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What Causes Acid Reflux at Night?

June 19, 2025

Ever wake up with a burning feeling in your chest? Or a sour taste creeping up your throat?

Acid reflux at night can make sleep feel impossible.

So, why does it happen – and what can you do about it? We asked Inam Shaikh, MD, a general surgeon with Hartford HealthCare Medical Group at Charlotte Hungerford Hospital Department of General Surgery, to break it down.

Acid reflux isn’t random.

Acid reflux happens when stomach acid sneaks back up into your esophagus — the tube that connects your mouth to your stomach.

“That backflow, or reflux, can irritate the lining of your esophagus, which causes that burning feeling we call heartburn,” explains Dr. Shaikh.

It can happen to anyone, but it’s more common in:

• Adults over 40.
• People who are pregnant.
• Those who are overweight or living with obesity.
• People who smoke or drink alcohol.

If you’re reaching for antacids at night, this might be why:

1. You ate heavy (or late).

That big dinner right before bed?

“This is one of the most common heartburn triggers,” says Dr. Shaikh. “Lying down after a large meal puts extra pressure on the lower esophageal sphincter (LES), the muscle that keeps acid where it belongs.”

Try this instead: Stick to smaller meals and give it a few hours before heading to bed or the couch. Elevating your head can also help you feel more comfortable.

> Related: Is Eating Before Bed Bad for My Health?

2. Your food choices are working against you.

We might love plenty of different foods – but they don’t always love us back.

“Spicy foods, citrus fruits, chocolate, caffeine and alcohol can all relax the LES, making reflux more likely,” says Dr. Shaikh.

Try this instead: Enjoy those trigger foods only in moderation – and avoid them later in the day.

> Related: 7 Tips for Nighttime Heartburn Relief

3. You’re carrying extra weight.

When it comes to acid reflux, those extra pounds play a big role.

“Excess weight, especially around the abdomen, puts added pressure on your stomach,” says Dr. Shaikh. “That pressure can push acid up into the esophagus and lead to reflux symptoms.”

Try this instead: Eat a balanced diet, stay active and work toward a healthy weight. If weight loss feels overwhelming, ask your doctor for help.

4. You have a hiatal hernia.

A hiatal hernia happens when part of your stomach pushes up through the diaphragm.

“This shift in anatomy can weaken the LES, making it easier for acid to travel back up into the esophagus,” explains Dr. Shaikh.

Try this instead: Meet with your doctor. If a hiatal hernia is part of the problem, they can walk you through the next steps to get relief.

> Related: Is a Hernia Causing Your Heartburn?

Don’t lose sleep over acid reflux.

If acid reflux strikes more than twice a week or over-the-counter medications aren’t helping, see your PCP.

Bring a simple log of your symptoms and potential triggers to make the most of the appointment.

“Acid reflux at night is frustrating, but there’s a lot we can do to help,” says Dr. Shaikh. “Let’s figure out what’s going on and help you get back to living – and sleeping – more comfortably.”