From the Guidelines
The best position to sleep with heartburn is on your left side with the head of the bed elevated, as this has been shown to improve nocturnal esophageal acid exposure and reduce symptoms of GERD. This recommendation is based on the most recent and highest quality study available, which suggests that positional changes during sleep, including elevating the head of the bed and sleeping in the left lateral decubitus position, can help manage GERD symptoms 1. Some key points to consider when implementing this recommendation include:
- Elevating the head of the bed by at least 6-8 inches to use gravity to keep stomach acid from flowing up into the esophagus
- Avoiding food intake for at least 2-3 hours before recumbency to allow the stomach to empty before lying down
- Losing weight if obese, as this has been associated with a reduction in symptoms and esophageal acid exposure 1
- Avoiding sleeping on the right side or lying flat on the back, as these positions can worsen acid reflux It's also important to note that while dietary avoidance of certain foods may be beneficial for some patients, the data on this is limited, and avoidance of trigger foods on a patient-by-patient basis is a more reasonable practice 1. If heartburn persists despite positional changes, consulting with a healthcare provider about additional treatment options, such as over-the-counter medications, may be necessary.
From the Research
Sleeping Position and Heartburn
There is no direct evidence in the provided studies that discusses the best sleeping position to alleviate heartburn.
Treatment of Gastroesophageal Reflux Disease
- The studies focus on the treatment of gastroesophageal reflux disease (GERD) using histamine-2 receptor antagonists (H2RAs) and proton pump inhibitors (PPIs) 2, 3, 4, 5.
- H2RAs and PPIs are commonly used to reduce stomach acid and alleviate symptoms of GERD 2, 3.
- The combination of H2RAs and PPIs has been shown to enhance gastric acid suppression 4.
Gastric Acid Suppression
- A study found that concomitant administration of an H2RA and a PPI resulted in a significantly longer time that the gastric pH remained higher than 4, compared to either medication alone 4.
- The combination of an H2RA and a PPI also resulted in a higher median gastric pH and a higher percentage of time that the gastric pH remained higher than 4, compared to either medication alone 4.
Limitations of Current Evidence
- The provided studies do not address the specific question of the best sleeping position to alleviate heartburn.
- Further research is needed to determine the optimal sleeping position for individuals with heartburn and GERD.