The suffering of being unable to sleep due to burning heartburn and chest congestion throughout the night goes beyond simple discomfort and significantly degrades our quality of life. Modern medicine explains the cause of this pain as gastroesophageal reflux disease. In a healthy person, when food travels down through the esophagus to the stomach, the lower esophageal sphincter between the stomach and esophagus closes to prevent gastric acid from refluxing. However, when this sphincter weakens or fails to function properly, stomach contents flow back up into the esophagus, irritating the esophageal mucosa and causing inflammation. This is reflux esophagitis.
There are several scientific reasons why reflux esophagitis symptoms worsen particularly at night. When we lie down, gravity exerts less effect, allowing gastric acid to reflux more easily into the esophagus, and saliva secretion decreases during sleep, weakening the action that washes away the acid that has refluxed into the esophagus. In addition, the frequency of swallowing decreases remarkably during sleep, causing gastric acid to stay longer in the esophagus. All these factors aggravate reflux esophagitis symptoms during the nighttime, thereby disrupting deep sleep.
Yet the important point here is that it is not merely reflux. Chronic acid reflux also affects our nervous system. Esophageal inflammation and irritation activate the vagus nerve, which regulates autonomic functions of our body such as digestion, heart rate, and respiration, and is also deeply involved in sleep quality. When the vagus nerve is overly stimulated, it interferes with the body relaxing comfortably and can activate the sympathetic nerve, disrupting hormonal balance such as the secretion of melatonin that induces sleep.
Furthermore, the suffering of acid reflux that persists day and night drives our body into a state of chronic stress. This activates the hypothalamic-pituitary-adrenal axis that regulates the stress response, increasing the secretion of stress hormones like cortisol. Elevated cortisol levels disrupt the sleep cycle, specifically interfering with REM sleep and deep non-rapid eye movement sleep, leaving you feeling unrested even after sleeping.
Consequently, reflux esophagitis triggers insomnia, and insomnia worsens reflux esophagitis symptoms, creating a vicious cycle. This is because sleep deprivation can increase gastric acid secretion and elevate esophageal hypersensitivity, making reflux symptoms even more severe. Breaking this cycle and finding true peace for our bodies is now vital.
