Both carbonated soft drinks and commonly-used prescription sleeping pills can lead to nighttime heartburn, possibly indicative of a severe degree of gastroesophageal reflux disease (GERD), according to researchers.
Heartburn is a symptom of the reflux of acidic stomach content back into the esophagus, and chronic gastroesophageal reflux can lead to inflammation of the esophagus, scarring, and even precancerous or cancerous changes within the esophagus. When heartburn occurs at night, it is considered to be suggestive of a more serious or advanced form of reflux disease. Heartburn during sleep can also cause nighttime awakening, sleep loss, and daytime sleepiness.
Doctors studied responses to a questionnaire about sleep habits from over 15,000 people from different areas of the United States. Almost 25% of respondents reported that they experience nighttime heartburn, defined as being awakened at night two or more times per month because of heartburn. Examination of the other lifestyle and demographic characteristics of the participants revealed that both drinking carbonated soft drinks (which have a very high acidity level) and use of benzodiazepines (prescription anti-anxiety medications often prescribed as a sleep aid, including diazepam (Valium), alprazolam (Xanax), and others) were strongly associated with nighttime heartburn.
Other factors that were related to nighttime heartburn included overweight, asthma, high blood pressure, and sleep disorders. Interestingly, certain medications that are known to increase one's risk of gastrointestinal reflux - the calcium channel blockers and antidepressants - did not appear to precipitate heartburn during sleep.
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This study suggests that avoiding carbonated soft drinks and discontinuing benzodiazepine use may be simple steps that can reduce the frequency of heartburn during sleep. Other lifestyle measures, such as:
Further lifestyle changes that can help control the symptoms of heartburn are avoiding certain foods that trigger heartburn, in particular:
- fatty or fried foods,
- spicy foods,
- tomato-based dishes,
- citrus fruits, and
- garlic or onions.
If you have persistent heartburn, your doctor can advise you about both the lifestyle alterations and medical therapies that would be of greatest benefit for you.
Reference: Ronnie Fass, Stuart F. Quan, George T. O'Connor, Ann Ervin, and Conrad Iber. Predictors of Heartburn During Sleep in a Large Prospective Cohort Study. Chest, May 2005; 127: 1658 - 1666.