Woman Sleeping With Stomach Pain.

Is Sleeping on a Full Stomach Bad? (Doctor’s Verdict)

by
Dr-Babar-Naeem.

This article was written by Dr. Babar Naeem (MBBS, MRCPCH) – a licensed and practicing medical doctor – to ensure maximum factual accuracy and unique content.

I often find myself having my main meal late at night just before bed due to work commitments.

But is sleeping on a full stomach bad for you or not?

Sleeping on a full stomach is bad because it can cause acid reflux which can lead to GERD (Gastroesophageal Reflux Disease) – which can stop you from getting to sleep due to heartburn, and may lead to the condition called Barrett’s esophagus – which can cause esophageal cancer in around 1% of GERD cases.

So is it better to sleep on an empty stomach?

Sleeping on an empty stomach is bad because it can lower blood sugar levels and cause you to wake up or not be able to get to sleep. Instead, consume a moderately sized meal that doesn’t contain a lot of fat 3 hours before lying down to help stabilize blood glucose and prevent hunger pangs.

But what if you have no choice but to sleep on a full stomach – what’s the best sleeping position?

The best position to sleep in on a full stomach is on your left side to aid with digestion, or on your back with your head elevated using pillows or an adjustable bed. Avoid sleeping on your right side or stomach as this can make acid reflux and heartburn worse.

In the rest of this article, I have used my medical knowledge and access to scientific literature in combination with my professional experience as a practicing medical doctor to explain in more detail the pros and cons of sleeping on a full stomach.

Related: click here to see the best adjustable beds to stop acid reflux at night.

5 Reasons Why Sleeping on a Full Stomach is Bad

Why Is Late Night Eating Bad For You?

Below are the 5 main reasons why sleeping on a full stomach is bad for you:

1: Gastroesophageal Reflux Disease (GERD)

Going to bed on a full stomach can increase the chance of Gastroesophageal Reflux Disease (GERD) – which is characterized by heartburn, acid reflux, and food regurgitating – because a full stomach makes it more likely that digestive juices and food will move back into the esophagus.

This is because when you are standing, gravity helps keep food in your stomach, but when you are lying down, the beneficial effect of gravity is lost, and food can regurgitate back into the esophagus – resulting in acid reflux and GERD.

This produces epigastric burning, nausea, and a sensation of discomfort.

If we eat a large meal just before going to bed, the chances of getting gastroesophageal reflux are increased because a full stomach forces the food contents to move back into the food canal.

The second reason for increased chances of GERD when sleeping on a full stomach is the relaxation of the lower gastroesophageal sphincter (LES).

The LES controls the movements of food into the stomach and prevents backward movement.

At night, the LES relaxes and allows the regurgitation of food back into the esophagus.

A study conducted by researchers in Brazil in 2011 showed that GERD frequency could increase up to seven times after dinner, and symptoms could last from 30 to 60 minutes after the meal.

This is due to the formation of small pockets of gastric acid in some parts of the stomach [2].

Solution: Avoid Eating Within 3 Hours of Bed Time and Sleep On Your Left Side

The best solution to this problem is to avoid eating late – allow a good 3 hours to pass before you lie down.

Furthermore, you should sleep in the left lateral position with your head elevated to the point of good posture with a comfortable pillow to minimize the chances of reflux.

It would also be beneficial to avoid caffeine, alcohol, and nicotine to prevent digestive upset.

If symptoms are not controlled with these simple lifestyle measures, you should consult a doctor for the prescription of antacids, proton pump inhibitors, or histamine blockers.

Click here for 11 ways to sleep better with GERD and acid reflux.

2: Esophageal Cancer

The stomach and esophagus are not just different parts of the same structure but are designed to perform different functions.

The stomach is exposed to acidic pH all the time, and hence has a more resistant type of epithelial lining.

This lining is called the mucus columnar epithelium, and it protects the stomach from the acid.

The esophagus is designed to move the food to the stomach and has a different type of epithelium, called the stratified squamous epithelium.

When we sleep immediately after eating, the chances of food moving back to the esophagus increase.

The sensitivity of the esophagus to the acid is also increased while sleeping.

Sleeping on a full stomach for a few days causes minor problems, such as heartburn, nausea, and indigestion – however, if this habit is continued for a more extended period of time, the superficial lining of the esophagus is altered, in order to protect it from the acid.

The superficial lining of the esophagus becomes columnar (typically found in the stomach), which is called Barrett’s esophagus.

Although this change in the lining is to adapt to the stomach acid, Barrett’s esophagus carries the risk of developing into esophageal cancer [3] – the risk of developing esophageal cancer is less than 1% in patients with GERD.

But GERD is very prevalent in the western world, and about 30% of people in the USA have GERD symptoms.

So even the low incidence of cancer can considerably impact the population if left unchecked [4].

Solution: Consult Your Doctor and Change Your Diet

The best solution for tackling this deadly problem is through prevention.

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), dietary changes, like decreasing fat intake, eating small, frequent meals, and avoiding caffeine are the best strategies.

If you have had symptoms of GERD for a long time, you should discuss with your doctor for the screening of Barrett’s esophagus.

If Barrett’s esophagus is detected at earlier stages, it can be managed easily, and the risks of cancer can be minimized.

Check out the best sleeping positions if you have a stomach ulcer here.

3: Poor Digestion

If you eat a large meal immediately before going to bed, the proper digestion of the food is impaired.

The relationship between sleep and the digestive system is very complex.

Although the digestion time of various food is different, the stomach needs about 3-6 hours, on average.

Fast and fried foods take more time to digest and tend to produce stomach upsets.

The digestive system works best when you are in an upright position, and slows down when you sleep.

During sleep, swallowing movements, peristalsis, and saliva production decrease, and acid production increases.

Food stays for more time in the stomach, and digestion is impaired [5].

Digestion problems disrupt sleep quality, and sleep deprivation further worsens gastrointestinal problems.

Research conducted by the Canadian Society of Intestinal Research showed that insomnia increases the risks of functional dyspepsia, irritable bowel syndrome, and GERD [6].

Solution: Sleep On Your Left Side

To solve these problems, you should sleep on your left side – or your back if you can’t sleep on your side.

Avoid eating late, eat a moderately sized meal, and wait for a few hours before going to bed.

These are the essential components of solving this problem.

Regular exercise, relaxation techniques, and sleep hygiene practices are also helpful.

Try these 6 ways to sleep better with stomach pain.

4: Weight Gain

Sleeping immediately after having a large meal is a predisposing factor for gaining weight.

One of the most obvious reasons is that eating more calories than required will result in weight gain.

Physical activity burns calories, while lying down slows the consumption of calories.

When we go to sleep with a full stomach, the consumption of energy lessens, and all the calories of the food are absorbed, adding weight.

Another interesting aspect of eating late, explored by the scientists, is that people who eat late tend to eat more.

This research was conducted in 2008, in collaboration with the National Institute of Diabetes and Digestive and Kidney Diseases, NIH.

And the results of the study showed that people who ate late at night consumed 500kcal more than the average individual, and gained 5 kilograms more weight [7].

Type of food, and the number of calories, are not the only reasons for gaining weight.

Studies have shown that eating a normal amount of calories at a specific time can result in weight gain.

This is due to the internal clock, or circadian rhythm, that tells the body that nighttime is for rest.

When we go against the circadian rhythm, the normal function of the body is disrupted.

This theory was tested by researchers at the Center for Sleep and Circadian Biology, Northwestern University, Evanston, USA.

They divided mice into two groups; one group was fed in opposition to the circadian rhythm, and the other was fed in waking hours.

Although the food provided was similar in both groups, the mice that ate against their circadian rhythm gained more weight [8].

Solution: Eat No Later than 9PM

The best solution that I recommend for avoiding gaining excessive weight is to eat before 9 PM – with at least 3 hours clearance before you go to bed.

Consumption of desserts, junk foods, and snacks should be avoided at night.

Regular physical activity should be encouraged.

Try these 10 ways to stop sleep apnea from causing weight gain.

5: Sleep Disturbance

Sleep disturbance can result for a number of reasons when sleeping on a full stomach.

Heartburn, chest pain, nausea, regurgitation, and dyspepsia can make sleeping very difficult.

When the stomach is full, the focus of the body is to digest the food.

This is achieved by activating specific nerves that result in failure to relax.

Recently published research confirmed that sleep disturbance is much more common in patients with acid regurgitation, abdominal pain, and digestive problems [9].

Solution: Allow 3 Hours for Your Food to Settle Before Lying Down

Dinner should be eaten at least three hours before going to bed, and sleep hygiene practices should be followed.

Food and drugs that interfere with sleep should be discontinued.

Click here for 6 ways to sleep better with a stomach ulcer.

3 Pros of Sleeping on a Fuller Stomach

While sleeping on a full stomach can create many problems, sleeping on an empty stomach is not a good idea either.

Most of the problems from sleeping on a full stomach are caused by having a large meal, and immediately going to bed afterwards.

If you are sleeping hungry, your mind will keep you alert because of the hunger.

Even if you manage to sleep, nighttime hypoglycemia may wake you.

Moderation is always the key, and you can enjoy maximum benefits by eating a moderate-sized meal 3-4 hours before going to bed.

Some of the benefits of sleeping with a full stomach (but not overly distended, and not sleeping immediately after eating) are described below.

1: Stable Glucose (Less Nightmares and Sleep Disturbance)

When the glucose level in the blood falls below 60mg/dl at night, this condition is called nocturnal hypoglycemia.

This can cause irritability, trembling, palpitations, nightmares, and sleep disturbances.

This phenomenon is widespread among individuals who sleep on an empty stomach, especially if they have diabetes, have some infection, take alcohol, or exercise before bedtime [10].

Nocturnal hypoglycemia is a serious problem for patients with specific diseases, like glycogen storage disease, or fatty acid oxidation defects.

Having a good-sized meal in the evening provides enough glucose to last through the night.

So sleeping on a fuller stomach stabilizes the glucose levels for the night, and prevents hypoglycemia-associated problems.

Click here for 10 ways to sleep better if you exercise late at night.

2: Curb Late-Night Snack Cravings

A late-night craving for snacks is an under-recognized problem and can have many health detriments.

If you go to bed on an empty stomach, the sugar levels in the body will drop in the night, resulting in a craving for food.

This can also be induced by emotional factors, such as anger, frustration, and boredom, as well as eating disorders.

Problems caused by the nighttime craving for food include sleep disturbance, dyslipidemia, obesity, and poor performance [11].

When we sleep on a fuller stomach, there are almost no chances of having nighttime hypoglycemia, and the craving for food at midnight is decreased.

Discover the 8 dangers of sleeping in headphones here.

3: Better Sleep

Sleep is a very complex process and is affected by overeating, as well as under-eating.

If you go to bed on an empty stomach, it will not be possible to enjoy good quality sleep, due to hunger, hypoglycemia, and cravings for food.

Having a healthy meal about three hours before going to bed is very important, in order to have a peaceful and uninterrupted night’s sleep.

Find out if sleeping in AirPods can cause cancer here.

How to Sleep on a Full Stomach Comfortably

Getting an adequate amount of sleep is essential for our health.

Sleep deprivation can exacerbate all the problems caused by sleeping on a full stomach.

There are many other simple things that you can do the prevent the problems of sleeping on a full stomach.

1: Sleep On Your Left Side to Stop Acid Reflux

Sleeping on your left side is the best position when sleeping on a full stomach because it minimizes the chances of acid reflux, regurgitation of food, Barrett’s esophagus, and nausea.

When you sleep in this position, the esophagus is above the stomach, and gravity works in your favor to keep food in the stomach.

Although sleeping on the right side seems similar, studies have demonstrated that this position can worsen heartburn and GERD.

If you are unable to sleep on your left side, because of some medical condition, the other best sleeping position is on your back [12].

Here are the 10 most common causes of morning hiccups.

2: Elevate Your Head

Elevating your head by 15-30 degrees (6 to 9 inches) can help to aid digestion and prevent acid reflux when sleeping on a full stomach.

This is because gravity will help move the food forward into the intestines and prevent any backward movement into the esophagus.

Stomach acid will not be able to reach the esophagus, and the risks of Barrett’s esophagus and esophageal cancer will be decreased.

This can be achieved by placing pillows or cushions under your mattress or by using an adjustable bed (which is safer for your neck and more comfortable).

Please remember that elevating the bed to more than 30 degrees can strain the neck and back muscles, and cause more harm than good.

Click here to see the best adjustable beds to help prevent acid reflux.

3: Use an Adjustable Bed

An adjustable bed is an excellent option for patients sleeping on a full stomach.

Elevating the head end can be achieved easily, without pillows or cushions.

You can adjust the sleeping position for your comfort with these beds.

Although adjustable beds seem costly, investing in your health is always the best choice – especially if you have other conditions like sleep apnea or snore a lot.

You could eventually end up spending more money on your health conditions, which could be easily prevented by using an adjustable bed.

Click here to see the best adjustable beds to help with nighttime digestion.

4: Wait for Three Hours Before Going to Bed

The digestion times of different foods vary.

Some foods like white rice, noodles, pasta, low-fat milk, and low-fat cheese are cleared rapidly from the stomach.

In contrast, foods with a high-fat content stay in the stomach for a longer period of time.

So the ideal time a person should wait before going to bed after having a full meal depends on the types of food consumed.

However, most doctors recommend waiting for at least three hours before going to bed, to decrease the chances of heartburn and digestion problems.

This is known as the three-hour rule and should be followed daily.

Try these 10 ways to sleep better using lavender.

5: Avoid Large Meals at Bedtime

If it is not possible for you to wait three hours before going to bed, then the best advice is to eat light.

I always recommend my patients avoid eating three large meals a day.

Instead, it is a better option to eat smaller meals more frequently.

This eating behavior reduces the risks of acid reflux and dyspepsia because it’s easier for the digestive system to handle small meals.

Here are 9 ways to sleep better with a fever.

6: Aerobic Exercise

Regular exercise benefits the body’s overall health, and quality of sleep.

If you have a full stomach, the best idea is a light aerobic exercise – like walking for one to two blocks, or light stretching.

Please keep in mind that doing heavy exercise at night can disrupt normal digestion, by diverting blood flow from the gut to the exercised muscles, and cause sleep disturbance.

Find out if hot chocolate really can help you sleep better or not here.

7: Drink Water

Eating a sizeable meal can reduce water intake which may lead to feeling thirsty at night – especially if you eat a lot of salt.

So I always advise my patients to stay hydrated.

This will reduce the total calories taken in, and help with the absorption of the food.

Carbonated beverages can have the opposite effect, and cause more harm than good.

If you are worried that you will have to wake up at night to urinate, then the best idea to stay hydrated is to drink plenty of water during the day.

Find out if Tylenol can keep you awake here.

Conclusion: Eat a Moderate-Sized Meal 3 Hours Before Bed

Rather than going to bed on a full or empty stomach, eat a moderately sized meal 3 hours before lying down to go to sleep.

Hydration, regular light exercise, and avoidance of caffeine are also helpful.

If you are sleeping on a full stomach, the recommendation is to sleep on your left side, or on your back with an elevated head.

Up next: 13 memory foam mattress problems solved.

References

[1] T. A. Yasuhiro Fujiwara, Ai Machida, Yoko Watanabe, Masatsugu Shiba, Kazunari Tominaga, Toshio Watanabe, Nobuhide Oshitani, Kazuhide Higuchi, “Association between dinner-to-bed time and gastroesophageal reflux disease,” Am J Gastroenterol, DOI: 10.1111/j.1572-0241.2005.00354.x.

[2] F. A. M. Herbella, F. P. P. Vicentine, L. C. Silva, and M. G. Patti, “Postprandial proximal gastric acid pocket and gastroesophageal reflux disease,” Dis. Esophagus, vol. 25, no. 7, pp. 652–655, Oct. 2012, doi: 10.1111/j.1442-2050.2011.01293.x.

[3] S. Bhat et al., “Risk of malignant progression in Barrett’s esophagus patients: results from a large population-based study,” J. Natl. Cancer Inst., vol. 103, no. 13, pp. 1049–1057, Jul. 2011, doi: 10.1093/jnci/djr203.

[4] T. Yamasaki, C. Hemond, M. Eisa, S. Ganocy, and R. Fass, “The Changing Epidemiology of Gastroesophageal Reflux Disease: Are Patients Getting Younger?,” J. Neurogastroenterol. Motil., vol. 24, no. 4, pp. 559–569, Oct. 2018, doi: 10.5056/jnm18140.

[5] V. Khanijow, P. Prakash, H. A. Emsellem, M. L. Borum, and D. B. Doman, “Sleep Dysfunction and Gastrointestinal Diseases,” Gastroenterol. Hepatol. (N. Y)., vol. 11, no. 12, pp. 817–825, Dec. 2015, [Online]. Available: https://pubmed.ncbi.nlm.nih.gov/27134599.

[6] “Sleep,” Canadian society of intestinal research, 2008. https://badgut.org/information-centre/a-z-digestive-topics/sleep/ (accessed Jan. 19, 2022).

[7] M. E. Gluck, C. A. Venti, A. D. Salbe, and J. Krakoff, “Nighttime eating: commonly observed and related to weight gain in an inpatient food intake study,” Am. J. Clin. Nutr., vol. 88, no. 4, pp. 900–905, Oct. 2008, doi: 10.1093/ajcn/88.4.900.

[8] D. M. Arble, J. Bass, A. D. Laposky, M. H. Vitaterna, and F. W. Turek, “Circadian timing of food intake contributes to weight gain,” Obesity (Silver Spring)., vol. 17, no. 11, pp. 2100–2102, Nov. 2009, doi: 10.1038/oby.2009.264.

[9] M. K. Hyun, Y. Baek, and S. Lee, “Association between digestive symptoms and sleep disturbance: a cross-sectional community-based study,” BMC Gastroenterol., vol. 19, no. 1, p. 34, 2019, doi: 10.1186/s12876-019-0945-9.

[10] “Hypoglycemia: Nocturnal,” John Kopkin Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/diabetes/hypoglycemia-nocturnal (accessed Jan. 20, 2022).

[11] J. Yoshida, E. Eguchi, K. Nagaoka, T. Ito, and K. Ogino, “Association of night eating habits with metabolic syndrome and its components: a longitudinal study,” BMC Public Health, vol. 18, no. 1, p. 1366, Dec. 2018, doi: 10.1186/s12889-018-6262-3.

[12] D. O. C. L C Katz , R Just, “Body position affects recumbent postprandial reflux,” doi: 10.1097/00004836-199406000-00004.

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