Why Do I Get Nauseous At Night?

Overview

Have you been feeling sick at night-time recently? If yes, don’t worry; most cases of night-time nausea are not a cause for immediate concern.

The sensation of nausea (feeling sick) is a commonly encountered symptom, which can sometimes occur without an underlying condition. However, if experienced more than once a week, it could be a sign of another condition. Nausea is associated with stomach discomfort and the sensation of wanting to vomit. It is commonly defined as a precursor to the act of vomiting1 and can occur at any time during the day. However, there are some conditions that can exacerbate the feeling at night.

Read on to learn more about the causes of night-time nausea and how you can treat it.

Causes of night-time nausea

Imagine the scenario: you’ve had a great day at work and ticked things off your to-do list, however, at night-time you suddenly develop a feeling of nausea. But why are you suddenly developing this nausea at night? It is worth investigating in order to establish the underlying condition causing the nausea, as different causes will have specific treatments. 

Most often, the causes of night-time nausea are the same as the variety of sources that result in day-time nausea. However, actions such as eating larger meals and lying down to go to sleep can potentially exacerbate the feeling of nausea.  

Anxiety

Nausea is an incredibly common physical symptom of anxiety that everyone will experience occasionally. However, if it is occurring frequently, it can become debilitating and negatively impact your quality of life.2 

But why does anxiety result in nausea? Well, when faced with a threat or stressor, the body enters “fight-or-flight” mode. This results in the activation of our sympathetic nervous system (which controls some of the body’s unconscious processes) and the subsequent release of stress hormones such as adrenaline, corticotropin-releasing factor (CRF) or cortisol. These hormones prepare your body to face a crisis. This is a natural reaction to stress and originally evolved to help us survive.3 

These stress hormones activate neurotransmitters (chemical messengers) in the brain, which send messages to the rest of your body to:

  • increase blood pressure
  • dilate the pupils
  • increase heart rate
  • increase your respiratory rate
  • divert blood to the large muscle groups

This process also has consequences on the gastrointestinal (GI) system. The release of stress hormones diverts blood away from the digestive tract to large muscle groups, inhibiting the movement of your digestive tract.  In addition to this impact on the digestion processt, the stress hormones associated with anxiety can also interact with your enteric nervous system, which lines your gut. CRF in particular can result in physical symptoms such as irritation in your digestive system, nausea, spasms and diarrhoea.

Since the severity of anxiety can become worse at night, you may be more likely to experience increased nausea at night.

According to the DSM-5, other symptoms of anxiety include:4

  • restlessness
  • muscle tension
  • sleep disturbance
  • irritability
  • difficulty concentrating

Pregnancy (morning sickness)

Nausea and vomiting will occur in up to 74% of pregnant people.5 Although this is often termed “morning sickness,” the timing and severity can vary widely, with only 1.8% reporting symptoms exclusively in the morning.6 According to Mayo Clinic, however, symptoms are usually resolved during the second three months of pregnancy.7 

The experience of morning sickness is unfortunately not well understood.  However, studies have observed that the severity of nausea and vomiting correlate with levels of the hGC hormone alongside the mass of the placenta.

You should contact your GP immediately if your nausea is so severe that you can’t keep food or liquids down. 

GORD

Acid reflux is something that most people experience from time to time. It occurs when stomach acid leaks up into your oesophagus. However, when acid reflux keeps happening repeatedly, it is called gastro-oesophageal reflux disease (GORD). It usually occurs as a consequence of the muscles at the bottom of the oesophagus becoming weakened.

The most frequent symptom of GORD or acid reflux is heartburn. GORD can also result in nausea, particularly when lying down after eating late at night.

Other symptoms of GORD include:8

  • unpleasant sour taste in your mouth - this is caused by stomach acid
  • bad breath
  • bloating
  • a hoarse voice

Medication side effects

Night-time nausea can be a side effect of medications, some of which include:9

  • antibiotics
  • aspirin
  • NSAIDs (such as ibuprofen)
  • antidepressants

If you take these medications at night, it could result in the development of nausea.

Gastroparesis

Gastroparesis is a chronic condition where the stomach abnormally empties itself. It is thought to be a result of damage to the vagus nerve, which is responsible for contracting stomach muscles to help move food. As your day goes on, the food you eat builds up in your stomach.10 This can lead to more severe nausea at night-time.

Stomach ulcers

Stomach ulcers are sores, often caused by the bacteria H. pylori or certain anti-inflammatory drugs such as aspirin. The ulcers can develop on the lining of your stomach and the small intestine. The symptoms associated with the ulcers, such as nausea, can often get worse at night-time.11 

Signs and symptoms of night time nausea

Symptoms of nausea can be difficult to describe. Common symptoms experienced include:12

  • feeling like you are going to vomit
  • a stomach ache
  • retching and dry heaves
  • vomiting
  • profuse sweating

Management and treatment

Treatment for nausea will be influenced by the underlying condition.

Many nausea remedies will not treat the underlying condition, but will help you feel more comfortable. Check with your GP before using any of these.

  • Ginger has been used as a treatment for gastrointestinal complaints since ancient times. Numerous clinical studies have shown that ginger is a safe and effective treatment for morning sickness13
  • Plain foods such as bananas, crackers and toast. This allows your body to receive some required nutrients without irritating your stomach. Electrolyte beverages are also recommended, especially if you have been vomiting
  • Fruit juice. Drinking a small amount of slightly sweet liquid is recommended. However, try to avoid citrus fruit juice
  • Peppermint is often recommended as a treatment for nausea due to its calming effects on the digestive tract. Drinking peppermint tea could potentially ease your nausea. However, do not drink if you are suffering from GORD14 
  • Avoid physical activity. It is important to rest when feeling nauseous. If lying down increases the severity of your nausea, try elevating your head slightly
  • Vitamin B6 supplements are effective at treating nausea in pregnant women. They can be used as an alternative to anti-sickness medication

How can I prevent night-time nausea?

Although you can treat and manage night-time nausea, it is difficult to prevent. If you are experiencing serious nausea whilst pregnant, your clinician may opt to put you on anti-sickness medication to try and improve your morning sickness. 

When to see a doctor

If you experience a single spell of night-time nausea, you can probably relax. However, if the feeling of nausea becomes severe or lasts for longer than a week, see your GP. They can look for potential causes and suggest treatments, and may even prescribe anti-sickness medicine if it is required. 

Summary

Prolonged night-time nausea is usually the consequence of an underlying condition. Some of the most common conditions are: anxiety, pregnancy, GORD, stomach ulcers, medication side effects and gastroparesis. Home remedies can help to relieve the discomfort caused by nausea, but if you are dealing with it longer term, it is best to consult your GP. 

References

  1. Singh P, Yoon SS, Kuo B. Nausea: a review of pathophysiology and therapeutics. Therap Adv Gastroenterol [Internet]. 2016 Jan [cited 2023 Jan 27];9(1):98–112. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4699282/
  2. Brenes GA. Anxiety, depression, and quality of life in primary care patients. Prim Care Companion J Clin Psychiatry. 2007;9(6):437–43.
  3. The Biological Effects and Consequences of Anxiety [Internet]. Anxiety UK. Available from: https://anxietycare.org.uk/the-biological-effects-and-consequences-of-anxiety/
  4. Munir S, Takov V. Generalized anxiety disorder. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 [cited 2023 Jan 27]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK441870/
  5. Louik C, Hernandez-Diaz S, Werler MM, Mitchell AA. Nausea and vomiting in pregnancy: maternal characteristics and risk factors. Paediatr Perinat Epidemiol. 2006 Jul;20(4):270–8.
  6. Lacroix R, Eason E, Melzack R. Nausea and vomiting during pregnancy: A prospective study of its frequency, intensity, and patterns of change. Am J Obstet Gynecol. 2000 Apr;182(4):931–7.
  7. Morning sickness - Symptoms and causes [Internet]. Mayo Clinic [cited 2023 Jan 27]. Available from: https://www.mayoclinic.org/diseases-conditions/morning-sickness/symptoms-causes/syc-20375254 
  8. Heartburn and acid reflux [Internet]. nhs.uk. 2017 [cited 2023 Jan 27]. Available from: https://www.nhs.uk/conditions/heartburn-and-acid-reflux/
  9. What to do when your medication causes nausea [Internet]. Harvard Health. 2017 [cited 2023 Jan 27]. Available from: https://www.health.harvard.edu/staying-healthy/what-to-do-when-your-medication-causes-nausea
  10. Gastroparesis [Internet]. nhs.uk. 2017 [cited 2023 Jan 27]. Available from: https://www.nhs.uk/conditions/gastroparesis/
  11. Stomach ulcer [Internet]. nhs.uk. 2017 [cited 2023 Jan 27]. Available from: https://www.nhs.uk/conditions/stomach-ulcer/
  12. Symptoms [Internet]. [cited 2023 Jan 27]. Available from: https://stanfordhealthcare.org/medical-conditions/digestion-and-metabolic-health/chronic-nausea/symptoms.html
  13. Lete I, Allué J. The effectiveness of ginger in the prevention of nausea and vomiting during pregnancy and chemotherapy. Integr Med Insights [Internet]. 2016 Mar 31 [cited 2023 Jan 27];11:11–7. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4818021/
  14. Peppermint information | mount sinai - new york [Internet]. Mount Sinai Health System. [cited 2023 Jan 27]. Available from: https://www.mountsinai.org/health-library/herb/peppermint
This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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