Does Your POTS or HR vary by time of day?

How does time of day affect your heart rate?


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Sparrow

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Assuming you were doing the exact same activity, is your heart rate higher in the morning, or in the evening? Are your POTS symptoms in general worse at one of those times than the other?

My HR and POTS are best first thing in the morning, and then get progressively worse as the day goes on. By evening it can be really bad. On an average day, my HR walking around in the morning can be around 105. By evening, 125 - 130 is more typical (and on a bad day, it can be far worse than that). ...But from what I've read, this seems to be the other way around for most POTS patients. I also haven't had any noticeable help from high compression stockings, increased salt/water intake, etc., despite visible evidence that my blood is pooling in my feet sometimes when I sit/stand too long. Keeping my legs crossed rather than hanging down while sitting does help a lot, though. Maybe my body is so out of whack that the more subtle interventions can't do enough to make a noticeable difference. Maybe my problem is related to cortisol and I get a boost in the morning. Maybe I'm still overdoing it with the tiny amount of activity I have during the day, and my body's worn out by nighttime. Who knows.

Anyway, I've been curious how much of what's wrong with me on that front is different from the standard, and how helpful other interventions may or may not be as a result, so I wanted to ask if anyone else here has O.I. symptoms that are worse later in the day. And if so, have any medications been helpful to you in managing them? Were you able to definitively identify what the problem is for you, or come up with a way to help it?
 

Valentijn

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My heart rate stays pretty steady, unless I'm having Issues. But my blood pressure and/or pulse pressure get lower later in the day.
 

Ruthie24

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Generally I have tended to have more tachycardia in the morning but since I had a really bad relapse during this past winter it's been worse in the late afternoon/evening/night. Maybe that's tied in with the way my sleep cycles have also gotten so totally messed up again as well?

I take a beta blocker in the morning that is supposed to have a long half life and should be covering me all day but it's not working to control my symptoms very well later in the day now.
 
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My HR is definitely higher in the morning. I can barely tolerate being upright for more than a couple minutes for the first few hours of each day. The difference used to be very noticeable - HR above 130 in the morning, and around 100 at night (and feeling almost normal!). Unfortunately I've gotten worse recently and now its more like 160 in the morning, 130 at night and I don't physically notice much of a difference.

That is really interesting that you get worse throughout the day, because you're right, I do think it's more common to be better at night. I'm not sure that is ever been formally studied but suggested reasons I've heard from doctors are: overnight dehydration, BP drops while sleeping, and hormonal changes at night (the only one I can remember is cortisol). Maybe get your cortisol checked?

Do you know if you have any blood pressure changes that correlate with how you feel? Also..do you spend a lot of your day upright? Is it possible that your HR is getting higher throughout the day from the continued stress of being upright? Have you ever had a mostly reclining day and checked your changes in HR? Just some thoughts!
 

Sparrow

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Do you know if you have any blood pressure changes that correlate with how you feel? Also..do you spend a lot of your day upright? Is it possible that your HR is getting higher throughout the day from the continued stress of being upright? Have you ever had a mostly reclining day and checked your changes in HR? Just some thoughts!
I've been wondering if cortisol might be involved for me.

BP has done some messed up stuff since getting ill, but it doesn't seem to change much in line with how I'm feeling. It's much more consistent throughout the day. Raises when I've been standing or physically active, but by a similar amount regardless of the time.

Can't be the strain of being upright because I'm bed bound except for bathroom trips. I do think I get more worn out as the day goes on, and I definitely think that's a factor. It also gets way higher when I crash, so I know that takes a toll. Maybe I'm just still overdoing it more than I think...

Thanks for your input. It just seems a little weird to me that this doesn't seem to quite match up with what seems common with POTS. Makes me wonder if there's something different to it for me.
 

SOC

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I was told by my cardio that high HR in the morning is due to low blood volume. We don't replenish by drinking water overnight so blood volume is usually lowest in the morning. I was told to drink 0.5-0.75 L of electrolyte water immediately before bed and another 0.5-0.75 L before getting out of bed in the morning. It's something of a pain, but it does make me feel a whole lot better in the morning. And my HR is lower, of course. :)
 

ukxmrv

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My POTS is much worse in the morning. I can faint if I sit or stand up too quickly. Have black spots in front of my eyes and shake. Have always assumed that it was due to my low morning cortisol. As the day goes on it gets much better.
 

taniaaust1

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I dont know if mine as far as heart beat goes is same, better or worst in the mornings.. but there can be an increase of up to 67 beats per minute if I take it before getting out of bed and then when standing. Going by my POTS symptoms I feel it seems to impact me to the same degree all the time (I do wake to drink multiple times during the night so probably dont dehydrate then)
 

Shell

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My IST can be shocking in the evening or even the middle of the night. Getting up and moving around in the morning with kick up my HR but not usually to a daft level. Evenings when I am well knackered seems to be the time.
 

Sparrow

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Shell - If you ever find out anything more about your situation, please let me know. It sounds like you've got the same pattern I do. Mine is super bad when I'm really worn out.
 

Sparrow

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I think I worded that poorly. Mine does jump way up when I'm run down, but the effect of that still can't match the effect of time of day. Super crashy and feeling awful in the morning, my heart rate is still lower than evening on a good day.
 

vli

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I was told by my cardio that high HR in the morning is due to low blood volume. We don't replenish by drinking water overnight so blood volume is usually lowest in the morning. I was told to drink 0.5-0.75 L of electrolyte water immediately before bed and another 0.5-0.75 L before getting out of bed in the morning.
I do this too, though gotta confess that since I don't always have water mixed with electrolyte ready when i wake, for at least a year now I've often just taken at least 1mg Rivotril (think in America it's Klonopin), instead on waking.
 
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Assuming you were doing the exact same activity, is your heart rate higher in the morning, or in the evening? Are your POTS symptoms in general worse at one of those times than the other?

My HR and POTS are best first thing in the morning, and then get progressively worse as the day goes on. By evening it can be really bad. On an average day, my HR walking around in the morning can be around 105. By evening, 125 - 130 is more typical (and on a bad day, it can be far worse than that). ...But from what I've read, this seems to be the other way around for most POTS patients. I also haven't had any noticeable help from high compression stockings, increased salt/water intake, etc., despite visible evidence that my blood is pooling in my feet sometimes when I sit/stand too long. Keeping my legs crossed rather than hanging down while sitting does help a lot, though. Maybe my body is so out of whack that the more subtle interventions can't do enough to make a noticeable difference. Maybe my problem is related to cortisol and I get a boost in the morning. Maybe I'm still overdoing it with the tiny amount of activity I have during the day, and my body's worn out by nighttime. Who knows.

Anyway, I've been curious how much of what's wrong with me on that front is different from the standard, and how helpful other interventions may or may not be as a result, so I wanted to ask if anyone else here has O.I. symptoms that are worse later in the day. And if so, have any medications been helpful to you in managing them? Were you able to definitively identify what the problem is for you, or come up with a way to help it?

I know this is a really old post, but I have the same symptoms that are gone in the morning and get worse over time each day. I'm searching for what to do, what is wrong and why I have this problem. If you get this email and can share any details with me that would be wonderful. Thanks,

-Matt