Acid reflux at night

Repeated waking, coughing or sour fluid in the mouth deserves attention because reflux can irritate the oesophagus and throat even when daytime heartburn is mild.

Gravity helps keep stomach contents down while you are upright. In bed, acid can travel more easily through a weakened or relaxed valve at the bottom of the oesophagus. A full stomach near bedtime adds pressure, and a hiatus hernia can make the barrier less effective.

Night reflux may cause chest burning, regurgitation, a bitter or sour taste, throat clearing, hoarseness or coughing. Some people mainly notice disrupted sleep rather than classic heartburn. These symptoms can overlap with respiratory or heart conditions, so the full pattern matters.

Finish the evening meal several hours before lying down and choose a smaller portion if large meals are a trigger. Stay upright after eating. Track personal triggers such as rich, spicy or fatty foods, caffeine or alcohol instead of removing many foods without a clear reason.

Raise the head end of the bed or use a firm wedge that lifts the upper torso; stacking ordinary pillows can bend the body at the waist and may be less useful. Sleeping on the left side may reduce reflux for some people. A pharmacist can advise on short-term remedies and medicine interactions.

Book a medical review if symptoms regularly interrupt sleep, continue despite sensible changes, require frequent non-prescription medicine, or occur with trouble swallowing, painful swallowing, persistent vomiting, unexplained weight loss or an ongoing cough. Treatment may need to reduce acid and allow irritated tissue to heal.

Get emergency help for vomiting blood, black stool, severe breathing difficulty or chest pressure accompanied by sweating, faintness, nausea or pain spreading to the jaw, arm or back. New chest pain should not automatically be labelled reflux.

Note the time of your last meal, sleep position, symptoms that wake you and any remedies used. Ask whether your current medicines could contribute, whether acid-suppressing treatment is appropriate and whether swallowing problems or respiratory symptoms require further investigation.