Gastroesophageal Reflux Disease: The Impact of Mood and Sleep

Most people get relief from their gastroesophageal reflux disease (GERD) symptoms by making lifestyle changes and taking medicines and/or nutritional supplements. 

Even with the best of treatments, you may still have symptoms. One of the reasons is the impact of other factors on your GERD symptoms.

GERD

GERD, or acid reflux, is a long-term (chronic) condition affecting the gastrointestinal (GI) tract.  With GERD, stomach contents flow back into your esophagus. 

Occasional reflux is normal - with GERD, the reflux lasts longer and irritates your esophagus. Common symptoms are heartburn, regurgitation (the backflow of stomach contents into the esophagus), sour taste in the mouth, and chest discomfort. 

Relationship between GERD, Mood, and Sleep

Many medical problems are affected by other factors like mood (anxiety, depression, etc.) and sleep. GERD is just one of them. 

The diagram shows you how all three affect each other. Mood and sleep affect GERD, GERD symptoms impact both mood and sleep, and mood and sleep affect each other.

Your Mood (Anxiety and Depression) and GERD

For a moment, think about your GERD symptoms. When you’re able to manage them, how do you feel? What is your mood like? If you feel anxious, down, or depressed, do your feelings affect your GERD symptoms?

The Brain-Gut Connection

The brain-gut or gut-brain connection is a very complicated communication system between the brain and the GI system, where the enteric nervous system (the part of the nervous system that is located in the lining of the GI tract) is located. In this 2-way system, your mood affects the GI system and the GI system affects your mood.

When this connection is not working well, your mood may lead to a worsening of your GERD symptoms. The opposite is also true - your GERD symptoms may contribute to an unhealthy mood, increasing anxiety and/or depression symptoms. Additionally, you may be overly sensitive to your GERD symptoms and experience more intense symptoms. This may contribute to increased anxiety, etc.

Study results support the effect of mood on GERD - i.e. the brain on the gut. They’ve found that anxiety and depression are much more common in people with GERD. 

Studies also demonstrate how GERD symptoms impact the brain - i.e. the gut on the brain. Long-term GERD symptoms increase stress and may lead to feeling anxious, down, or depressed (especially if symptoms aren’t relieved by treatment).

Your Sleep and GERD

How do you sleep when your GERD symptoms increase? Do you wake up with heartburn? On the other hand, if you don’t sleep well do your GERD symptoms worsen? Are you tired the following day? Do you find it difficult to cope with your GERD symptoms?

You’re not alone if GERD interferes with sleep and if poor sleep affects your GERD symptoms. People with trouble sleeping are more likely to develop night-time (nocturnal) GERD. And, it is more common for those with GERD to have trouble sleeping.

Mood and Sleep

Mood and sleep also impact each other. Anxiety and depression may make it difficult to sleep. Trouble sleeping is also likely to worsen symptoms of anxiety and depression. 

Treatment for GERD

You may take medicines like a proton pump inhibitor (PPI), H2 blocker, or antacid to manage or lessen your GERD symptoms. You may also take nutritional supplements or herbal products, like deglycyrrhizinated licorice extract (DGL), or drink chamomile tea.

GERD treatment also includes lifestyle changes that relieve symptoms. You can elevate your upper body when sleeping, allow 2 to 3 hours between eating and going to bed, and avoid those foods that cause heartburn or other GERD symptoms. 

These treatments usually provide relief. However given the impact of mood and sleep on GERD, a broader approach may even be better. 

Treatment for Mood and Sleep

If you do have symptoms of anxiety and/or depression or trouble sleeping, whether or not they’re related to GERD, treating the conditions can help lessen your GERD symptoms.

One of the primary treatments for anxiety, depression, and sleep problems is psychotherapy also called talk therapy. One specific type is cognitive behavioral therapy - CBT (which can also help you with GERD). 

CBT focuses on the interaction between your thoughts, feelings, and behaviors. It can help you understand and change thoughts, feelings, and behaviors that negatively affect symptoms (e.g. anxiety, depression, trouble sleeping, GERD, etc.). 

Managing anxiety, depression, or sleep problems may also include other mind-body techniques like yoga, meditation, and relaxation. Over-the-counter (OTC) medicines and nutritional supplements may also lessen symptoms. Lifestyle changes may also be part of your care.

You may also receive care from your doctor or a specialist. They may order tests, provide therapy, recommend supplements, or prescribe medications/other therapies.

Key Points

  • The relationship between GERD, mood, and sleep is complicated. 

  • Treatment of GERD may focus on relieving symptoms.

  • Addressing mood and sleep problems may be part of GERD treatment.