Why do I feel nauseous when I wake up at night?

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Medically reviewed by Dr. Ola Tarabzuni

Key Takeaways

  1. Waking up in the middle of the night nauseated can indicate underlying mental and medical states which will present themselves as a lack of appetite, vomiting, dry heaves and cramps in the stomach.
  2. Causes can vary from anxiety, stress, gastroenteritis, stomach ulcers, cyclic vomiting or medication adverse effects. 
  3. Treatment and management of night nausea include anti-anxiety medications, reduced caffeine/alcohol consumption, bismuth subsalicylate (Pepto-Bismol, Kaopectate) , loperamide (Imodium), metoclopramide (Reglan) and erythromycin can be used accordingly.

Overview

Everyone cherishes a good night’s sleep, but waking up feeling nauseated in the middle of the night is a nightmare nobody wants to experience. Experiencing night sickness can leave you feeling unprepared and drained the following day. This is because during the night, your body recharges, and the added discomfort of nausea further contributes to your exhaustion. The by-product of various underlying issues your body may be experiencing can manifest in different ways. This article will delve into the underlying causes of your unexplained nighttime nausea, providing you with a comprehensive understanding of the issue.

Common symptoms of nausea at night

Although nausea itself is a symptom of other conditions, let’s first see some of the signs of nighttime nausea as what most people experience:

  • Vomiting
  • Lack of appetite
  • Sweating excessively
  • Stomach aches and unease in the upper abdomen
  • Retching (involuntary stomach contractions to vomit)
  • Dry heaves (feeling of excessive vomit, but nothing comes out)
Any unusual health symptom must never be ignored. If you have persistent nausea at night, get professional help!

Why do I get nauseous at night?

There can be several reasons for nausea, including anxiety or stress, GERD, gastroenteritis, stomach ulcers, gestation or pregnancy, cyclic vomiting, and medication side effects.

Anxiety and Stress

In this era of digital technology, from online friends to online problems and even digital solutions to those problems have somehow increased our anxiety levels due to different daily triggers. Everybody feels this way occasionally, and that’s how your body’s normal functioning gets disrupted, and you feel nervous and anxious. Frequent feelings of anxiety can be indicative of generalized anxiety disorder. In either case, as stress worsens at night, so do the nauseous feelings.

So next time you wonder why I am throwing up in the middle of the night or feel sick at night but fine during the day, here’s your answer. During the day, the routine and life keep us busy and distracted, but at night, when overthinking strikes, your anxious thoughts pop up and leave you feeling nauseous.

How to avoid nighttime nausea due to anxiety?

Anxiety and stress can be reduced by using some effective treatments, one of which is psychotherapy. One such therapy is cognitive behavioral therapy, also known as CBT which is very effective as it helps manage the way you think and behave. It also helps identify harmful or destructive thought patterns and reframe them into positive thoughts.

Anti-anxiety medications and changes in lifestyle can also help manage these issues, including exercise and reducing caffeine or alcohol consumption.

Seek professional advice for nighttime nausea due to anxiety or stress.

GERD

GERD stands for Gastroesophageal reflux disease, also known as Reflux Esophagitis or Acid Reflux. It is a condition in which the stomach acid back flushes through the esophagus and occurs due to a loosened band of muscle between the stomach and esophagus. This causes the back flush of stomach juices up to the esophagus. This condition aggravates when eating late and lying right after eating a meal. So, GERD is the answer to why you get nauseous at night when you lie down. Moreover, it also causes a bitter taste in the mouth and an uncomfortable feeling in the chest called heartburn. As a result, you may feel nauseous, and the following symptoms can follow too:

How to stop nausea at night due to GERD?

GERD or acid reflux can be treated using over-the-counter medications that reduce acid production, like antacids or H2 blockers. Other options include:

  • Proton pump inhibitors are medications that can be used over prescription and are more potent acid reducers. 
  • Lifestyle changes like avoiding spicy foods, eating smaller portions for better digestion, reducing caffeine and alcohol consumption, and avoiding late eating. 
  • Surgery, in cases where medications don’t work.

Gastroenteritis

It is caused by a bacterial or viral infection accompanied by nausea and vomiting. Gastroenteritis causes a sudden urge to throw up and watery diarrhea due to stomach infection and is thus often called stomach flu. Children are more prone to it than adults due to weak immune systems against viral or bacterial infections. Although the patient recovers within a week, it leaves the body dehydrated due to vomiting and diarrhea; therefore, drink lots of fluids to restore your water balance.

How to stop nausea at night due to Gastroenteritis?

It can be treated with antibacterial or antiviral medications depending on the contracted infection type. Adults’ over-the-counter medicines include bismuth subsalicylate (Pepto-Bismol, Kaopectate) and loperamide (Imodium), used to treat diarrhea. In contrast, Zofran (ondansetron) treats nausea and vomiting caused by Gastroenteritis.

Gastroparesis

Gastroparesis is when food movement from the stomach to the small intestine is slowed, resulting in delayed emptying of stomach contents. This is more common in diabetic people. However, other causes include: 

  • Scleroderma or surgery
  • Antidepressants
  • Infections or upset stomach, which can be caused by vagus nerve injury

Injury to the vagus nerve causes delayed food movement as it is responsible for contracting stomach muscles for food movement. The potential symptoms of gastroparesis include bloating, nausea, vomiting, lack of appetite, heartburn, and feeling full for a long time after eating little.

How to stop nausea at time due to Gastroparesis?

For treating gastroparesis, certain medications can help, including the following: 

  • Medicines to restore the loosened stomach muscles like metoclopramide (Reglan) and erythromycin. 
  • Medicines like Zofran treat nausea and vomiting. 
  • In severe cases, surgery.
  • Lifestyle changes such as eating easy-to-digest foods. 

Stomach Ulcers

Stomach ulcers, also called peptic ulcers, cause nighttime nausea and vomiting. They are the sores that line the inside of your stomach or small intestine.H. pylori bacteria can cause stomach ulcers. This bacterial infection causes radiating pain between ribs and navel followed by nausea, gas or bloating, burping, vomiting, black stools accompanied by blood, and feeling full after eating small amounts of food. This causes weight loss, and the symptoms worsen at night and post-meal. There are various causes of stomach ulcers,s including: 

How to stop nighttime nausea due to stomach ulcers?

To treat stomach ulcers and the associated symptoms, including nausea, you can get an online prescription for antibiotics from a healthcare professional targeting Helicobacter pylori. Moreover, antacids and proton inhibitors can also be used to reduce stomach acids. Avoiding spicy foods and smoking is another layer that can make a difference.

Gestation or Pregnancy

During pregnancy, nausea and vomiting are common and are often termed morning sickness, which can happen anytime. It occurs in the 1st trimester more frequently and is not dangerous to either the baby or the mother. The hormones take the toll and cause nausea due to increased pregnancy hormones like human chorionic gonadotropin (HCG) and remain from the 6th to 12th week of pregnancy in most cases. 

Approximately 75% of mothers experience nausea and vomiting during pregnancy. However, not everyone experiences it, but those who do share it throughout the pregnancy. It’s not dangerous until and unless you can keep the food down; however, you can see a doctor online if you’re experiencing frequent vomiting. Based on your hyperemesis gravidarum evaluation, they will prescribe you a severe nauseous condition accompanied by vomiting that causes fluids and electrolyte imbalance.

How to stop nighttime nausea due to gestation or pregnancy?

Morning sickness is like a horror story for every pregnant woman. The first treatment is taking smaller meals in short intervals instead of one large meal and avoiding spicy and fatty foods, especially at night, as they can trigger nighttime nausea. Vitamin B6 can also help if prescribed by your healthcare provider or eating foods rich in vitamin B6, like salmon, cereals fortified with vitamin B6, chicken, chickpeas, and leafy green vegetables.

Gastroparesis

Gastroparesis is when food movement from the stomach to the small intestine is slowed, resulting in delayed emptying of stomach contents. This is more common in diabetic people. However, other causes include: 

  • Scleroderma or surgery
  • Antidepressants
  • Infections or upset stomach, which can be caused by vagus nerve injury

Injury to the vagus nerve causes delayed food movement as it is responsible for contracting stomach muscles for food movement. The potential symptoms of gastroparesis include bloating, nausea, vomiting, lack of appetite, heartburn, and feeling full for a long time after eating little.

How to stop nighttime nausea due to gastoparesis?

For treating gastroparesis, certain medications can help, including the following: 

  • Medicines to restore the loosened stomach muscles like metoclopramide (Reglan) and erythromycin. 
  • Medicines like Zofran treat nausea and vomiting. 
  • In severe cases, surgery.
  • Lifestyle changes such as eating easy-to-digest foods. 

Cyclic Vomiting

It is a rare disorder causing recurrent episodes of severe nausea and vomiting. This condition worsens at night and is accompanied by other symptoms, including: 

How to stop nighttime nausea due to cyclic vomiting?

The following medications can help in the treatment of cyclic vomiting, a rare disorder causing recurrent episodes of severe nausea and vomiting that worsen over time: 

  • Anti-nausea medicines work by blocking the vomiting center in the brain or receptors that trigger the vomiting center. 
  • IV fluids in case of severe dehydration from vomiting. 
  • Anticonvulsant medicines work by calming the hyperactivity of the brain. 
  • Anti-migraine medicines work by reducing migraine and relieving the symptoms of nausea.

Medications Side Effects

Nausea is a common side effect of various medications, including blood pressure medications, antibiotics, aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), vitamins, opioids, and chemotherapy. If the timing of medicine intake is night, it can cause frequent nausea at night.

How to stop nighttime nausea due to medication side effects?

Consult your doctor if your medicine is the root of your morning diarrhea. They can change your medicine, boost the dosage, or offer advice on handling the side effects.

Read More: Is Zofran (Ondansetron) Safe for Pregnancy?

Home Remedies

People often have this question why they wake up nauseous in the middle of the night, even when I am not pregnant. Whether you are pregnant or not, the treatment plan depends upon the root cause of night or daytime nausea. Following home remedies can help overcome this uncomfortable feeling: 

  • Avoid strenuous physical activity and take rest until the condition is better
  • Eat non-greasy, non-fatty, and less spicy foods like plain crackers or bread. 
  • Avoid overeating or eating to your full potential; instead, eat in small proportions.
  • Avoid lying down right after a meal, which can cause bloating and nausea. 
  • Drink more clear fluids and teas that have a calming effect on the stomach, like ginger or peppermint tea.

If your nighttime nausea does not go away for a long duration of time you should discuss with your doctor.

Talking to a professional rules out the possibility of something serious. Get profesisonal help.

How can I prevent night-time nausea?

It can be prevented by following these simple steps: 

  1. Position yourself when sleeping in a way to avoid laying flat while sleeping, and use a pillow on the sides to keep the position intact for most of the night, which will help the stomach to not irritate and cause nausea.
  2. Drinking ginger and peppermint tea 1 hour before bedtime will not only help in maintaining a good sleep but will reduce nausea to a great extent.
  3. Drinking any sweet fluid, without citric acid can prevent nighttime nausea to a great extent. 
  4. Make your dinner small in portions full of bland food for some days to avoid stomach acidity and nausea on waking up.

Some conditions still need professional help so always consult a doctor when you have persistent nighttime nausea.

Conclusion

In a nutshell, nausea is just a symptom of an underlying condition that triggers at night more often. To treat the symptom, first, you have to identify the root cause and then go for treatment. If you cannot identify the reason, go to someone who can, a doctor.

FAQs About Nausea at Night

What is the best position to sleep when nauseous?

When feeling nauseous, the best posture to sleep is to elevate your head instead of lying down flat. Your head should be at least 12 inches over the feet. It reduces the likelihood of food moving up to the esophagus, causing nausea and vomiting while sleeping.

Is it common to feel sick at night?

No, it is not common to feel nausea at night. However, it is a red flag from your body saying you should treat the root cause and underlying symptoms as soon as possible.

How do you know if you have nausea from anxiety?

Nausea from anxiety can be detected if you have an overwhelming feeling, just like the one you experience before a presentation or job interview. This type of nausea accompanies other anxiety symptoms like headache, shortness of breath, and shakiness.

Why does my nausea get worse when I lay down?

When you lay down flat on your back, gastric juices can rise and increase feelings of nausea and overall discomfort. Instead of that, when you’re nauseous, try reclining with your upper body elevated and moving around as little as possible. Taking any sugary sweets will help.

Why do I feel sick all the time but never vomit?

Poor diet, anxiety, stress and other triggers like running or exercising after meals can affect you and make you feel sick. It’s good to avoid the general triggers that affect your body and make you feel nauseated.

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