Elevating the Head of the Bed for POTS

My neurologist shared with me this pro-tip for POTS that I wanted to pass along to you fellow Potsies: Elevate the head of your bed to a 10-15 degree angle. According to a survey, a little over 50% of respondents had some degree of improvement by raising the head of their bed. So, this may be worth your consideration if you have POTS or another form of Dysautonomia.

Why does this help?

At night, when we lie flat, our body releases an increased amount of a hormone called Atrial Natruiretic Peptide (ANP). ANP signals the kidneys to reabsorb less sodium. As sodium leaves the body, water follows due to osmosis. Less water in our body means less blood volume. Less blood volume means lower blood pressure and a potential exacerbation of orthostatic intolerance. To explain it alternatively, when we are upright, less ANP is secreted, so less urine is formed, and that fluid is retained in the body. If the head of the bed is elevated, our body registers that as “upright” and will release less ANP and maintain a higher fluid and blood volume. Pretty cool hack, isn’t it?

In addition to fluid retention benefits, Dysautonomia International states that elevating the head of the bead also helps to recondition the body to orthostatic stress and alleviate gastric motility issues. Working on POTS recovery can be time consuming, so to be able to reap orthostatic tolerance benefits while you sleep is huge.

How to do it

My neurologist instructed me to stack a board, books, bricks, or something hard like that under the head-end of the mattress to elevate it to a 10-15 degree angle. The entire bed must be on an angle. I wonder if it would work better to do it under the box spring (if you have one) as it would keep the angle more intact since it is harder than the mattress. You could also use risers to elevate the head side of the bed. With all of these methods, make sure everything is secure so that you stay safe. I have not tried this, so I cannot say which of these methods work best.

What not to do- bunk beds from Step Brothers

Why I do not do elevate the head of my bed

Other interventions to expand fluid volume have not had a significant impact on how I feel. I’m concerned that I would potentially mess up my quality of sleep, but not reap much benefit. However, if I had more severe orthostatic intolerance and/or interventions like salt, increased water intake, and Florinef were more useful, I would try elevating the head of my bed without any hesitation. Or, if I had gastric motility/G.E.R.D, I would also consider trying this. Although I doubt this method’s usefulness in my circumstances, that does not mean that it couldn’t be useful for you.

Does anyone elevate the head of their bed for POTS? How does it work for you?

Disclaimer: I am not a medical professional. Statements on this site are not meant to be taken as medical advice. These statements reflect my personal experiences having mild-ish post-viral POTS and ME. Due to the wide spectrum of these diseases, comorbidities, and everyone being different, your experiences may be very different than mine.

Note: If you post a comment, this site does NOT have a feature to notify you of responses to your comment. I have not found a good solution for that yet. However, I usually respond to every comment in a timely manner, so be sure to check back.

You may also like

12 Comments

    1. Thank you for catching this. I’m going to correct the article to reflect Dr. Peter Rowe’s recommendation which is 10-15 degrees. I must have written this on a bad brain fog day or something. I’m sorry for the confusion.

  1. I need to do this for other reasons that will ultimately benefit my POTS too. I have cervical spine issues and instability along with a hyper mobile spine. Lying on my back would probably be the best option for sleeping to prevent pinched nerves. But I can’t do that without also experiencing sleep apnea pretty much the moment my airway relaxes when I fall asleep.

    I’m not sure how I’ll elevate the head of the bed since I have faux wood laminate flooring that can be a bit slippery and I can’t lift cement blocks or attach anything to the floor. As many of us know, disabled folks don’t usually have loads of spare $$$ to spend, which means figuring this out for me means spending nearly $0 on whatever safe hack I can figure out.

    In absence of being referred to anyone to actually diagnose my POTS (though my GP readily acknowledges I have it), I really appreciate reading about the ANP secretion and how elevation might help this in some folks. It’s specifics like explaining in layperson’s terms how ANP affects POTSies that helps to know why elevation is recommended in the first place.

    I’m not sure how many inches 60 degrees equals from a starting point of a 90 degree angle (I’m dyspraxic so this math might make easy sense to some people but it’s a challenge for me). Summer is coming and it’s even worse for me than winter what with being unable to regulate my body temperature in the heat, so I hope I can figure this one out soon.

    Thanks for sharing!

    1. Hey Nicole, thanks for sharing. Yeah, that sounds tricky on figuring out how to hack it with slippery floor… Hm… I wonder if you carpet taped a small rug or remnant under where you plan to put your propping up items at? Ah yeah, I see what you mean with the inches up vs. angle. I do not know how many inches that would equate to. If anyone reads this and knows, please chime in.

    2. I have hypermobile EDS myself and struggle to breath well sleeping on my back. I have found that sleeping on my side with a pillow to keep my neck in neutral and a U-shaped body pillow behind / in front of me helpful so I don’t twist.
      I have had to elevate my whole bedframe on 4×4″ boards to get a slant – I have wood floor so put anti-skid pads like what you put under carpets beneath them.

  2. Great post. I was shocked when I tried elevating the head of my bed with how well it worked. My husband used books to elevate it about 6 inches. My sleep is better and in the morning getting out of bed is easier. My fatigue decreased significantly and my exercise tolerances improved.

  3. GREAT post! It has been very helpful & informative. We have elevated our kiddo’s bed & there is improvement in how she feels upon waking up in the AM now. Also seems to help her fall asleep more quickly & is seeming to help with pain too. Hubby is in the process of elevating all the beds in our house now for the rest of the family. lol

    1. I’m so glad to hear that it helped your daughter. Thank you for sharing your experience. Haha, I like that your whole family is doing it now. Take care!

  4. Just elevated it today. I have a terrible time going to sleep anyway but we’ll see how I feel in the morning. 🤞

  5. I can’t..,I can’t…I can’t breathe…I’m laughing too hard!!! 🤣🤣🤣💖

Leave a Reply

Your email address will not be published. Required fields are marked *