Snoring isn’t the only sound that can keep you up and disturb your partner. Belching and flatulence can become more frequent during the night and disrupt your sleep as well as those around you!
If you’ve noticed you or your partner is extra gassy at night, you are not alone. Although it can feel embarrassing, it is very common and often a normal part of digestion. That said, when nighttime gas becomes extreme, it can feel awkward, uncomfortable and disrupt sleep.
My first experience with nighttime burping was on a college camping trip with friends. I was snuggled in my sleeping bag and laying peacefully on my camping pillow when I heard the steady flow of belching coming from a nearby tent. It was loud and went on for quite some time. The following day it was apparent I wasn’t the only one kept up by the loud burping all night.
Generally, a burp is normal. It happens when your body needs to release the excess air that has entered your digestive tract during eating or drinking. But when it is excessive like it was on that camping trip, it can be a sign of digestive issues or a behavioral condition.
One theory is that nighttime burping may be caused by a behavioral condition related to CPAP use. An article published in the Journal of Clinical Sleep Medicine found that burping may be more prevalent in those using a CPAP. Some patients receiving CPAP treatment have noted aerophagia, a symptom related to excessive belching. This is considered a behavioral condition where a person consciously or unconsciously moves air into the esophagus by swallowing air. This air becomes trapped in the stomach, which is either released as a burp or moves to the intestines. The author of the article believed that aerophagia in CPAP users is a manifestation of CPAP treatment. Although clinical observations related to CPAP have been made, there remains minimal research on how to treat aerophagia.
The more common cause of nighttime burping is a condition called GERD. Gastroesophageal Reflux Disease (GERD), more commonly known as acid reflux, is when acid from the stomach backflows into the esophagus. In the U.S., roughly 20% of adults have GERD. Heartburn is another common symptom of GERD, which feels like a burning sensation in the chest and often worsens by lying down. Heartburn can also trigger radiating chest pain, which affects the jaw, arms, neck, and back. Some may also experience regurgitation, where a small amount of food and stomach acid comes up the back of the throat. This can cause a feeling of choking, coughing, hoarse voice, and sore throat. With time, GERB can have long-term effects. It can cause significant sleep troubles and damage the esophagus, increasing one’s risk of esophageal cancer.
So, why does this happen?
It’s because the muscles at the bottom of the esophagus aren’t working as they should. They should be blocking stomach acid, but instead, it moves up to the esophagus. Research has found there are several risk factors that can cause this. The first is obesity. Studies have found that GERD occurs more frequently in those who are obese or overweight. Smoking cigarettes and drinking alcohol can also make GERD worse as it affects the pressure near the esophageal sphincter, which slows the clearance of stomach acid.
Some people may also find that certain foods or beverages make their symptoms worse. Common examples include spicy food, carbonated drinks, fatty foods, vinegar, tomatoes, coffee, and chocolate.
Although technically GERD isn’t caused by sleep, it is often cited as the cause of a sleeping problem because it happens at night. According to a poll by the National Sleep Foundation, nearly 60% of people with heartburn say that it affects their sleep.
GERD worsens after you lay down on your cooling pillow because gravity can’t keep stomach acid down. Additionally, when you sleep, you don’t swallow as much, allowing stomach acid to creep its way up, and you don’t produce enough saliva at night, which neutralizes stomach acid. When these effects are combined, it causes stomach acid to leak into the esophagus and stay in place longer. This causes more severe symptoms.
As the stomach acid rises up, you may then respond by increasing swallowing. Although sleep decreases swallowing, GERD increases it. This causes you to ingest large quantities of air more frequently, which leads to burping. As a result, you burp more. The good news is you can quickly treat nighttime burping caused by acid reflux, by treating the acid reflux. Over-the-counter antacids can reduce acid and burping, helping you sleep better.
There are other medical conditions that could be causing you to belch at night. For example, peptic ulcers which are sores on the esophagus. It could also be caused by gastroparesis, which is weakened stomach wall muscles, or gastritis which is inflammation of the stomach lining. Other conditions include lactose intolerance, Helicobacter pylori, and fructose or sorbitol malabsorption.
Lastly, certain foods may trigger belching at night, even without acid reflux. Carbonated drinks or foods high in sugar, fiber, and starch can cause gas. For example, eating a late-night snack or dinner consisting of beans, broccoli, onions, bananas, whole-wheat bread, lentils, or peas can make you burp at night.
Intestinal gas known as flatulence is a whole other issue that can be just as disruptive, especially when it is accompanied by discomfort or stomach pain. Like belching, flatulence is also entirely normal and a part of the digestive process and can be caused when you ingest air when drinking or eating. Gas is also created during the digestive process.
Christine Lee, M.D., told Shape Magazine, “the healthy bacteria that live along your intestinal tract (to help us digest food) create gas all day and throughout the night, even during your sleep.” The bacteria in your gut spend the day fermenting the foods you have eaten. This process takes about 6 hours and forms gas which is why you may be experiencing more gas in the evening. Flatulence can become worse at night if you are eating too close to bedtime. Eating a large meal and then lying down too soon can cause indigestion which can increase gas.
The food you eat can also increase gas production. Foods high in fiber, specifically soluble fiber, are highly fermentable, which causes more gas. These foods include apples, blueberries, grains, and lentils. Our body can’t break down fiber and instead relies on bacteria in the gut. This process results in gas. Further, those with food sensitivities may also be more prone to nighttime gas, such as those sensitive to gluten. Also drinking milk late at night or with dinner, can cause gas and digestive issues for many people.
The timing of your meals is important too. If you eat the majority of your day's calories later in the day, digestion will be more difficult. Being consistent with your eating times and having dinner between 6 and 7 PM will be best as it will reduce gassiness and keep your circadian rhythm in check.
Another reason you can be gassier at night is because your body becomes more relaxed at night. This is because your automatic nervous system maintains the closure of the anal sphincter. During the day, the seal is tighter, but as you relax, it becomes looser, releasing gas in the large intestine as a result.
Lastly, just as there are medical conditions that can cause belching, there are some that can cause an increase in flatulence. For example, Irritable Bowel Syndrome (IBS) can cause abdominal pain, diarrhea, and excessive gas. Another condition causing excessive gas is Small Intestinal Bacterial Overgrowth (SIBO) which is a disorder where an overgrowth of bacteria is present in the small intestine. Inflammatory diseases like Crohn’s, Ulcerative Colitis, and Celiac Disease can also cause increase gas as well as medications like anti-inflammatory drugs such as ibuprofen, laxatives, statins, and antifungals.
In many cases, adjusting your lifestyle and diet can help reduce nighttime gas and help you sleep better on your water pillow! If you want to reduce your nighttime gas, try the following:
- Eat small, frequent meals throughout the day (don’t just wait until dinner!)
- Don’t chew gum, as this can cause you to swallow air
- Avoid carbonated drinks and alcohol
- Chew and eat slowly
- Quit smoking
- Have dinner earlier and wait 3 hours before laying down
- Avoid trigger foods at night that can increase gassiness
- Drink plenty of water throughout the day
- Exercise often
It is possible that you aren’t passing more gas at night but are simply noticing it more. When we are busy with our daily activities, we may not be as in tune with how much gas we are passing, but when the room is quiet as you lay on your buckwheat pillow, you become attentive to it. Most people expel gas around 14 times each day but often don’t realize it. However, if you feel your gas is excessive, you should speak with a medical professional. As you can see, there are plenty of underlying causes that may trigger nighttime gas, and only by treating these conditions or causes can you reduce gas.