While the symptoms of gastroesophageal reflux disease (GERD) can be troubling and uncomfortable at any time of the day or night, research from the American College of Gastroenterology and other sources indicates that the symptoms of GERD, when they do occur at night, can be more damaging than these same symptoms during the day. This is because at night, and when sufferers are sleeping, their bodies are less prepared to deal with the symptoms and prevent potentially lasting damage.
GERD, a condition that involves the backward flow, or reflux, of stomach contents – including caustic hydrochloric acid used to digest food – into the esophagus, the tube that runs from the upper throat to the stomach, carrying food and liquid to the stomach for digestion.
If left untreated, GERD can lead to serious health problems. Stomach acid can cause inflammation of the esophagus (esophagitis), and this condition can, in turn, lead to the development of ulcers in the esophagus, or bleeding in the area. Another condition that can result is Barrett’s esophagus, which occurs when the lining of the esophagus becomes severely damaged, and may be a precursor condition for cancer of the esophagus.
In addition to the disruption of sleep that can occur as a result of nighttime reflux symptoms, there are a number of factors that make nighttime GERD more likely to cause damage than daytime GERD. One is the supine position of the body during sleep. This is because stomach acid – which, in GERD patients, is released into the esophagus even when patients are in upright positions – can flow more easily into the esophagus and throat when a person is lying down.
Also contributing to heightened risk is the fact that people cannot flush their mouths with liquid, for example by sipping water or swallowing more frequently, when they are asleep, so once acid does enter the area, there is nothing to rinse it away.
If acid flows into the mouth, there is an additional risk of choking or coughing as sleeping patients take their next breath, and acid in the respiratory tract can cause similar types of damage to those caused in the esophagus, disrupting the health of fragile respiratory tissue. Patients may also wake up sputtering or feeling as though they have trouble breathing.
Patients who wake up in the night from GERD symptoms, or have reason to believe that they suffer from GERD and have yet to seek treatment, should see their health care practitioner and discuss their symptoms. Frequently, the medications that control reflux during the day can also help at night, but it is important to review symptoms and treatments periodically, to make sure that all necessary preventative and reparative measures are taken to cope with the disease before permanent damage can occur.