The Single Most Important Advice I Give To Patients

The New York Times confirmed what I’ve been telling patients for years—that eating within 3-4 hours of bedtime can promote acid reflux. What the journalist didn’t mention was the fact that acid reflux and obstructive sleep apnea go hand in hand. Here’s what I wrote in reply to his article:

Having heartburn at night also means that you’re at risk of stomach juices reaching your throat, which not only has acid, but bile, digestive enzymes, and bile. In light of the fact that about 10 to 25% of the population has at least some sleep apnea (the majority in the elderly in some studies), any pauses in breathing will literally suction up your stomach juices into your throat, causing not only arousals, but also swelling and inflammation, leading to post-nasal drip, chronic throat clearing, chronic cough, and even Eustachian tube dysfunction. 

The more often you stop breathing at night, the more you’re likely to suction up stomach juices into your throat, which can also lead to desensitization of your  pressure and sensory nerve endings. Over time, this can lead to loss of protective upper airway reflexes, predisposing one to obstructive sleep apnea. In addition, vibratory trauma from snoring is thought to not only desensitize sensory nerve endings, but also cause carotid artery wall thickening.

Not eating late will also increase your sleep efficiency, which can promote weight loss. On the contrary, any degree of sleep deprivation or sleep inefficiency will promote weight gain. Gaining weight promotes more reflux and sleep apnea.

Counseling New Yorkers to avoid eating (and drinking alcohol) within 3-4 hours of bedtime is the simple most important recommendation I make, in addition to my routine treatment options.

Please note: I reserve the right to delete comments that are offensive or off-topic.

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