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Clinical Autonomic Research

, Volume 18, Issue 6, pp 318–324 | Cite as

Head-up sleeping improves orthostatic tolerance in patients with syncope

  • Victoria L. Cooper
  • Roger HainsworthEmail author
RESEARCH ARTICLE

Abstract

Objectives

This study was designed to examine the effect of head-up sleeping as a treatment for vasovagal syncope in otherwise healthy patients. Treatment for syncope is difficult. Pharmacological treatments have potential side effects and, although other non-pharmacological treatments such as salt and fluid loading often help, in some cases they may be ineffective or unsuitable. Head-up sleeping may provide an alternative treatment.

Methods

Twelve patients had a diagnosis of vasovagal syncope based both on the history and on early pre-syncope during a test of head-up tilting and graded lower body suction. They then underwent a period of 3–4 months of sleeping with the head-end of their bed raised by 10°, after which orthostatic tolerance (time to pre-syncope during tilt test) was reassessed.

Results

Eleven patients (92%) showed a significant improvement in orthostatic tolerance (time to pre-syncope increased by 2 minutes or more). Plasma volume was assessed in eight patients and was found to show a significant increase (P < 0.05, Wilcoxon signed-rank test). There was no significant change in either resting or tilted heart rate or blood pressure after head-up sleeping.

Interpretation

Head-up sleeping is a simple, non-pharmacological treatment which is effective in the majority of patients. However, it may not be tolerated by patients or bed-partners long term and whether the effects continue after cessation of treatment remains to be determined.

Keywords

syncope head-up sleeping plasma volume blood pressure 

Notes

Conflict of interest statement

There are no conflicts of interest.

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Copyright information

© Springer 2008

Authors and Affiliations

  1. 1.Cardiorespiratory UnitSt James’s University HospitalLeedsUK
  2. 2.Institute for Cardiovascular ResearchUniversity of LeedsLeedsUK

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