Physiological effects of sleeping with the head of the bed elevated 18 in. in young healthy volunteers
- 121 Downloads
Sleeping with the head of bed tilted upwards (SHU) is recommended as a treatment of orthostatic hypotension though the supporting evidence is weak.
To investigate the physiological effects of SHU amongst a group of young healthy volunteers.
Twenty-nine volunteers, mean age 22 years, underwent 1-week of SHU at 18-in. elevation. Before and after hemodynamic and non-haemodynamic parameters were recorded.
After SHU, there were reductions in the systolic blood pressure drop on standing, upright total peripheral resistance, haemoglobin, nocturnal urinary volume, orthostatic dizziness and increases in weight, standing cardiac output and ankle circumference. There were no differences in heart rate, stroke volume, renin, aldosterone, pro-atrial natriuretic peptide or 24-h blood pressure.
In these healthy subjects, SHU for 1 week had a nocturnal antidiuretic effect with both intra- and extra-vascular accumulation of fluid and was associated with reduced postural drop in SBP and improved orthostatic tolerance.
KeywordsSleep Blood pressure Physiology
- 1.The Consensus Committee of the American Autonomic Society and the American Academy of Neurology (1996) Consensus statement on the definition of orthostatic hypotension, pure autonomic failure, and multiple system atrophy. Neurology 46(5):1470Google Scholar
- 15.Mathias CJ, Bannister R (2002) Management of postural hypotension. In: Bannister R, Mathias CJ (eds) Autonomic failure: a textbook of clinical disorders of the autonomic nervous systems. Oxford Medical Publications, Oxford, pp 342–356Google Scholar
- 17.MacLean AR, Allen EV (1940) Orthostatic hypotension andorthostatic tacchycardia: treatment with the ‘head-up’ bed. J Am Med Assoc 115:2162–2167Google Scholar
- 18.Corcoran AC, Browning JS, Page IH (1943) Renal hemodynamics in orthostatic hypotension: effects of angiotonin and head-up bed. J Am Med Assoc 119(10):793–794Google Scholar
- 21.Wieling W, Karemaker JM (2002) Measurement of heart rate and blood pressure to evaluate disturbances in neurocardiovascular control, 4th edn. Oxford Medical Publications, OxfordGoogle Scholar
- 23.Walters J, Garrity P (2003) Performance evaluation of the Sysmex XE-2100 Hematology Analyzer. Lab Hematol 6:83–92Google Scholar
- 27.Mathias CJ, Fosbraey P, da Costa DF, Thornley A, Bannister R (1986) The effect of desmopressin on nocturnal polyuria, overnight weight loss, and morning postural hypotension in patients with autonomic failure. Br Med J (Clin Res Ed) 293(6543):353–354Google Scholar
- 28.Bannister R, Mathias CJ (1992) Management of postural hypotension. In: Autonomic failure: a textbook of clinical disorders of the autonomic nervous system. Oxford Medical Publications, OxfordGoogle Scholar