At one point or another, everyone's been shaken from sleep by a nightmare or an intense urge to pee. But waking from a deep slumber because you got the hiccups while sleeping? That might have you wondering what's up with your body.
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Hiccups happen when your diaphragm (your major breathing muscle that sits below your ribcage, separating your chest and stomach) suddenly and involuntarily contracts, according to the Mayo Clinic. In response, your vocal cords shut, generating the typical hiccup noise.
But why the heck are hiccups hampering your zzzs? We spoke to gastroenterologist Elena A. Ivanina, DO, MPH, to understand why you can get hiccups while sleeping, plus how you can prevent them from becoming, well, a hiccup to hitting the hay.
If your hiccups won’t go away after 48 hours, visit your doctor. While an occasional case of hiccups is no cause for concern, hiccups that are intractable (i.e., lasting more than 30 days) or frequently affect your quality of life may be a symptom of a more serious health problem, Dr. Ivanina says.
1. You Have GERD
Your nightly hiccups could be a symptom of gastroesophageal reflux disease (GERD), a condition that happens when stomach acid frequently streams back into the esophagus (the tube that connects your mouth and stomach).
When acid washes back into your esophagus, it not only causes irritation in the lining of the food pipe, but also in the nearby diaphragm, Dr. Ivanina says. And this can trigger hiccups.
Per the Mayo Clinic, in addition to hiccups and disrupted sleep, other symptoms of GERD may include:
- A burning sensation in your chest called heartburn, usually after eating, which might be worse at night
- Chest pain
- Difficulty swallowing
- Regurgitation of food or sour liquid
- Sensation of a lump in your throat
- Chronic cough
- New or worsening asthma
Fix it: If your hiccups stem from GERD, the best way to prevent them is by treating the root problem. Talk to your doctor, who can appropriately assess you and provide a proper course of treatment.
According to the Mayo Clinic, the following lifestyle changes can help curb GERD for some people:
- Lose weight if you have overweight
- Stop smoking
- Elevate the head of your bed
- Don't lie down for about three hours after a meal
- Eat food slowly and chew thoroughly
- Avoid foods that trigger reflux, including fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion and caffeine
- Avoid tight-fitting clothing
Still, others may find reflux relief with over-the-counter or prescription antacids that help neutralize stomach acid.
2. You’re Eating or Drinking Near Bedtime
Snacking too close to lights out can lead to hiccups in the middle of the night.
Here's why: It typically takes a couple hours for food to be digested and leave your stomach, per the Cleveland Clinic. During digestion, food distends the belly, which also produces more acid to break it down.
When someone lies down or goes to sleep before this process is finished, all the food and acid remain in the stomach, and may even travel up into the esophagus, causing reflux. This can disrupt the diaphragm, producing hiccups, Dr. Ivanina says.
What's more, certain types of food and drink — including spicy dishes and alcohol — can irritate the diaphragm and esophagus and increase your odds of developing hiccups.
Fix it: Limit food and drink — especially peppery plates and liquor — at least four hours before you hit the sheets.
Though it may feel like it's easier to fall asleep when you drink alcohol before bed, alcohol actually leads to more disrupted slumber.
3. You’re a Smoker
Puffing on cigarettes can produce sleep-hampering hiccups, too.
Smokers are susceptible to hiccups because they're swallowing a lot of air with each drag and distending the stomach, according to Texas A&M Health.
And whenever your belly expands excessively, it can lead to spasms in the neighboring diaphragm.
Fix it: Kick the habit and quit smoking. Here are some strategies to consider:
- Stress reduction
- Social support
- Prescription medication
The American Lung Association’s Freedom From Smoking program supplies tips and support to help you quit (and it’s free).
4. You’re Taking Certain Medications
If you can't seem to shake the hiccups during sleep, you might look to your medicine cabinet for the culprit. Yep, certain medications may cause hiccups via various mechanisms, like if they affect the phrenic nerve or vagus nerves (which serve the diaphragm), Dr. Ivanina says.
For example, barbiturates, steroids and tranquilizers can lead to long-term hiccups, according to the Mayo Clinic.
Fix it: If you think your meds are meddling with you in the hiccup department, speak to your doctor, who may be able to prescribe you a different drug or dosage.
5. You Have an Ear Infection
Believe it or not, ear infections are a common cause of hiccups.
That's because when you have an infection, the tympanic membrane in your ear (also called your eardrum) becomes irritated, according to Texas A&M Health. The same type of irritation can also occur if a hair makes its way inside your ear and tickles your tympanic membrane.
This irritant can cause damage to the nerves that supply the diaphragm (like the phrenic or vagus nerve), which, as we know, can bring on a bout of hiccups, per the Mayo Clinic.
According to the Cleveland Clinic, other telltale signs of an ear infection include:
- Ear pain
- Loss of appetite
- Poor sleep
- Drainage from the ear (yellow, brown or white fluid)
- Trouble hearing
Fix it: Once again, treating the primary cause is the best way to get rid of hiccups. See your doctor, who may prescribe you an antibiotic to eradicate the ear infection.
Don't attempt to remedy an earache by sticking cotton swabs inside your ear to clean the affected area — this can push earwax further in or damage sensitive tissue, per Cedars Sinai, all of which can make your ear pain worse.
6. You Have Another Underlying Medical Issue
While rare, hounding hiccups during bedtime may be an indicator of another serious medical issue.
For example, physical problems that irritate the nerves in the chest, including laryngitis, goiters (enlargement of the thyroid gland), tumors in the neck, infections near the diaphragm and hiatal hernia can result in regularly occurring hiccups, according to Harvard Health Publishing.
In addition, tumors, infections or damage to your central nervous system can also affect your body's ability to handle the hiccup reflex, per the Mayo Clinic. That's why conditions such as encephalitis, meningitis, multiple sclerosis, stroke or traumatic brain injury can cause recurrent hiccups.
Fix it: If your hiccups are hanging around and disrupting your quality of life, visit your doctor, who can perform a thorough examination to rule out any serious underlying medical disorders.
Can You Die From Hiccups While Sleeping?
There's no evidence to show that getting a case of the hiccups overnight can lead to death. But if you notice your hiccups are accompanied by other symptoms, talk to your doctor to see if you may have an underlying condition that needs taking care of.
Other Tips to Manage Hiccups
Sometimes, despite your best attempts to avoid hiccups while sleeping, they still creep up on you. When that happens, try the following techniques to help stop hiccups in their tracks, per the Cleveland Clinic:
- Drinking water quickly
- Swallowing granulated sugar, dry pieces of bread or crushed ice
- Gently pulling on your tongue
- Gagging (sticking a finger down your throat)
- Gently rubbing your eyeballs
- Gargling water
- Holding your breath
- Breathing into a paper bag (do not use a plastic bag)
- Mayo Clinic: “Hiccups”
- Cleveland Clinic: “Hiccups”
- Texas A&M Health: “You Asked: What Are My Hiccups Telling Me?”
- Mayo Clinic: “Gastroesophageal reflux disease (GERD)”
- Cleveland Clinic: “Ear Infection (Otitis Media)”
- Harvard Health Publishing: “What’s up with hiccups?”
- Cedars Sinai: "Is It Really Dangerous to Clean My Ears with Cotton Swabs?"
- American Lung Association: "I Want To Quit Smoking"
- Cleveland Clinic: "How Long Does It Take to Digest Food"