How to Sleep with POTS

Living with Postural Orthostatic Tachycardia Syndrome (POTS) can make even the simplest activities, like getting a good night’s sleep, feel like a challenge. If you’re struggling with sleep due to the unique symptoms of POTS—such as dizziness, rapid heart rate, and trouble maintaining an upright posture—you’re not alone. Sleep is essential for everyone’s health, but for those with POTS, finding ways to rest comfortably and wake up feeling rejuvenated can feel elusive.

In this guide, we’ll explore practical tips and strategies that can help you manage your POTS symptoms at night, so you can finally enjoy a restful, restorative sleep.

Understanding the Sleep Challenges of POTS

Living with POTS can make it challenging to get the restful sleep you need, but understanding the unique sleep-related issues associated with the condition is the first step in finding relief.

Common Sleep Issues for People with POTS

For those living with Postural Orthostatic Tachycardia Syndrome (POTS), getting a good night’s sleep can often feel like an impossible task. The very nature of the condition—which affects the autonomic nervous system—leads to a variety of sleep disturbances. The most common sleep-related issues include insomnia, poor-quality sleep, and frequent waking throughout the night.

People with POTS frequently experience insomnia, or an inability to fall asleep due to heightened symptoms when they lie down. Rapid heart rate, a hallmark of POTS, tends to increase when lying flat, making it difficult to relax and drift off. This can result in prolonged periods of tossing and turning as the body struggles to stabilize.

In addition to trouble falling asleep, individuals with POTS often deal with poor-quality sleep. While they may manage to fall asleep, the body remains in a state of constant agitation, causing sleep to be shallow and unrefreshing. The feeling of waking up still tired is common, as the body doesn’t enter the deeper stages of sleep necessary for physical and mental recovery.

Frequent waking throughout the night is another issue for many with POTS. Symptoms such as dizziness, discomfort from lying in one position for too long, or an increased heart rate can lead to regular interruptions in sleep. This lack of continuous rest further exacerbates fatigue, making the day that follows even more difficult.

The Importance of Sleep in Managing POTS Symptoms

Sleep is a cornerstone of managing POTS symptoms and improving overall well-being. A consistent, restful night’s sleep allows the body to recuperate, recharge, and restore vital energy. For people with POTS, quality sleep plays a crucial role in managing the condition. When sleep is compromised, the body becomes more prone to heightened POTS symptoms.

One of the most noticeable effects of poor sleep is an increase in fatigue. A lack of restorative sleep can leave individuals feeling drained, which in turn makes it harder to cope with the daily physical demands of living with POTS. This chronic tiredness can make simple tasks feel insurmountable and increase the intensity of POTS-related symptoms, such as dizziness, heart palpitations, and muscle weakness.

Brain fog is another common symptom that worsens with poor sleep. Lack of sleep affects cognitive function, making it difficult to concentrate, think clearly, or process information. For someone with POTS, this mental fog can significantly impact daily life, making everything from work to personal relationships more challenging.

When the body doesn’t receive the necessary rest it needs, the autonomic nervous system, which regulates many involuntary functions like heart rate and blood pressure, becomes more imbalanced. This imbalance can lead to an intensification of POTS symptoms, making it even harder to manage the condition.

Tips for Improving Sleep with POTS

Living with POTS can make getting restful sleep feel like an uphill battle, but by making strategic adjustments to your routine and environment, you can improve both the quality and consistency of your sleep. These practical tips in the Sleeping with POTS guide can help reduce the impact of POTS symptoms at night, enabling you to wake up feeling more rested and refreshed.

1 – Establishing a Consistent Bedtime Routine

A consistent bedtime routine is essential when managing POTS-related sleep disruptions. Our bodies thrive on routine, and sticking to a regular sleep schedule can significantly help signal to your brain when it’s time to wind down. Aim to go to bed and wake up at the same time each day, even on weekends, to establish a consistent circadian rhythm. This regularity can help improve the timing of your body’s internal sleep-wake cycle, making it easier to both fall and stay asleep.

Beyond just setting a sleep schedule, it’s helpful to create a relaxing pre-sleep routine that encourages a calm transition from the busyness of the day into a more restful state. Activities like reading, journaling, or listening to soft music can be relaxing and signal to your body that it’s time to wind down. Avoiding screens such as phones, tablets, or TVs for at least an hour before bed is important, as the blue light emitted can interfere with the production of melatonin, the hormone that signals to your body that it’s time to sleep.

Additionally, ensure that your sleep environment is conducive to rest. Keep the bedroom cool, dark, and quiet. A cool room temperature (60-67°F or 15-19°C) promotes better sleep, while blackout curtains can help block out light that may disrupt your sleep cycle. A white noise machine can also be a great tool to mask any sudden noises in the environment, helping you sleep more soundly.

2 – Optimizing Your Sleeping Environment

Creating the right sleeping environment can have a profound effect on sleep quality for those with POTS. The ideal sleep environment should be cool, dark, and quiet, as these conditions help the body relax into deeper, more restorative stages of sleep. Keeping the room at a cooler temperature—between 60 and 67°F—is recommended to help lower your body’s core temperature, a key part of transitioning into restful sleep.

To achieve a dark and quiet room, blackout curtains are an excellent investment. These curtains block out external light sources such as streetlights or early morning sunshine, helping to maintain a consistent sleep environment throughout the night. If outside noises tend to disrupt your sleep, a white noise machine or a fan can be helpful to drown out background sounds, providing a more peaceful sleeping experience.

When it comes to bedding, consider breathable fabrics for your sheets and blankets, such as cotton or linen, which allow air circulation and prevent overheating. A mattress and pillow that provide proper support for your body, especially for those with POTS, can also play a significant role in promoting comfortable sleep. If necessary, consider using a mattress topper or pillows designed to relieve pressure points and promote spinal alignment, ensuring that your body remains comfortable throughout the night.

3 – Using Elevated Pillows or an Adjustable Bed

For many people with POTS, elevating the head slightly while sleeping can help improve circulation and alleviate some of the discomfort associated with the condition. Lying flat can exacerbate symptoms such as dizziness and rapid heart rate, as blood tends to pool in the lower extremities, making it harder for the heart to pump blood effectively. By elevating the head of the bed, you can promote better blood flow, reducing these symptoms.

One option for achieving this elevation is through an adjustable bed, which allows you to raise the head of the bed with ease. If an adjustable bed is out of your budget or space limitations, consider using a bed wedge to elevate your upper body. The incline can help reduce pressure on your heart and improve blood circulation, which may alleviate symptoms like dizziness and heart palpitations during sleep.

4 – Staying Hydrated Throughout the Day

Hydration is essential for managing POTS, and maintaining adequate fluid levels throughout the day can help prevent symptoms from worsening at night. Dehydration can lead to low blood volume, which can intensify symptoms like dizziness, fatigue, and rapid heart rate. Ensuring that you drink plenty of water during the day is key to keeping your body hydrated and maintaining healthy blood pressure levels.

However, while staying hydrated is crucial, it’s important to balance fluid intake to avoid disruptions in your sleep. Drinking large amounts of water right before bed may increase the likelihood of waking up in the middle of the night to use the bathroom. Instead, aim to hydrate consistently throughout the day, spacing out fluid consumption so that your body remains adequately hydrated without overloading your bladder at night.

Consider adding electrolyte-rich fluids to your hydration routine, especially if you experience a lot of blood pooling in your legs or have issues with maintaining proper blood pressure. Electrolytes help maintain the balance of fluids in your body, which can be especially beneficial for those with POTS.

5 – Incorporating Gentle Exercise into Your Routine

Engaging in regular gentle exercise is another effective way to help improve sleep quality. Low-impact activities, such as yoga, tai chi, or stretching, can help improve circulation, reduce stress, and promote relaxation—all of which are vital for better sleep. These types of exercises encourage blood flow and help your body relax without putting additional strain on your heart or cardiovascular system.

Exercise should be done earlier in the day to avoid overstimulation before bedtime. Performing physical activity too close to bedtime can raise adrenaline levels, making it harder for your body to unwind. Try to schedule your workouts at least 3-4 hours before bed to give your body enough time to cool down and relax.

Additionally, incorporating relaxation techniques such as deep breathing exercises or progressive muscle relaxation after exercise can further promote restfulness, helping you wind down more effectively before bed.

Relaxation Techniques for Better Sleep

Managing POTS symptoms is challenging enough during the day, but it can be especially difficult when trying to sleep. However, relaxation techniques can help calm the nervous system, reduce anxiety, and promote restful sleep. Incorporating these practices into your pre-sleep routine can be highly beneficial in addressing the common sleep disturbances associated with POTS.

Deep Breathing and Meditation Practices

Deep breathing and progressive muscle relaxation are effective relaxation techniques that can help calm the nervous system and reduce pre-sleep anxiety. Deep diaphragmatic breathing, also known as belly breathing, involves inhaling deeply through your nose, expanding your diaphragm, and exhaling slowly through your mouth. This type of breathing helps to activate the parasympathetic nervous system (the body’s “rest and digest” system), promoting relaxation and lowering heart rate.

Another useful practice is progressive muscle relaxation (PMR), which involves tensing and relaxing different muscle groups in the body, starting from your toes and working your way up to your head. This technique helps release physical tension and can also encourage mental relaxation. Together, deep breathing and PMR can be very effective in reducing the tension that may contribute to restless sleep and symptoms like rapid heart rate and dizziness, which are common with POTS.

Both techniques have been shown to lower heart rate, reduce muscle tension, and ease the anxiety that many people experience before bedtime. As a result, these practices can significantly improve your ability to fall asleep and stay asleep throughout the night.

Mindfulness and Visualization Exercises

Mindfulness is another powerful tool for promoting relaxation before sleep. This practice involves focusing your attention on the present moment and accepting it without judgment. By becoming more aware of your body, breath, and surroundings, mindfulness can help quiet the mind and reduce the racing thoughts that often prevent people from falling asleep. For those with POTS, practicing mindfulness can help ease anxiety related to symptoms like dizziness or heart palpitations that often become more pronounced at night.

Visualization techniques can also be incredibly effective in creating a sense of relaxation. This practice involves imagining calming and peaceful scenes or environments, such as a serene beach or a tranquil forest. As you focus on these peaceful images, you can help shift your mind away from the stressful thoughts or discomforts associated with POTS symptoms. Visualization can help lower stress levels, making it easier to transition from wakefulness to sleep.

Mindfulness and visualization can be especially helpful in reducing pre-sleep anxiety, which can exacerbate symptoms of POTS and disrupt your ability to fall asleep. By grounding your mind and focusing on soothing thoughts, these exercises create a mental environment conducive to sleep.

Using Sleep Apps or Guided Audio for Support

For those who find it difficult to relax before bed, using sleep apps or guided meditations can be an excellent way to support your relaxation efforts. Many apps are specifically designed to help manage sleep in individuals with chronic health conditions like POTS, offering audio tracks that guide you through calming exercises, deep breathing routines, or gentle relaxation techniques. These resources can be a great way to integrate relaxation into your evening routine without having to remember or follow complex steps.

Apps like Calm, Headspace, or Insight Timer offer guided meditations, breathing exercises, and even sleep stories, which can help guide your mind into a relaxed state and prepare it for sleep. Some apps also have settings for sleep sounds or white noise, which can mask any disruptive background noises and provide a comforting auditory environment for sleep.

Medical Support and Supplements

When managing POTS, sleep disturbances can sometimes require additional support from healthcare providers. In some cases, medications and supplements may be helpful in addressing both POTS symptoms and sleep-related issues. However, it’s essential to approach any form of medical intervention carefully and under the guidance of a healthcare professional to ensure safety and effectiveness.

Medications for Sleep and POTS Symptom Management

If you’re struggling to manage sleep disturbances due to POTS, it’s important to consult your healthcare provider about potential sleep aids or medications that may be appropriate for your specific needs. Some medications may help reduce POTS symptoms and, by extension, improve sleep quality. However, due to the complexity of POTS and its interaction with various body systems, these medications should only be prescribed and managed by a doctor.

Common medications prescribed for POTS that may also aid with sleep issues can include:

  • Beta-blockers: These may help manage heart rate and reduce symptoms like palpitations, which can interfere with sleep.
  • Fludrocortisone: This medication helps increase blood volume, potentially improving blood pressure and preventing blood pooling, which can alleviate discomfort during sleep.
  • SSRIs (Selective Serotonin Reuptake Inhibitors): These antidepressants can help manage anxiety, which may also contribute to sleep problems in some individuals with POTS.
  • Sleep aids: In some cases, doctors may prescribe low-dose sedatives or antihistamines for short-term sleep support, though these should be used with caution.

Conclusion

Getting quality sleep when living with POTS can be challenging, but with the right strategies and support, it is possible to improve your sleep and better manage your symptoms. Establishing a consistent bedtime routine, optimizing your sleep environment, staying hydrated, and incorporating gentle exercise into your day are all practical steps that can help ease the sleep disruptions caused by POTS. Additionally, relaxation techniques like deep breathing, mindfulness, and guided audio can be incredibly effective in calming both the mind and body before bed.

For those who need extra support, medications and supplements—when guided by a healthcare professional—can play a key role in improving sleep quality and addressing specific symptoms. Remember, POTS affects everyone differently, so it’s essential to work closely with your doctor to tailor a sleep plan that works best for you.

Prioritize rest and relaxation, and be patient with yourself as you experiment with different approaches. Quality sleep is an integral part of managing POTS, and taking steps to improve it can lead to better symptom management, greater energy, and overall well-being.