AZ Sleep

GERD And Sleep Apnea: How Treating Both Can Help Acid Reflux

If you suffer from sleep apnea, you already know that this condition brings with it a host of other symptoms. One connection you may not have made is between GERD and sleep apnea. If you suffer from sleep apnea and GERD, treating one condition can help improve the other. Here’s what you should know.

How are GERD and sleep apnea related?

Gastroesophageal reflux disease (GERD) begins with a chronic case of acid reflux. Acid reflux occurs when your lower esophageal sphincter (LES) malfunctions. This muscle in the lower part of the esophagus closes after we swallow, keeping the contents of the stomach where they belong.

When this valve malfunctions, it allows stomach acid back into the esophagus, resulting in acid reflux. If this malfunction occurs at least twice weekly, it is then considered chronic GERD. Approximately 20% of people suffer from GERD.

Obstructive sleep apnea, the most common type of sleep apnea, occurs when a person’s airway becomes blocked during sleep. The person then takes a gasping breath as they wake up out of deep sleep. In severe cases, this pattern can be repeated more than 30 times an hour.

GERD and sleep apnea may seem unrelated, but new research is finding an increased incidence of obstructive sleep apnea in GERD patients. A study in 2010 found that an estimated 60% of GERD patients also have obstructive sleep apnea. Other studies put that percentage of sleep apnea secondary to GERD as high as 76%.

The reason these two conditions are connected is not entirely clear, but the studies above indicate there is a connection that can cause each condition to worsen.

Symptoms of GERD and sleep apnea

In general, GERD symptoms occur most often at night, when gravity is not helping to keep the LES closed. Sleep apnea can occur whenever a person rests but is obviously most common at night.

GERD and sleep apnea also share similar primary risk factors, including obesity, smoking, and respiratory conditions. They also share some symptoms including:

  • Nocturnal choking: The gasping intake of breath (or apneas) that occurs during pauses in breathing mimics the choking feeling patients with GERD report.
  • Respiratory difficulties: Patients with GERD also report respiratory difficulties that occur when a sudden breath is taken in after the feeling of acid in their throat. The pressure of this inhale causes stomach acid to rush up. In this way, the sharp intake of breath can worsen GERD at night.
  • Bad breath: People with both GERD and sleep apnea may have bad breath, both due to patterns of mouth breathing at night.
  • Burping and gas: Burping is common in both conditions, likely due to swallowing excessive air from the sudden intake of breath.

Other GERD symptoms can include sore throat, heartburn, acid regurgitation, erosion of tooth enamel, and gum inflammation. GERD patients may also experience coughing and an increase in seasonal asthma.

Treating GERD and sleep apnea

As with any medical condition, the most important step is a proper diagnosis of both conditions.

Patients with GERD are often under-diagnosed. They can suffer from aspiration pneumonia when stomach acid is inhaled into the lungs. Post-nasal drip from any condition may also contribute to symptoms of GERD. Both aspiration pneumonia and post-nasal drip can be symptoms of GERD, but patients may think they’re suffering from a cold or allergies. Unfortunately, simply treating the pneumonia or post-nasal drip does not treat the underlying case of GERD.

Similarly, an estimated 80% of sleep apnea, some of it severe, goes undiagnosed. Patients with GERD symptoms that occur primarily at night should also be screened for sleep apnea with either a sleep study in a clinic or an at-home sleep test.

Once a diagnosis is achieved, there is good news. Both conditions are treatable, and treating one often vastly improves the other. The following four treatment options can help provide relief from GERD and a good night’s sleep.

1. Maintain a healthy weight

As obesity is a primary risk factor for both conditions, maintaining a healthy weight can help you improve the symptoms of both conditions.

Further, there are many foods that cause acid reflux, including:

  • Chocolate
  • Caffeine
  • Garlic and onion
  • Fatty or fried food
  • Citrus or tomato-based foods

Many of the above are often heavily processed foods. Sticking to a diet of fruits, non-acidic vegetables, whole grains, and lean proteins can help you maintain a healthy body weight and minimize stomach acid production.

When paired with exercise, a healthy diet can promote better sleep and help reduce or eliminate GERD and sleep apnea symptoms.

2. Find the best sleeping position

Acid reflux or GERD that occurs at night is made possible when the body is flat and gravity is not keeping the LES closed. A sleeping wedge can help to slightly elevate your upper body to treat this.

While sleeping on the back is not the best position for sleep apnea, many inveterate back sleepers find that a sleeping wedge also helps them get a better night’s sleep. This slightly propped position helps keep the airway open, even when the throat muscles relax.

If the wedge pillow is not comfortable, you could also use bed risers to incline the top half of your bed.

3. Change your dietary habits

Watching what you eat and making sure not to eat too late can help with both conditions.

GERD patients who eat a heavy, fatty meal and then immediately recline suffer more nocturnal episodes than do patients who eat light and early.

4. Use a CPAP machine

A continuous positive airway pressure (CPAP) machine is a first line treatment of severe obstructive sleep apnea, but it can also help reduce the nocturnal instances of GERD. A small study in 2003 found that patients who used CPAP regularly had a significant improvement in GERD symptoms (as compared to the control group, which had no improvement at all).

In 2016, another study found the same results among patients with both GERD and sleep apnea – improvements in both GERD and sleep apnea symptoms.

Get help

A dentist can spot symptoms of both sleep apnea and GERD in your mouth, as well as suggest treatment approaches. If sleeping with a CPAP mask on sounds unbearable, they can also custom-make a dental device that repositions your jaw at night. This can reduce sleep apnea symptoms and help you better manage GERD.

At AZ Sleep, we recognize the signs of GERD and sleep apnea and can offer treatment options for both. We are your sleep apnea dentists in Arizona. Get in touch today!   

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