Why have I started getting heartburn at night?If your sleep is being disturbed by an uncomfortable burning sensation under your breastbone, you're not alone. Heartburn and indigestion are common during pregnancy (CKS 2012). These discomforts are generally harmless, but are a real annoyance if you're trying to get to sleep (BAP 2010).
Heartburn is caused by some of the hormonal and physical changes going on in your body (Murray and Hassall 2014, NHS 2012).
The placenta produces the hormone progesterone, which relaxes the smooth muscles of your womb (uterus).
Progesterone also relaxes other tissues in your body, including the valve that separates your gullet (oesophagus) from your stomach. Because the valve is not working as well as usual, the acids that break down food in your stomach can seep back up into your gullet.
It's these acids that cause the unpleasant burning sensation, which you can feel anywhere from the bottom of your breastbone to your lower throat (NHS 2012).
Progesterone also slows down the digestion of your food. Your gullet and guts squeeze food through your body's digestive system with wave-like contractions. These contractions slow down because of progesterone, making digestion less efficient.
Later in pregnancy, your growing baby crowds your belly, pushing the stomach acids back up into your gullet (BAP 2010).
Heartburn and indigestion will probably come and go until your baby is born.
How can I ease heartburn at night?There's no certain way to avoid getting heartburn or indigestion. But you can take steps to lower your chances of being disturbed by them at night (CKS 2012). Your first step can be to cut down on foods that are known to trigger digestive problems. These include:
- Citrus fruit or juices. These are acidic, but there are plenty of other fruits you can try. Mangos, melon, apricots, peaches and pears are all less acidic than citrus fruit.
- Rich, fatty or spicy dishes
- alcohol (NHS 2012)
If you smoke, stop. Smoking can harm your baby, and it won't help your digestion either. When you smoke, the chemicals you inhale can cause the muscle that separates your gullet from your stomach to relax. This allows stomach acid to leak back up into your gullet more easily (NHS 2012).
If you’re interested in complementary therapies, then you could try acupuncture. A few studies suggest acupuncture could help to relieve heartburn and indigestion in pregnancy, and in turn help you to sleep (Da Silva et al 2009). However, you'll have to pay for acupuncture sessions.
Here are practical tips to help you avoid heartburn and indigestion:
- Don't eat big meals, especially late at night. Lying down with a full stomach can keep you awake (CKS 2014) and will only make heartburn worse. Instead, eat several small meals during the day. Take your time eating and chew food thoroughly (CKS 2014, NHS 2012).
- Don't eat close to bedtime. Give yourself three hours to digest food before you lie down (NHS 2012).
- Sleep propped up in bed with several pillows to support you. Staying a little more upright will help keep your stomach acids where they belong (CKS 2012, NHS 2012).
If none of the above help, ask your doctor or midwife about an over-the-counter antacid or medicine that is safe to use during pregnancy (NHS 2012, NICE 2010: 20). Take a dose at night-time if heartburn is disturbing your sleep (NHS 2012).
Last reviewed: October 2014
BAP. 2010. Consensus statement on evidence-based treatment of insomnia, parasomnias and circadian rhythm disorders. British Association for Psychopharmacology. Journal of Psychopharmacology 0(0):1-25
CKS. 2012. Clinical topic: Dyspepsia – pregnancy. NICE Clinical Knowledge Summaries
CKS. 2014. Clinical topic: Insomnia.NICE Clinical Knowledge Summaries
Da Silva JBG, Nakamura MU, Cordeiro JA et al. 2009. Acupuncture for dyspepsia in pregnancy: a prospective, randomised, controlled study. Acupunct Med. 27: 50-53
Murray I, Hassall J. 2014. Change and adaptation in pregnancy. In: Marshall J, Raynor M. eds. Myles Textbook for Midwives. 16th ed. Edinburgh: Churchill Livingstone, 143-177
NICE. 2010. Antenatal care. National Institute for Health and Care Excellence
NHS. 2012. Indigestion and heartburn in pregnancy. NHS Choices, Health A-Z. Pregnancy and baby