Causes for Sudden Vomiting in the Middle of the Night

Waking up during the night due to nausea and vomiting can be frustrating for many people, as it disturbs their sleep schedule and causes fatigue. However, if you’re experiencing night-time nausea and vomiting, it may be a valid indicator of an underlying gastrointestinal condition.

We define these gastrointestinal conditions on this page, providing related symptoms to help you identify what could be causing your night nausea and vomiting. 

Why am I Waking Up Nauseous and Vomiting During the Night?

Numerous gastrointestinal disorders and conditions may contribute to sudden night-time vomiting and nausea. Such conditions commonly include:

  • GORD
  • Stomach Ulcers
  • Gastroparesis
  • Gastroenteritis
  • Hiatal Hernia
  • Pregnancy
  • Cyclic Vomiting Syndrome

While most of these are not considered a medical emergency, it is always important to see a healthcare professional to confirm the diagnosis and assess the severity of your gut condition. 

 

Other Conditions Connected to Night-Time Nausea and Vomiting

Before diagnosing yourself with a gastrointestinal condition, you should consider if you have recently started taking any new medications, as this could be causing severe vomiting. Common medications that cause nausea and vomiting as a side effect include aspirin, ibuprofen, antibiotics, blood pressure and steroid drugs. If you believe that a new course of medication is causing recurrent vomiting during the night, speak to health professionals such as a GP to find an appropriate substitute.  

Additionally, if you have experienced an isolated vomiting episode at night, you must consider the foods you ate before bed. Food poisoning and food allergies are often common causes of isolated instances, causing vomiting during the night. 

Your night-time nausea and vomiting could also be due to severe anxiety. When waking up during the night, reflecting on how you feel and assessing your full symptoms is essential. If you’re feeling panicked and tight in the chest, you may be suffering from anxiety, which is known to cause nausea during night-time episodes. 

Reasons for sudden vomiting in the middle of the night can include various gastrointestinal disorders and other conditions.

Potential causes for sudden vomiting in the middle of the night.

GORD

Gastrointestinal Oesophageal Reflux Disease (GORD or GERD) occurs when the muscle that separates your stomach from your food pipe is weakened and triggers acid reflux. As your stomach’s contents enter your oesophagus, they irritate the lining of the pipe, causing symptoms such as a burning sensation in the throat, nausea, vomiting, belching and chest discomfort. 

Patients with GORD note that their symptoms are particularly exaggerated when lying down for extended periods, as the position promotes the flow of the stomach’s contents back into the oesophagus. Therefore, when sleeping, the build-up of stomach acid could suddenly force you to vomit during the night. This is particularly relevant if you eat large meals before bed. 

Other common symptoms of GORD include:

  • Bad gut breath 
  • Dry coughing 
  • Sour taste in the mouth after vomiting 
  • Hiccups and gas
  • Chest pain
  • Dysphagia (inability to swallow)
  • Indigestion

 

Treatment

If you believe that your sudden night-time vomiting results from GORD, try avoiding alcohol, coffee, chocolate, tobacco and fatty or spicy foods. Furthermore, you should avoid eating 3 to 4 hours before sleeping. This will allow your food to properly digest and prevent stomach acid from leaking into the oesophagus. When sleeping, we recommend using an extra pillow to raise your head upwards, helping avoid your oesophagus filling with stomach contents during the night. 

There is also a range of over-the-counter medications for more serious instances of GORD. In some extreme cases, we may recommend a laparoscopic procedure to tighten the muscle between your stomach and oesophagus. For more information on our treatments available at the Centre of Gastrointestinal Health, head to our GORD management page

Stomach Ulcers

Stomach ulcers, also known as peptic ulcers, are lesions or sores in your stomach lining and small intestine. Stomach ulcers typically cause you to feel a sharp burning pain in your abdominal region alongside nausea. The discomfort can last between a couple of minutes and a few hours. 

Most patients with stomach ulcers experience this abdominal pain at night or in between meals during the day. Consequently, this pain may cause you to wake up feeling nauseous and compel you to vomit. 

Other symptoms of stomach ulcers include:

If you believe that a stomach ulcer is causing your nausea and vomiting during the night, you must consult a gastroenterologist for further examination. This is because ulcers can lead to various complications, such as internal bleeding in the small intestine, blockages in the bowel and infection. 

 

Treatment

When consulting a gastroenterologist, you will likely need an endoscopy to help discover the location and cause of the ulcer. Following your endoscopy, your doctor will recommend a range of proton pump inhibitors, receptor blockers and antibiotics (if caused by an infection) to treat your ulcers.  

Gastroparesis

Gastroparesis is another known gastrointestinal disorder that causes night-time nausea and vomiting. The disorder occurs when the stomach cannot effectively empty itself of digested foods, leading to symptoms such as abdominal pain, severe nausea and vomiting. While there is no clear cause for gastroparesis, people with diabetes are more likely to contract the disorder. 

Studies have shown that people with gastroparesis commonly experience night-time vomiting as a symptom. This is due to the food consumed during the day building over time in the stomach, causing symptoms to worsen during the night and force vomiting. 

Some other typical symptoms of gastroparesis include:

  • Loss of appetite and constantly feeling full 
  • Malnutrition 
  • Weight loss 
  • Bloating

While gastroparesis is not a life-threatening disorder, complications such as malnutrition can seriously affect your general health and well-being. For this reason, it is important to consult a gastroenterologist to help manage the condition.

 

Treatment

Unfortunately, there is no single cure for gastroparesis. However, various management strategies are effective in minimising the disorders’ impacts. For example, taking medications that prevent nausea alongside a small diet change (smaller high-fibre and low-fat meals) can reduce the risk of waking up during the night to vomit.

In extreme circumstances, you may need surgery to help strengthen your stomach muscles and promote a more efficient digestive symptom. However, we only consider surgery if medications and lifestyle changes fail to improve your symptoms.  

Gastroenteritis

Alternatively, your night-time vomiting could result from an infection in your gastrointestinal tract. Gastroenteritis, commonly referred to as the stomach flu, is a common gut infection caused by exposure to a virus or bacteria. This condition is more common in children, as their immune systems are less efficient in fighting bacterial and viral infections.

Gastroenteritis attacks the gut and can cause persistent vomiting throughout the night, forcing you to wake suddenly. You may have gastroenteritis if you experience any of these other symptoms:

Most episodes of gastroenteritis typically last between one night to a few days. If your vomiting lasts any longer, we recommend consulting medical care for further examination. 

 

Treatment

As gastroenteritis is not a chronic condition, there is no need for drastic treatment options as your body can fight the infection. There are some over-the-counter medications that adults can take to help manage their nausea and prevent vomiting. However, these medications cannot be given to children.

The key to managing gastroenteritis is to avoid dehydration, as this can often exacerbate the symptoms of the gut infection. A rehydration solution is the best way to ensure that you keep up with your fluid intake. Sometimes, you may need to submit yourself for medical care where they can provide an intravenous drip of fluids to help rehydrate your body. 

Hiatal Hernia

A hiatus hernia involves your stomach protruding outside the diaphragm’s muscular wall, consequently pushing upwards into your chest cavity. This is commonly caused by a tear in your diaphragm, which can occur due to old age or excessive straining when lifting objects. 

A hiatus hernia can trigger acid reflux, which may cause you to experience heartburn and regurgitation. Similar to GORD, most patients notice their symptoms at night when lying down or straining to lift heavy objects. In extreme cases, you may notice the presence of blood in your vomit, resulting from gastrointestinal bleeding. 

While most people with a hiatus hernia do not encounter symptoms, larger hiatus hernias can cause:

  • Dysphagia (difficulty swallowing)
  • Sharp pain in the abdomen 
  • Chest pain 
  • Shortness of breath
  • Nausea 
  • Blackened stool caused by gastrointestinal bleeding

If you wake up at night with nausea and the need to vomit, you should consider seeing a gastroenterologist for a consultation on repairing the hernia. 

 

Treatment

The most effective treatment for a hiatus hernia is a simple repair procedure. Hernia repairs are minimally invasive and offer little risk of complications, only requiring a short 2-week recovery before returning to normal activities. For information on the procedure, see our hernia repair service page to understand more about preparation, complications, and recovery time. 

Pregnancy

Despite common misconceptions, nausea and vomiting during pregnancy aren’t restricted to “morning sickness”. Many women in their first-trimester experience nausea and persistent vomiting due to increased production of hormones. As a result, you may experience nausea during the night and the sudden need to vomit when sleeping. 

Furthermore, pregnant women are also more vulnerable to GORD and hiatus hernias as their bodies begin to grow. This can consequently lead to further night-time nausea in the later stages of pregnancy. 

 

Treatment

If you’re experiencing first-trimester nausea and vomiting during the night, there are several home remedies that you can try to treat your condition. A key is to adjust your diet to avoid certain foods that may trigger nausea; these include coffee, meat, eggs, dairy products and spicy foods.

If you’re experiencing GORD or a hiatus hernia in the later stages of your pregnancy, you will need to see a gastroenterologist and discuss a management plan. At the Centre for Gastrointestinal Health, our doctors are experienced in dealing with pregnancy-specific conditions, providing expert care that ensures you and your baby’s health. 

Cyclic Vomiting Syndrome

Despite being rare among cases, cyclic vomiting syndrome is another possible condition that could be causing your night-time nausea and vomiting. Cyclic vomiting syndrome (CVS) is a gastrointestinal disorder that involves repeated random episodes of severe vomiting and nausea. One vomiting episode can last from a couple of hours to multiple days. 

CVS episodes tend to occur at the same time for a patient. Therefore, if you find yourself having repeated episodes of vomiting suddenly during the night, you may have CVS. 

Furthermore, a range of triggers for patients can start a vomiting episode. Most importantly, exhaustion and fatigue are common triggers, which also explains why patients are more likely to experience CVS at night. 

Some other common symptoms of CVS include:

  • Lethargy
  • Headaches
  • Motion sickness (dizziness)
  • Severe pain in the abdomen 

As episodes can be random in nature and frequency, CVS can be difficult for medical professionals to conduct. However, if you believe you’re suffering from CVS, you should consult a gastroenterologist for treatment and management. A gastroenterologist can confirm your diagnosis through an endoscopic ultrasound, identifying any other digestive conditions that could be contributing to the syndrome. 

 

Treatment

While there is no single cure for CVS, a medical professional can prescribe you medications that provide relief from nausea and suppress your stomach acid production. It is also important to note what triggers your vomiting episodes to help increase control over the syndrome. 

Some common triggers that we have found among patients include:

  • Anxiety
  • Stress 
  • Excitement 
  • Alcohol consumption 
  • Food allergy and common food sensitivities (dairy, MSG, chocolate)
  • Fasting  

Children with CVS are known to outgrow symptoms as they age. In contrast, adults tend to experience a more chronic form of a gastrointestinal condition. At the Centre for Gastrointestinal Health, we can help children or adults by diagnosing and effectively managing their CVS with a holistic approach for the best results.

Treatments for Sudden Night-Time Vomiting

Some general home remedies you can try to help reduce the risk of you waking up during the night to vomit. 

  • Sleep with your head in a raised position with an extra pillow. This will help prevent stomach contents from leaking into the oesophagus. 
  • Consume sweet drinks like lemonade. This neutralises your stomach acid and minimises nausea. 
  • Drink chamomile, peppermint or ginger tea. These herbal teas have been a tried and trusted method for temporarily alleviating severe nausea. 
  • Eat plain snacks such as toast, cereals or crackers. A simple bedtime snack can help settle an upset and empty stomach, as these foods are easily digestible and non-acidic. 

However, if your symptoms persist for more than a few days, we recommend seeing your GP, who can provide a referral to a gastroenterologist. Our doctors at The Centre for Gastrointestinal Health are experts in diagnosing, managing and treating various gut conditions. Our extensive range of services will ensure that we can diagnose the true cause of your night-time vomiting and nausea, helping you sleep more easily. 

For more information on how we can help you, contact us at 1300 580 239 or practicemanager@centreforgastrointestinalhealth.com.au. 

FAQs

Is it OK to sleep after vomiting?

Before going back to bed, you should remain seated upright until you no longer feel nauseous. When feeling better, it is important that you sleep elevated and on your side to avoid choking on your vomit. 

 

How should I sleep to avoid vomiting?

If you are vomiting in your sleep, try positioning your head above your body. You can achieve this by using an extra pillow behind your neck to help avoid stomach acid rising into your food pipe. You should also sleep on your side and be elevated from the ground. 

 

When should I be concerned about vomiting?

If your symptoms persist for more than two days, you should consider booking an appointment with your doctor for further examination.