Sleep “chief nourisher of life’s feast” (Macbeth, Shakespeare).
Good sleep is critical to all physical and emotional functions. In search of good sleep, or as part of the remedies for poor sleep, consideration of reflux is almost always overlooked. Only recently have some medical research papers discussed the association between sleep disorders and reflux, particularly the association between sleep apnea and reflux. To discover the importance of the link between these two conditions, and a guide to their treatment, read on !
Sleep apnea (Greek: apnea – no breath) may affect 20% or more of the adult population. It is caused by repeated episodes of collapse of the throat and nose at night causing actual interruptions of breathing, sometimes up to 50 or more times an hour. The result is very poor sleep quality, with multiple arousals during the night and excessive sleepiness during the day. In addition, the stress caused to the body from insufficient breathing and oxygenation of tissues (low oxygen level in your body) causes myriads of medical problems ranging form high blood pressure, heart disease, and diabetes, to anxiety, depression, and sexual dysfunction. Much of the health affects are related to damage to the smaller blood vessels in the body. Signs and symptoms of sleep apnea include snoring, headaches, difficulty concentrating, memory loss, and ... reflux! In fact a recent study found that almost all patients with significant sleep apnea had reflux. In most cases, when sleep apnea was treated, the reflux improved.
Reflux can result in sleep disturbances by causing arousals every time a reflux episode occurs. In other words, reflux episodes occurring in the middle of the night, wake you up, and then, yes: your mind will start racing and falling back asleep can be very difficult. Reflux can also be one of the causes of night - time breathing interruptions, if the reflux episodes lead to laryngospasm (a medical term meaning that the vocal cords close completely and prevent you from breathing until you wake up gasping for air). Very few in the medical world are aware that reflux may be causing these symptoms, and often attribute them to anxiety, asthma, or heart abnormalities. It is very important to consider that reflux may be causing these nighttime events, and that treating your reflux will certainly improve some aspects of your sleep.
Sleep apnea can now be diagnosed in the comfort of your own home using devices smaller than mobile phones. Usually one night sleeping with the device will determine whether or not you are suffering from sleep apnea, and how severe it is. If you already have been diagnosed with sleep apnea, treating your reflux will likely improve your sleep, and may decrease the severity of your sleep apnea. Of course losing weight will help both conditions, and the reflux diet will help with all: reflux, weight, and sleep apnea!
Remember, if you have tried everything to control your reflux, including our reflux diet, you should probably have a sleep study to rule out sleep apnea as an underlying cause of your persistent reflux. You may even need to undergo simultaneous acid pH testing and sleep testing. Very few centers perform this type of testing. We are the only group of doctors currently offering this new technique, and our technology allows for simultaneous testing of sleep apnea and reflux at home!
What else should you know about sleep and reflux? Avoid eating at least 3 hours before lying down, and make sure you have the head of your bed elevated. Remember that drinking enough alcohol to make you sleepy will also cause reflux, and also cause a subsequent alcohol withdrawal (hangover) about 4 hours into your sleep. You will wake up feeling irritated or anxious, sweaty, thirsty, and you will have great difficulty falling back asleep. That’s why drinking alcohol to help you sleep (a night cap) is not recommended.
Foods that help you sleep? There’s no magic. Even if some foods have substances in them such as melatonin that can help us fall asleep, we would have to eat so much (cherries for example – very bad for reflux) that the side effects of eating so much of the foods would be far worse for your sleep problems. Chamomile, or a warm glass of low fat milk (as long as you can tolerate milk and lactose), as part of your bedtime routine can be helpful.
It is very important to establish a healthy sleeping routine which includes powering down all electronics one hour before bedtime (you really don’t need to text in the middle of the night!), dimming the lights, taking a warm bath, and avoiding any strenuous exercise (except sex which will help you fall asleep!) Soft, quiet calming music can also help (www.BLUESLEEPMUSIC.com). Make sure your eyes and ears are protected form excessive stimuli and use earplugs and eye masks if necessary.
Take your sleep seriously. If you constantly feel sleepy or tired during the day, discuss this with your physician. You can get more information at BLUESLEEP.com where Dr. Stern discusses his holistic approach to sleep disorders as well as new technology and treatments for snoring, sleep apnea, and other sleep disorders.
The BlueSleep dietary recommendations for reflux are described by Dr. Stern and his co-authors in their book ‘Dropping Acid: the Reflux Diet Cookbook and Cure” available at Amazon.
Jordan C. Stern, MD
And the BlueSleep medical staff
