07 Nov Wedge Pillows and Night-Time Reflux
Sleeping on an incline is one of the more commonly suggested measures for night-time acid reflux, and it works on a straightforward principle. It is also a symptom measure rather than a diagnosis.
The Principle
Reflux is stomach contents moving back up the oesophagus. Lying flat removes gravity from the equation entirely, which is why symptoms are frequently worse at night than during the day.
Raising the upper body puts gravity back on your side. Guidance on reflux commonly includes elevating the head of the bed for exactly this reason.
The Other Measures
- Avoiding food in the two to three hours before lying down
- Identifying and reducing personal trigger foods
- Sleeping on the left side, which several studies suggest helps
- Avoiding alcohol close to bedtime
- Weight management, where relevant, which has good evidence behind it
A wedge is one component of that list rather than a replacement for it. Wedges in the six-to-eight-inch range with washable covers, of the kind at xtreme-comforts.com, are aimed at this use alongside general propping.
Elevate the Torso, Not the Head
The point most people get wrong. Stacking ordinary pillows bends the neck and folds the body at the waist, which can increase abdominal pressure and make reflux worse rather than better.
What is wanted is a gradual incline from the hips upward, which is what a wedge provides. A wedge of around six to eight inches is a common starting point.
Raising the whole head of the bed on blocks achieves the same thing and suits some people better.
When It Is Not Reflux
The important part. Chest pain should never simply be assumed to be heartburn.
Cardiac symptoms can present very similarly, and chest pain that is severe, crushing, spreading to the arm, neck or jaw, or accompanied by breathlessness, sweating or nausea requires emergency medical attention immediately.
People do delay calling for help because they assume indigestion, and that delay matters.
Symptoms That Need Assessment
Persistent reflux is worth having properly assessed rather than managed indefinitely with a pillow.
Difficulty swallowing, food sticking, unintentional weight loss, vomiting blood or black stools, or symptoms that are new in someone over a certain age all warrant prompt medical advice. Long-standing untreated reflux can cause changes to the oesophagus.
Getting Used to It
Sleeping on an incline feels strange for several nights and many people slide down during the night.
A wedge that extends far enough down the torso helps, and a pillow under the knees reduces sliding.
Not for Infants
Stated plainly because it matters. Sleep positioners and wedges are not recommended for babies, and there have been infant deaths associated with them.
Safe sleep guidance is consistent: a firm flat surface, on the back, with nothing else in the cot.