Heartburn early in the morning

When you lie down, gravity no longer helps keep stomach contents below the food pipe. A late or heavy evening meal may add to this effect, and reflux can irritate the throat during sleep. Some people wake with a burning chest feeling, sour taste, cough or hoarse voice. Morning symptoms can fit [Acid Reflux](/conditions/acid-reflux/), but other conditions, including [Gastritis](/conditions/gastritis/), can cause upper abdominal discomfort.

Keep dinner portions moderate and leave time between eating and lying down. Note whether alcohol, caffeine, rich foods or a particular snack precedes symptoms, then adjust the pattern that affects you. Raise the upper part of your sleeping surface only with safe, stable advice; avoid improvised arrangements that could cause injury. If symptoms are recurring, ask a clinician or pharmacist whether [Acid Reflux Medication](/treatments/medical-management/acid-reflux-medication/) is appropriate. Do not rely on frequent self-treatment without finding out why it is needed.

Book medical advice if waking heartburn happens often, persists despite changes, or comes with swallowing difficulty, repeated vomiting, weight loss or poor intake. Seek urgent help for severe chest pain, breathlessness, fainting, vomiting blood or black stools. Pain that is new, intense or spreading should be assessed rather than labelled heartburn at home.

Could my evening meal, sleep position or medicines explain the morning pattern? Do I need testing or treatment? Could [Hiatus Hernia](/conditions/hiatus-hernia/) or [Peptic Ulcer](/conditions/peptic-ulcer/) be relevant to my symptoms?