Orthostatic Dysregulation Quiz
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Dizziness
Lightheadedness when I am standing
Dizzy when standing up
Fatigue is worse in the morning
Feeling faint
Off-balance like floating
Blacking out
Not seeing your symptoms? No worries!
What is Orthostatic Dysregulation?
Orthostatic dysregulation (OD) is a general term that describes abnormal blood pressure changes triggered by sitting up or standing, most commonly resulting in low (orthostatic hypotension) or, less commonly, high blood pressure (orthostatic hypertension). OD is most common in the elderly, and can be due to certain medications (e.g. anti-depressants and anti-hypertensives), certain diseases affecting the nervous system (e.g. diabetes, Parkinson disease, multiple sclerosis), and can be seen in certain sleep disorders.
Typical Symptoms of Orthostatic Dysregulation
- Fatigue or low energy that is worse in the morning
- Fainting
- Dizziness
- Feel unsteady or floating when I am standing
- Headache that gets worse in the morning
- Forehead pain
- Dizziness when standing or after prolonged standing
- Stressed over daily life
Diagnostic Questions for Orthostatic Dysregulation
Your doctor may ask these questions to check for this disease:
- Do you experience fatigue or low energy that is worse in the morning?
- Have you fainted recently?
- Do you feel dizzy?
- Do you feel dizzy or floaty when standing?
- Do your headaches get worse in the morning?
Treatment of Orthostatic Dysregulation
Treatment aims to restore normal blood pressure. The simplest method is to sit back down if symptoms occur and stand up slowly. For OD caused by specific diseases, treatment of those diseases can control symptoms. Other lifestyle changes like maintainin hydration, reducing alcohol intake can help.
Reviewed By:
Benjamin Kummer, MD (Neurology)
Dr Kummer is Assistant Professor of Neurology at the Icahn School of Medicine at Mount Sinai (ISMMS), with joint appointment in Digital and Technology Partners (DTP) at the Mount Sinai Health System (MSHS) as Director of Clinical Informatics in Neurology. As a triple-board certified practicing stroke neurologist and informaticist, he has successfully improved clinical operations at the point of care by acting as a central liaison between clinical neurology faculty and DTP teams to implement targeted EHR configuration changes and workflows, as well as providing subject matter expertise on health information technology projects across MSHS. | Dr Kummer also has several years’ experience building and implementing several informatics tools, presenting scientific posters, and generating a body of peer-reviewed work in “clinical neuro-informatics” – i.e., the intersection of clinical neurology, digital health, and informatics – much of which is centered on digital/tele-health, artificial intelligence, and machine learning. He has spearheaded the Clinical Neuro-Informatics Center in the Department of Neurology at ISMMS, a new research institute that seeks to establish the field of clinical neuro-informatics and disseminate knowledge to the neurological community on the effects and benefits of clinical informatics tools at the point of care.
Yoshinori Abe, MD (Internal Medicine)
Dr. Abe graduated from The University of Tokyo School of Medicine in 2015. He completed his residency at the Tokyo Metropolitan Health and Longevity Medical Center. He co-founded Ubie, Inc. in May 2017, where he currently serves as CEO & product owner at Ubie. Since December 2019, he has been a member of the Special Committee for Activation of Research in Emergency AI of the Japanese Association for Acute Medicine. | | Dr. Abe has been elected in the 2020 Forbes 30 Under 30 Asia Healthcare & Science category.
Content updated on May 13, 2024
Following the Medical Content Editorial Policy
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People with similar symptoms also use Ubie's symptom checker to find possible causes
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- Spinning feeling
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- Chest pain with fainting
- A sense of motion or spinning (vertigo)
- Feeling faint before losing consciousness
- Confused or drowsy for a while after recovering consciousness
- Fainting when tired
- Fainted but retained the ability to recall fainting
- Dizzy in the morning
- Feeling skin warmth or "hot flashes" before fainting
See full list
Symptoms Related to Orthostatic Dysregulation
Diseases Related to Orthostatic Dysregulation
FAQs
Q.
What Is POTS? Why Your Heart Is Spiking & Medical Next Steps
A.
POTS is a disorder of the autonomic nervous system in which standing triggers a heart rate jump of 30 bpm or more without a major blood pressure drop, because blood pools in the lower body and the heart races to compensate, causing dizziness, palpitations, fatigue, and brain fog. Immediate next steps include tracking your lying vs standing heart rate, seeing a clinician for orthostatic vitals, tilt table testing and labs to rule out other causes, and beginning hydration, appropriate salt, compression, and gradual recumbent exercise, with urgent care for crushing chest pain, severe shortness of breath, or sudden fainting. There are several factors to consider that can change your plan; key causes, medication options, and red flags are explained below.
References:
* Sheldon RS, Grubb BP, Olshansky B, et al. Postural Orthostatic Tachycardia Syndrome: JACC Focus Seminar 2023. J Am Coll Cardiol. 2023 May 9;81(18):1811-1825. PMID: 37137691.
* Raj SR, Bourne KM, Sheldon RS, et al. Postural Orthostatic Tachycardia Syndrome: The American Autonomic Society Statement on Diagnosis and Management. Auton Neurosci. 2023 May;250:103164. PMID: 36764507.
* Vernino S, Bourne KM, Raj SR. Postural orthostatic tachycardia syndrome (POTS): current knowledge and future challenges. Eur Heart J. 2021 Dec 21;42(48):4927-4935. PMID: 34520556.
* Chandar N, Maalouf B, Maalouf J. Postural Orthostatic Tachycardia Syndrome (POTS): A Concise Review of Diagnosis and Management. Front Physiol. 2021 Jul 15;12:688642. PMID: 34335345.
* Fu Q, Vanegas-Arroyave N, Sheldon RS. Current Approach to the Diagnosis and Management of Postural Orthostatic Tachycardia Syndrome. Cardiol Clin. 2020 Aug;38(3):365-375. PMID: 32622438.
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1References
Kawai M, Miyai N, Arita M. The prevalence of orthostatic dysregulation among newly graduated female nurses after employment and its associations with autonomic nervous function, stress, and depressive symptoms. SAGE Open Med. 2021 Apr 29;9:20503121211012180. doi: 10.1177/20503121211012180. PMID: 33996079; PMCID: PMC8107664.
https://journals.sagepub.com/doi/10.1177/20503121211012180Roca F, Rougette K, Zmuda L, Noel G, Larose S, Bordage M, Chassagne P. Association between orthostatic blood pressure dysregulation and geriatric syndromes: a cross-sectional study. BMC Geriatr. 2022 Feb 26;22(1):157. doi: 10.1186/s12877-022-02844-8. PMID: 35219308; PMCID: PMC8881862.
https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-022-02844-8Tsuchiya A, Kitajima T, Tomita S, Esaki Y, Hirose M, Iwata N. High Prevalence of Orthostatic Dysregulation among Circadian Rhythm Disorder Patients. J Clin Sleep Med. 2016 Nov 15;12(11):1471-1476. doi: 10.5664/jcsm.6268. PMID: 27568888; PMCID: PMC5078701.
https://jcsm.aasm.org/doi/10.5664/jcsm.6268