Avoid Lying Down After Eating with Heartburn

The Three Hour Lying Down Rule with Heartburn and More

man sleeping on couch on his right side, sleeping on left side better for heartburn
Why is it important to avoid lying down for three hours after eating to avoid nighttime heartburn?. Morsa Images/DigitalVision/Getty Images

Did you know that there is one simple rule you can follow to help prevent nighttime heartburn? Learn about the "lying down after eating rule" and what else you should know to not only to prevent this uncomfortable symptom but the complications it may cause.

Nearly 50 million people suffer from nighttime heartburn at least once a week. That's a lot of people and a lot of heartburn.

It also accounts for many hours of lost sleep that could result in an inability to perform adequately at work the next day. Yet it is very treatable.

The Three Hour Lying Down Rule for Preventing Nighttime Heartburn

Let's start with a simple rule for preventing nighttime heartburn, but then explain the reasons for this rule, what to do when you can't follow the rule, as well as other ways to reduce heartburn.

The rule for reducing nighttime heartburn: "Avoid lying down at least three hours after eating."

Why Does Lying Down Cause Heartburn?

There are a number of different mechanisms that lead to heartburn. Understanding these different mechanisms responsible for heartburn will help you understand the many measures you can take to reduce your discomfort.

One of these mechanisms is a full stomach. When you get into a horizontal position with a full stomach, the contents of your stomach push harder against the lower esophageal sphincter—the opening in your diaphragm through which your esophagus passes and which acts as a valve keeping what belongs in your stomach, in your stomach.

This bundle of muscles (the lower esophageal sphincter) tends to relax when you lay down.

Another way in which lying down after eating increases your chance of heartburn is that, in general, sleeping slows down your digestive system. What this means is that food which is present in your stomach stays put longer, at the same time you are in a prime position for the food to be refluxed up into your esophagus.

The pressure of lying down alone pushes stomach contents against the lower esophageal sphincter, but there are many conditions which, when combined with a full stomach can result in the contents of your stomach ending up in your esophagus even more than if you were to lie down on a full stomach alone. Some of these include:

  • Gastric motility disorders - Some conditions slow the emptying of the stomach, which, when combined with a full stomach, can cause heartburn to persist.
  • There are several medications which can cause heartburn. Take a look at this list and ask your doctor if any of these can be substituted if they contribute to your heartburn.

What if You Can't Avoid Lying Down After Eating?

Too tired to wait?

Must. Get. Sleep.

It happens. If you must lie down within three hours of eating (or even longer if you have a digestive motility disorder), find a way to keep your head above your stomach.

Resting on an incline works much better than just grabbing an extra pillow or two. Creating an incline by stacking blocks, planks, or bricks under the head of your bed is ideal. This allows you to use gravity to diminish your gastric reflux. Other options include purchasing bed aids or a wedge pillow.

These so-called "positional therapy devices" can significantly decrease nighttime acid reflux symptoms.

Another way to combat nighttime heartburn is to consider your sleeping position. Sleeping on your left side may be better for your digestive health. Specifically, studies have shown that this will help aid in digestion and reduce stomach acid compared to right-side sleeping.

Other Ways to Reduce Nighttime Heartburn

How you sleep and when you fall asleep are not the only ways to prevent nighttime heartburn. Other considerations that may help reduce your symptoms include:

Make Sure It's Heartburn

It's important to point out that the symptoms we refer to as heartburn may have caused other than acid reflux. For example, heart disease in women often has different symptoms than heart disease in men, and one of these symptoms is the experience of burning in the chest. Talk to your doctor about your symptoms. If your symptoms are persisting, speak up. Get a second opinion if you still lack answers.

Bottom Line on Lying Down and Heartburn

Heartburn can be a literal pain, but there are many things you can do to reduce both your symptoms and the complications related to chronic acid reflux. As a quick review, make sure to check out these top 10 tips and lifestyle measures to ease nighttime heartburn.


Allampati, S., Lopez, R., Thota, P., Ray, M., Birgisson, S., and S. Gabbard. Use of A Positional Therapy Device Significantly Improves Nocturnal Gastroesophageal Reflux Symptoms. Diseases of the Esophagus. 2016 Sep 15. (Epub ahead of print).

Johnson, D., Le Moigne, A., Li, J., Pollack, C., and P. Nagy. Analysis of Clinical Predictors of Resolution of Sleep Disturbance Related to Frequent Nighttime Heartburn and Acid Regurgitation Symptoms in Individuals Taking Esomeprazole 20 mg or Placebo. Clinical Drug Investigations. 2016. 36(7):531-8.

Ness-Jensen, E., Hveem, K., El-Serag, J., and J. Lagergren. Lifestyle Intervention in Gastroesophageal Reflux Disease. Clinical Gastroenterology and Hepatology. 2016. 14(2):175-82.e1-3.