigan Medicine (2025) identified a "vicious cycle" between reflux and sleep: sleep deprivation can make the oesophagus more sensitive to acid, meaning the less you sleep, the more painful your reflux becomes the following night.

The Science Behind Elevation and Gravity

To combat acid reflux at night, we need to harness the "angle of attack." Clinical positioning is the single most effective non-drug intervention for nocturnal GERD.

Left-Side Sleeping: The Gold Standard

Anatomy plays a crucial role here.

The stomach sits primarily on the left side of the body, and when you sleep on your left side, the "entry hole" from the oesophagus remains above the level of gastric acid, even if the stomach is full.

A 2024 meta-analysis in the Journal of Digestive Health found that left-side alignment can reduce nocturnal acid episodes by up to 40%. Conversely, sleeping on your right side submerses the oesophageal valve in stomach acid, making leakage almost inevitable.

Jeroen Schuitenmaker PhD : “if you ask me, the advice to sleep on the left side should be added to the number of lifestyle changes already recommended by doctors to patients suffering from acid reflux”. Studies at Amsterdam UMC.

The American College of Gastroenterology clinical guideline (2022) explicitly recommends sleeping on the left side, noting it as one of the most evidence-based lifestyle modifications for GERD management.

The Power of 15 to 20 Degrees

Simply adding extra pillows under your head rarely works and can actually make matters worse. Propping up just your head often bends the neck or midsection, which increases abdominal pressure. True relief comes from elevated sleeping strategies where the entire upper body, from the waist up, is raised.

The Mayo Clinic recommends raising the head of your bed by 6 to 8 inches (15 to 20 cm). Clinical trials published in Diseases of the Oesophagus have shown that elevating the head of the bed leads to a 69% improvement in symptom scores over a six-week period.

According to the AGA (American Gastroenterological Association) 2023 Clinical Practice Update, "Head of bed elevation as well as left lateral decubitus position have been shown to improve nocturnal oesophageal acid exposure."

How to Stop Heartburn at Night Naturally

If you're wondering how to stop heartburn at night naturally, the solution involves a "mechanical" fix rather than relying solely on antacids or medication.

Gravity-Led Positioning

Adopt the best sleep position for acid reflux: lying on your left side at an incline. This dual approach uses both anatomy and physics to your advantage.

Early Dinner

Aim to finish meals at least three hours before lying down.

This allows your stomach time to empty, reducing the pressure on your lower oesophageal sphincter and minimising the risk of reflux.

Proper Elevation

Use a torso-wide support, such as a Putnams bed wedge, to ensure a consistent incline.

Does elevating your head help acid reflux?

Yes, but research from multiple clinical sources emphasises that a bed wedge of at least 15–20 cm (6–8 inches) is necessary to achieve a measurable decrease in oesophageal acid exposure.

Avoid using extra pillows alone. As the Mayo Clinic notes, "Raising your head by using only pillows doesn't work." Instead, use a Putnams bed wedge between your mattress and box spring to elevate your entire upper body.

Putnams offers a range of specially designed products to help alleviate the discomfort of acid reflux.

Their high-quality foam bed wedges are an excellent choice, providing the necessary elevation to reduce oesophageal acid exposure effectively. Available in various sizes and angles, the wedges are crafted to support your upper body comfortably while maintaining the recommended incline.

Additionally, Putnams' acid reflux products are portable and easy to use, making them ideal for both home and travel settings. By opting for a trusted solution like Putnams, you can take a step toward better rest and reduced reflux symptoms.

Avoid Trigger Foods

Common dietary triggers for GERD include:

Acidic foods (citrus fruits, tomatoes)
High-fat or greasy foods
Spicy dishes
Chocolate and mint
Caffeinated beverages (coffee, tea)
Alcoholic and carbonated drinks

Reducing or avoiding these foods, especially in the evening, can significantly decrease nighttime symptoms. Recipes for Acid Reflux sufferers.

Wear Loose-Fitting Clothing

Tight clothing, particularly around your waist, increases abdominal pressure and can push stomach contents back up into the oesophagus.

Opt for comfortable, loose-fitting sleepwear to reduce this risk.

Supporting the Upper Body for Restful Sleep

For the 30–70 age group experiencing chronic heartburn while lying down, dedicated torso support can be transformative. By using a Putnams bed wedge, you protect your airway from "silent reflux" (laryngopharyngeal reflux) and prevent the micro-aspiration of acid that causes morning hoarseness and chronic coughing.

Why Torso Support Matters

Protects the airway: Prevents micro-aspiration of acid into the lungs, reducing the risk of respiratory issues.

Reduces inflammation: Less acid contact means less pain and tissue damage in the oesophagus.

Improves sleep quality: You spend less time waking up to manage symptoms and more time in restorative REM sleep.

Research from the International Foundation for Gastrointestinal Disorders (IFFGD) found that 75% of nighttime heartburn sufferers report their symptoms directly impact their ability to function the following day. Proper positioning isn't just about comfort; it's about reclaiming your daytime productivity and overall quality of life.

Using the right tools can make a significant difference in managing symptoms of nighttime heartburn and improving sleep quality. Putnams Bed Wedges are an excellent solution for those seeking effective and comfortable support throughout the night.

These specially-designed wedges elevate the upper body at an ideal angle, reducing the likelihood of acid reflux by keeping stomach acid where it belongs. Made with high-quality foam and a soft, washable cover, Putnams Bed Wedges provide both firm support and a luxurious touch to your sleep environment.

By incorporating a Putnams Bed Wedge into your routine, you can experience fewer interruptions during the night, leading to deeper, more restorative sleep and improved functionality during the day.

Frequently Asked Questions

Does elevating your head help acid reflux?

Yes, but only if done correctly.

The entire upper body, from the waist up, needs to be elevated by 6 to 8 inches. Simply propping up your head with extra pillows can bend your neck and increase abdominal pressure, worsening symptoms rather than relieving them.

What is the best sleep position for acid reflux?

The best sleep position is lying on your left side with your upper body elevated at a 15- to 20-degree angle. This combination uses both anatomy and gravity to keep stomach acid where it belongs.

How can I stop heartburn at night naturally?

Natural strategies include eating dinner at least three hours before bed, avoiding trigger foods, sleeping on your left side, elevating the head of your bed, wearing loose clothing, and maintaining a healthy weight.

Why does acid reflux worsen at night?

Acid reflux worsens at night due to the loss of gravity when lying flat, reduced saliva production, decreased swallowing frequency, and slower gastric emptying during sleep. These factors combine to allow stomach acid to linger longer in the oesophagus, intensifying symptoms. Visit for more support, Living with Reflux.

Take Control of Night Time Heartburn

Acid reflux at night doesn't have to disrupt your sleep and diminish your quality of life.

By understanding the physiological mechanisms at play and implementing evidence-based positioning strategies, you can significantly reduce symptoms and enjoy restful, restorative sleep.

Combine left-side sleeping with proper upper-body elevation, avoid late meals and trigger foods, and consider using a bed wedge designed for torso support.

These simple yet powerful adjustments can transform your nights and your days.

If symptoms persist despite these lifestyle modifications, consult your GP or a gastroenterologist for further evaluation and personalised treatment options.

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