One danger of heartburn is that it can strike at any time—during a heavy meal, an exercise program, or while you’re sleeping. The first two activities occur during the day, while the latter occurs at night. Are there any differences—and any danger—in experiencing heartburn in the nighttime as opposed to the daytime?

Heartburn at any time can be painful and derail productivity, and its presence is staggering: in the United States, 60 million Americans suffer from it.1 However, the statistics on nighttime heartburn are just as alarming: nearly 8 in 10 experience nighttime symptoms, and roughly 75 percent say heartburn keeps them from falling asleep or wakes them up during sleep, according to studies done in 2000 by Gallup Organization for the American Gastroenterological Association (AGA).2

Gastroesophageal reflux (GER), or acid reflux, describes the process of stomach contents rising up into the esophagus, and its most frequent symptom is heartburn. One thing that helps prevent heartburn is the production of saliva, which is essential for acid neutralization. When you sleep, your swallowing rate is diminished, so you produce less saliva. This is one reason that has led Dr. William C. Orr, a Clinical Professor of Medicine, Oklahoma University Health Sciences Center, to write that experiencing GER during sleep is a much more "malignant" form of reflux.3 Additionally, the AGA reported that of those who experienced both daytime and nighttime symptoms, 50 percent said nighttime symptoms were worse.

It is also important to remember that what happens while you sleep can affect your day. The less we sleep, the more likely we are to be tired, lethargic, lazy, and worse at conducting our daily responsibilities. Not surprisingly, another uncovering reported by the AGA was that 40 percent of people suffering from nighttime heartburn reported an impact on their ability to work the next day.

From the study, the AGA made several other claims. It cited a study published in the New England Journal of Medicine that showed that those suffering from nighttime heartburn are 11 times more likely to develop esophageal cancer than those who do not, and it reported that nighttime heartburn, compared to daytime heartburn, can cause more esophageal damage, possibly leading to erosive esophagitis, Barrett’s esophagus, and esophageal cancer. However, a 2008 German study seemed to refute some of these findings. It concluded that "nighttime heartburn was not associated with Barrett's esophagus or most extra-esophageal symptoms."4