Nighttime Nausea

Nausea is the feeling of having to throw up; it sometimes leads to vomiting, but not always. It's not pleasant at any time of day, but it can be especially bothersome at night, when you’re trying to sleep.

Nausea is a common symptom of a variety of conditions. If you are having unexplained nausea, it’s a good idea to see your healthcare provider to explore what may be causing it. The diagnosis will help guide treatment.

Read on to learn more about common reasons you might have nausea at night, and how to treat it.

Symptoms of Nighttime Nausea

Symptoms of nausea can include:

• Feeling like you’re going to throw up
• Excessive sweating
• Stomach pain
• Retching and dry heaves (making an effort to vomit but with nothing coming up)
• Vomiting
  

Causes of Nighttime Nausea

Nausea at night can occur for a variety of reasons. Knowing the underlying cause can help guide the treatment.

Pregnancy

Roughly 75% of people will experience nausea and vomiting while pregnant. It's often referred to as morning sickness, but nausea during pregnancy can occur at any time of the day. While the exact cause is unknown, hormonal changes such as rising human chorionic gonadotropin (HCG) a pregnancy hormone) levels are likely a factor.

The good news is that about 60% of people notice they're less nauseated by the end of the first trimester, and about 87% of people feel better by week 20.

If your nausea is severe enough that you can't keep any food down, call your healthcare provider immediately. They can evaluate you for hyperemesis gravidarum, a form of severe nausea and vomiting that can cause imbalances in fluids and electrolytes.

Anxiety

Anxiety is a normal reaction to stress. When you experience anxiety, your body releases hormones and other chemicals that can interfere with digestion and cause nausea. Chronic anxiety that has started to affect your quality of life is known as an anxiety disorder.

GERD

Gastroesophageal reflux disease (GERD) is when the muscle connecting the esophagus to the stomach is too relaxed. This causes acidic stomach fluids to flow back into the esophagus. The most common symptom of GERD is heartburn, which is usually marked by a burning sensation in the chest and irritation. GERD can cause nausea, too—especially when you’re lying down at night.

Peptic Ulcers

Peptic ulcers, also called stomach ulcers, are sores on your stomach lining. They can form due to:

• Long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as Advil or Motrin (ibuprofen), Aleve (naproxen), or aspirin
• Helicobacter pylori (H. pylori) infection
• Zollinger-Ellison syndrome, in which rare tumors (both cancerous and benign) form on the stomach, duodenum, or pancreas

The most common symptom of a peptic ulcer is a dull, burning pain in the stomach, especially when the stomach is empty, like at night. But you may also experience nausea, vomiting, weight loss, and bloating. These symptoms can come and go for days or even months.

Medication Side Effects

Many over-the-counter (OTC) and prescription medicines can cause nausea, some of which are:

• Antibiotics
• Antidepressants
• NSAIDs
• Chemotherapy (cancer medicines)
• Opioid pain medications
• Vitamins and supplements

Gastroparesis

Gastroparesis (delayed gastric emptying) is a condition in which the movement of food from the stomach to the small intestine is slowed or stopped. Symptoms can include nausea, vomiting, bloating, burping, heartburn, lack of appetite, and feeling full soon after eating or feeling full for a very long time.

When to See a Healthcare Provider

If you have persistent nausea for no apparent reason and it's not responding to any OTC treatments, call your healthcare provider.

You should also call your healthcare provider if you’ve thrown up three or more times in 24 hours, cannot keep fluids down, or have been vomiting for more than a day.

Natural Remedies

Some at-home remedies may help relieve or minimize your nausea. Ask your healthcare provider before using any of these.

Ginger Tea

Ginger has been used for centuries as an herbal medicine, particularly for gastrointestinal (GI) issues. It has anti-vomiting properties, and it can also help improve digestion. Ginger comes in many forms, including supplements, candies, and tea.

Peppermint

The main ingredients in peppermint, menthol and methyl salicylate, have calming effects on the GI tract. A product like peppermint tea or peppermint candies may help your nausea. If you have GERD, however, you should not use peppermint.

Bland Food

When you have an upset stomach, it's often suggested that you eat a bland diet known as the BRAT diet: bananas, rice, applesauce, and toast. These foods give you nutrients without irritating your stomach.

Other bland foods can be added to the diet as well, like clear soup broth, plain potatoes, and saltine crackers. Fatty foods, sugars, and dairy should be avoided until you’re feeling better. Clear liquids or electrolyte beverages are also recommended, especially if you’ve been vomiting.

Rest

Nausea can be exhausting, so it’s important to get rest. If lying down makes your nausea worse, try resting with your head or upper body elevated.

How to Treat Nighttime Nausea

Once you know the underlying cause of your nighttime nausea, you can then treat it appropriately.

Pregnancy

The first-line treatment for pregnancy-associated nausea is smaller meals with low-fat, bland foods. Avoiding heavy, greasy, or spicy foods at night can also help with nighttime nausea. Taking vitamin B6 (under the direction of your healthcare provider) and eating foods rich in vitamin B6, such as chickpeas, bananas, chicken, dark leafy greens, fortified cereals, and salmon may also help. If your nausea persists, your healthcare provider may prescribe an anti-nausea medication.

Anxiety

Anxiety disorders are typically treated with:

• Psychotherapy (also called talk therapy) tailored to the person’s specific needs
• Medication such as antianxiety drugs
• A combination of both
  

GERD

Lifestyle changes can help treat GERD, such as:

• Losing weight if you are overweight
• Quitting smoking
• Dietary changes
• Elevating your head and upper back when you sleep

Medications may also be used, both OTC and prescription, including:

• Antacids
• H2 blockers, which block the signal for your stomach to make acid
• Proton pump inhibitors (PPI), which reduce the amount of stomach acid

Sometimes surgery is necessary if lifestyle changes and medications aren’t enough to treat symptoms. These procedures can include:

• Fundoplication (sewing the top of the stomach around the esophagus to add pressure)
• Bariatric (weight loss) surgery

Peptic Ulcers

The treatment for peptic ulcers depends on the cause of the ulcers.

If NSAIDs are the cause, you will need to reduce your dosage or use another type of pain reliever. Your healthcare provider may also recommend a medication to help treat the ulcer, such as:

• Proton pump inhibitors
• H2 blockers
• Protectants that coat ulcers against acid and enzymes so they can heal

For peptic ulcers caused by H. pylori, treatment will consist of antibiotics, PPI, and other medications.

Ulcers caused by Zollinger-Ellison syndrome are treated with medications, surgery, and chemotherapy.

Medication Side Effects

If your nausea is caused by a drug you're taking, your healthcare provider may suggest you take it with certain foods to reduce side effects, or they may switch your medication to something else.

Gastroparesis

Treatment for gastroparesis depends on the cause, your symptoms, and how you've responded to treatments in the past. Common treatments include changing your dietary habits, controlling glucose levels, medications, and tube feeding.

Prevention

While you can’t necessarily prevent nausea, you can treat and manage it. If you are pregnant and have severe nausea, there are prescription medications that can help control it. Talk with your healthcare provider about the risks and benefits of these medications.

If you are throwing up, you may be prescribed anti-nausea medication known as antiemetics. These medications help prevent vomiting, but may not always prevent the accompanying nausea.

Summary

Nighttime nausea is a symptom of various conditions, including pregnancy, anxiety, side effects of medications, GERD, and gastroparesis. Home remedies like ginger tea, peppermint, and eating a bland diet may help you feel better. It's best to talk with your healthcare provider to get help with persistent nausea. A provider can treat the underlying cause so you can get some relief.

A Word From Verywell

Nighttime nausea can keep you from sleeping well, leaving you physically and emotionally depleted. But you don't have to suffer in silence—there are many treatment options that can help you feel better. If your nausea is affecting your quality of life, don't hesitate to reach out to your healthcare provider.