Postural Orthostatic Tachycardia Syndrome: Living With Dizziness

Do you feel dizzy when you get out of bed? Do you feel tachycardic when you get up from lying down? If you experience frequent migraines as well, you could be suffering from a specific medical condition. Find out about it here.
Postural Orthostatic Tachycardia Syndrome: Living With Dizziness
Valeria Sabater

Written and verified by the psychologist Valeria Sabater.

Last update: 22 February, 2024

Many individuals experience dizziness on a regular basis. They’re people who, in the eyes of others seem weaker. That’s because, without really knowing why, they often faint or lose their balance. In fact, it can be something as simple as a slight drop in blood pressure, the heat, not having had breakfast, or even suffering a simple headache that makes their strength fail and sets their world spinning.

This disorder, which can happen at any time, has significant effects on the sufferer. Indeed, it’s a debilitating symptom that affects the daily lives of many people and limits their lives to a greater or lesser extent. It can arise due to various medical conditions.

One such rare disease is underdiagnosed. This is postural orthostatic tachycardia syndrome (POTS). Sufferers experience intense dizziness when they get up after lying down for a while. For example, it happens when they wake up and get out of bed. It’s a sudden dizziness that almost knocks them unconscious for a few seconds.

The causes of postural orthostatic tachycardia syndrome aren’t known for certain. However, it can occur after a viral illness, pregnancy, trauma, or surgery.

Sad man sitting on bed suffering suffering from postural tachycardia syndrome
The first thing that the sufferer of postural orthostatic tachycardia syndrome experiences when getting up is blurred vision.

Postural orthostatic tachycardia syndrome

Postural orthostatic tachycardia syndrome (POTS) is a rare disease of unknown origin. It involves a dysfunction of the autonomic nervous system. In effect, the volume of blood to the heart is reduced after the sufferer has been lying down.

This condition is also accompanied by other significant symptoms and associated problems. For instance, between 30 and 40 percent of sufferers also experience migraines. Furthermore, dizziness often ends in syncope (fainting). In turn, this can lead to blows or even bone fractures.

Today, this condition is receiving increasingly more attention, but not enough. Regular dizziness is especially common in women but isn’t necessarily due to hormonal factors or drops in blood pressure. Therefore, adequate diagnoses are necessary for the most accurate interventions to be provided.

Postural orthostatic tachycardia syndrome can also occur in children and adolescents.

How does it manifest?

Postural orthostatic tachycardia syndrome (POTS) presents with an extremely extensive and complex clinical picture. In fact, it’s an extremely limiting condition due to its recurrent fainting spells. The symptoms are as follows:

  • The sufferer experiences intense dizziness when moving from a lying down position to an upright one.
  • When they get up, for around ten minutes, they’re extremely tachycardic.
  • They feel a throbbing in their head.
  • They experience blurred vision.
  • When they sit up, they instantly feel overwhelming tiredness.
  • Their movements become heavy. For instance, it’s difficult for them to walk or dress.
  • They suffer gastrointestinal symptoms.
  • They experience nausea and cold sweats.
  • Their sleep is disturbed.
  • They experience heightened anxiety.
  • Between 30 and 40 percent of them suffer from migraines.

Who usually suffers?

As a rule, this syndrome appears in young people. That said, children and adults up to 50 years of age can suffer from it. An investigation conducted by the University of Texas (USA) claims that it’s more common in women at the peak of their working lives.

What are the causes?

The exact triggers for postural orthostatic tachycardia syndrome aren’t known. For this reason, programs and clinical trials that patients can join are being designed to facilitate both the understanding of the disease and the search for more effective interventions.

Currently, the scientific community believes that the main problem centers on the orthostatic condition. They think that there’s a failure in the sufferer’s circulation when they move from a lying position to a vertical one. There are a number of hypotheses for this process that have generated a good volume of research. They’re as follows:

  • Alterations in the heart and circulatory problems.
  • A mutation in the norepinephrine transporter gene. In fact, this is a nuance that appears in all sufferers of postural orthostatic tachycardia syndrome.
  • Many women experience the disease after pregnancy or surgery.
  • It could also be linked to menstruation and hormonal factors.
  • It may be linked to autoimmunity problems.
  • Some patients develop the condition after a viral illness.
  • Having suffered psychological trauma increases the risk of developing the condition.
woman suffering from postural tachycardia syndrome at the doctor
Many people will suffer chronically from postural orthostatic tachycardia syndrome.

Interventions exist

One of the most frequent clinical mechanisms to treat postural orthostatic tachycardia syndrome is to improve blood pressure and attend to cardiovascular health. However, firstly, and most importantly, the individual characteristics of each patient must be diagnosed.

The therapeutic approach is always multidisciplinary, based on drugs and lifestyle changes. After some time, the therapist analyzes the patient’s progress and adherence to the intervention. Then, they propose any necessary improvements. As a rule, it’s possible to improve the quality of life of the sufferer. On the other hand, it’s a chronic disease for which more questions than answers currently remain.

Living with dizziness can be hell. Therefore, postural orthostatic tachycardia syndrome needs to become more visible. Then, science will be able to conduct further research and develop the best possible interventions.

All cited sources were thoroughly reviewed by our team to ensure their quality, reliability, currency, and validity. The bibliography of this article was considered reliable and of academic or scientific accuracy.

  • Benrud-Larson, L. M., Dewar, M. S., Sandroni, P., Rummans, T. A., Haythornthwaite, J. A., & Low, P. A. (2002). Quality of life in patients with postural tachycardia syndrome. Mayo Clinic proceedings, 77(6), 531–537.
  • Bryarly, M., Phillips, L. T., Fu, Q., Vernino, S., & Levine, B. D. (2019). Postural Orthostatic Tachycardia Syndrome: JACC Focus Seminar. Journal of the American College of Cardiology, 73(10), 1207–1228.
  • Cortez, M. M., Millsap, L., & Brennan, K. C. (2021). Synergistic but separable sensory changes in postural tachycardia syndrome and chronic migraine. Clinical autonomic research : official journal of the Clinical Autonomic Research Society, 31(2), 263–271.
  • Fedorowski A. (2019). Postural orthostatic tachycardia syndrome: clinical presentation, aetiology and management. Journal of internal medicine, 285(4), 352–366.
  • Kim, H.J., Lee, J.O., Choi, J.Y. & Soo Kim, J. (2020). Etiologic distribution of dizziness and vertigo in a referral-based dizziness clinic in South Korea. Journal of Neuroly, 267, 2252–2259.
  • Low, P. A., Sandroni, P., Joyner, M., & Shen, W. K. (2009). Postural tachycardia syndrome (POTS). Journal of cardiovascular electrophysiology, 20(3), 352–358.

This text is provided for informational purposes only and does not replace consultation with a professional. If in doubt, consult your specialist.