Living with Postural Orthostatic Tachycardia Syndrome (POTS) is already a challenge, but when you add sleep issues into the mix, it can feel downright impossible to function. If you’re like me, you know the struggle of tossing and turning, waking up dizzy, or feeling just as exhausted in the morning as you did the night before. Sleep is so important for managing POTS symptoms, yet so many of us struggle to get enough quality rest.

If you’ve been searching for ways to finally get some decent sleep with POTS, you’re in the right place. In this post, I’ll break down what POTS is, how it’s diagnosed, how it affects sleep, why sleep deprivation makes symptoms worse, and—most importantly—how to improve your sleep as a POTS patient.

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Disclaimer: Hey there, friend! Just a quick reminder—I’m not a doctor, and this blog post isn’t medical advice (as much as I wish my Google searches made me a certified expert). Endometriosis is a complex condition, and everyone’s experience is different. If you suspect you have endo or are struggling with symptoms, please chat with a qualified healthcare provider. They have the tools, knowledge, and fancy medical degrees to give you the right guidance. This blog is all about sharing personal experiences and insights, not diagnosing or curing anything—so take what resonates, do your own research, and always prioritize your health. 💛

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What is POTS?

POTS is a form of dysautonomia, which means it affects the autonomic nervous system—the part of the body that controls involuntary functions like heart rate, blood pressure, digestion, and temperature regulation. Essentially, POTS makes it hard for the body to regulate blood flow, especially when moving from sitting or lying down to standing.

For many of us, this means experiencing symptoms like:

• A rapid increase in heart rate when standing
• Dizziness or lightheadedness
• Fatigue
• Brain fog
• Nausea
• Temperature regulation issues
• Exercise intolerance
• Digestive issues

POTS can be triggered by many things, including dehydration, heat, standing for long periods, and even lack of sleep—which is why getting enough rest is so crucial!

How is POTS Diagnosed?

Getting a diagnosis for POTS can be a long and frustrating journey. Many of us see multiple doctors before finally getting answers. If you suspect you have POTS, the main test used for diagnosis is a tilt table test or a 10-minute standing test:

• Tilt Table Test: You’re strapped to a table that tilts you from lying down to standing while doctors monitor your heart rate and blood pressure.
• 10-Minute Standing Test: You lie down for a few minutes, then stand up and remain standing while your heart rate is tracked. A heart rate increase of 30+ beats per minute (or 40+ bpm for teens) within 10 minutes is a key sign of POTS.

Many patients also undergo blood tests, autonomic nervous system testing, and other evaluations to rule out conditions that mimic POTS.

How POTS Affects Sleep

POTS and good sleep don’t exactly go hand in hand. Many of us deal with:

1. Insomnia

Trouble falling asleep and staying asleep is common. Our nervous systems are often stuck in “fight or flight” mode, making it hard to wind down.

2. Frequent Wake-Ups

Even if we do fall asleep, we might wake up frequently due to symptoms like palpitations, nausea, or needing to use the bathroom (thanks, overactive kidneys!).

3. Restless Legs & Muscle Cramps

Low blood circulation can lead to tingling, cramping, or that annoying restless leg sensation that makes relaxing impossible.

4. Temperature Dysregulation

Ever wake up drenched in sweat or freezing cold for no reason? POTS can make it hard for our bodies to regulate temperature, leading to disrupted sleep.

5. Low Blood Volume & Nighttime Dehydration

Since POTS can cause blood pooling and low blood volume, many of us wake up feeling extremely dehydrated. This can lead to nighttime headaches, dry mouth, and—again—frequent bathroom trips.

How Lack of Sleep Makes POTS Worse

Poor sleep doesn’t just make you tired—it can actually make POTS symptoms significantly worse. Here’s how:

• Increased Heart Rate & Dizziness – Sleep deprivation can cause even higher heart rate spikes, making dizziness and lightheadedness worse.
• Worsened Brain Fog – Already struggling with memory and focus? Lack of sleep can make it even harder to function mentally.
• More Fatigue & Weakness – POTS already drains energy, and sleep deprivation makes it even harder to get through the day.
• Lower Blood Pressure & Circulation Issues – Poor sleep can contribute to even lower blood volume, making symptoms like numbness and tingling worse.
• Heightened Anxiety & Stress – The autonomic nervous system struggles to regulate stress when we’re sleep-deprived, which can lead to increased anxiety and nervous system dysregulation.

Getting better sleep isn’t just about feeling well-rested—it’s a key part of managing POTS symptoms and improving overall quality of life.

Ways to Get Better Sleep as a POTS Patient

Okay, so now that we know why sleep is so difficult with POTS, what can we actually do about it? Here are some tips that have helped me and many others in the POTS community:

1. Stay Hydrated (But Smartly!)

Drink plenty of fluids throughout the day, but try to taper off a couple of hours before bed to avoid waking up for bathroom trips. Electrolyte drinks (like LMNT, Liquid IV, or my personal favorite, Cure Hydration) can help keep hydration levels stable.

2. Increase Salt Intake

Adding extra salt to meals can help with blood volume and circulation, reducing symptoms that might wake you up at night. Some POTS patients even keep salt packets near their bed for nighttime dizziness.

3. Elevate Your Head While Sleeping

Raising the head of your bed slightly (about 6–10 inches) can help regulate blood flow and reduce nighttime blood pooling.

4. Use Compression Garments

Compression socks (or even full compression leggings) during the day can help prevent blood from pooling, making it easier to regulate symptoms at night.

5. Cool Down Your Room

Since temperature regulation is often an issue, keeping your room on the cooler side (around 65°F) can help prevent night sweats and overheating. A cooling blanket or fan might also be helpful.

6. Follow a Consistent Sleep Schedule

Try to go to bed and wake up at the same time every day, even on weekends. A regular sleep schedule can help regulate your body’s internal clock.

7. Limit Caffeine & Stimulants

Caffeine can make insomnia worse, so it’s best to avoid it in the afternoon and evening. If you’re sensitive to caffeine, cutting it out entirely might be helpful.

8. Use Relaxation Techniques

Many POTS patients have an overactive nervous system, so relaxation techniques can be incredibly helpful. Try:

• Deep breathing exercises
• Progressive muscle relaxation
• Meditation (the Calm app is a great option!)
• Gentle stretching before bed

9. Consider Medication If Needed

If sleep is a major struggle, talk to your doctor about possible medication options. Some POTS patients benefit from melatonin, magnesium, or certain sleep aids.

10. Listen to Your Body

Most importantly, be kind to yourself. Some nights will be better than others, and that’s okay. If you have a bad night, try to rest during the day without stressing too much about lost sleep.

Final Thoughts

Getting good sleep with POTS isn’t easy, but it is possible with the right strategies. Prioritizing hydration, adjusting your sleep environment, using relaxation techniques, and maintaining a consistent routine can make a huge difference.

Remember, you’re not alone in this struggle. So many of us with POTS deal with sleep issues, but by making small changes and listening to our bodies, we can work towards more restful nights.