Heartburn is a condition that many people think of as more of an annoyance than a cause for alarm. Commercials advertising antacids may give the impression that heartburn is a condition brought about primarily by eating the wrong foods. Just like the flu or chickenpox, frequent heartburn is not often spoken of as a serious medical concern.
In truth, frequent heartburn could be a sign of gastroesophageal reflux disease (GERD), also known as acid reflux. This disease can cause several more severe complications if left untreated, including erosive esophagitis (severe inflammation of the esophagus), narrowing of the esophagus, and esophageal cancer. GERD is the 3rd most common gastrointestinal disorder in the U.S., and many sufferers report nighttime heartburn. A high number of GERD patients also experience sleep apnea, and studies are working to find whether these cases of sleep apnea were developed before or after acid reflux began.
Heartburn: a Cause For Concern
The esophagus is made of a different kind of lining than the stomach, which does not hold up against acid as well as the stomach walls. A valve at the bottom of the esophagus known as the lower esophageal sphincter (LES) prevents stomach acid from entering the esophagus and damaging the lining. In some people, this valve is weak, or leaks, allowing stomach acid to travel back up the esophagus. Acid will cause lasting damage to the lining of the esophagus over time.
This condition sometimes affects people who do not even realize they are having heartburn. Frequent exposure to stomach acid can cause the esophagus to become inflamed and press against arteries, forcing the heart to work harder to move blood. As a result, some people experience unexplained rapid heart rate during flare-ups rather than heartburn. Left untreated, GERD can cause a condition called Barrett’s esophagus, which increases the risk of esophageal cancer.
Sleep and Acid Reflux
Studies have found that GERD and sleep apnea are often paired, but the cause of this link is not yet clear. Research has found that 58-62% of people suffering from obstructive sleep apnea also experience GERD symptoms. The data collected does not eliminate factors that can cause both conditions such as obesity or age. Future research is needed to determine whether it is factors like age and weight that cause both conditions to appear in certain individuals, or if it is GERD or sleep apnea themselves that cause one another.
Despite limited knowledge of which condition comes first, research has found that sleep apnea treatment can reduce the occurrence of GERD in patients who experience frequent nighttime heartburn. Patients using continuous positive airway pressure (CPAP) to improve sleep apnea symptoms have shown a decrease in the total time that acid is in contact with the esophagus at night. Research that assesses esophageal irritation in sleep apnea patients without nighttime heartburn may provide future information on how these two conditions are related.
Habits to Help Prevent Nighttime Reflux
While researchers work to discover what the relationship is between sleep apnea and GERD, it is important to treat your own symptoms right now. If you experience nighttime heartburn, there are several ways to reduce the occurrence of reflux at night. One method is avoiding large meals before sleep. Large meals will increase gastrointestinal activity and acid production that may disrupt sleep. Large meals are best avoided with sleep apnea anyway, as they can disrupt diaphragm action. Cutting spicy meals out of your dinner menu as often as possible will also help to reduce stomach acid.
Weight loss has been found to make a difference in GERD symptoms for people with higher body-mass indexes as well. Extra body weight will press down on the stomach and esophagus and cause problems with the proper functioning of the LES. Sleep apnea symptoms can also improve with weight loss.
Learn more about the beneficial effects of sleep apnea treatment on your overall health by contacting Dr. Lowrance’s office at (361) 851-8274 or online for a consultation.