Heartburn When Lying Down: What to Know

When you are upright, gravity helps keep stomach contents down. Lying flat removes that assistance, so reflux can reach the lower throat and cause burning behind the breastbone, a sour taste, belching or an irritating cough. A large meal close to bedtime, alcohol, smoking, tight clothing and foods that personally trigger symptoms can add to the problem. Acid reflux is a common explanation, although stomach inflammation, a hiatus hernia or an ulcer can also cause upper-abdominal discomfort. A burning sensation is not a diagnosis by itself; note what you ate, when symptoms began and whether swallowing is affected.

Finish evening meals well before lying down and choose smaller portions if fullness brings on burning. Raise the upper end of the bed or use a suitable wedge so your chest is higher than your waist; stacking pillows under only your head may bend your body and be less helpful. Sleep on your side if that feels comfortable, avoid garments that press on the abdomen, and keep a record of triggers. A pharmacist or clinician can explain whether acid reflux medication is suitable, especially if symptoms recur or you take other medicines.

Arrange a medical assessment if heartburn keeps returning, disrupts sleep, needs frequent over-the-counter treatment, or comes with persistent nausea, vomiting, unexplained weight loss, painful swallowing or food sticking. Seek urgent help for severe or unfamiliar chest pressure, breathlessness, fainting, sweating, or pain spreading to the arm, back or jaw, because these symptoms can have a cause unrelated to reflux.

Ask whether your pattern fits reflux, whether another condition should be checked, which treatment is appropriate for your medicines, and how long to try lifestyle changes before arranging follow-up.