Lying flat plus late, large, fatty meals lets acid wash upward. Last meal 2-3 hours before bed, head of bed raised, left-side sleeping - and twice-weekly night heartburn is GERD territory worth treating.
What to do
Common questions
Why do I get heartburn at night?
Nighttime heartburn is reflux with the help of gravity - or rather, without it. Upright, acid tends to stay in the stomach; lying flat, the barrier between stomach and esophagus has no help, and acid washes up. NIDDK describes the mechanism: the lower esophageal sphincter relaxes or the stomach is too full, and acid irritates the esophagus lining. The classic triggers are the evening ones: a big or fatty late dinner, lying down within two to three hours of eating, alcohol, chocolate, peppermint, and tight waistbands in bed. Weight gain and pregnancy raise abdominal pressure and make it worse. The fixes that work: last meal two to three hours before bed, smaller evening portions, raise the head of the bed six inches - blocks or a wedge, extra pillows alone bend the neck not the stomach - and sleep on your left side, which anatomically keeps the stomach junction above the acid level. Antacids handle occasional nights; frequent nighttime heartburn - twice a week or more - is GERD territory and deserves real treatment, because nightly acid damages the esophagus over years. One caution: chest burning with sweating, breathlessness, or arm or jaw radiation is not heartburn until a doctor says so - get checked. Pymander is a free AI doctor, 24/7 by text. Describe when it hits and what you ate, and it can help you build the fix.