Low Blood Pressure Lying Down At Night

[Tessa]

Hi

My blood pressure nowadays (during the day) is about 103-67 But sometimes, I wake up at night, walk to the rest room and when I am back and l lie down in bed again, I am having chest pain or discomfort, discomfort breathing and sweats. (Thought I was having tachicardia too, but not according to the data).

Usually I cannot sleep again until all this is over, which can take about 30 to 90 minutes.

It does not happen every night.

Wondering why this was happening, I kept my blood pressure monitor close and checked my pulse and blood pressure for 2 nights.

Blood pressure: 95-50 heart rate: 72

and the other night it was 90-45 with a heart rate of 77

I?ve never had such a low blood pressure lying down before (at least the minimum)

I thought it was due because of getting up at night and walking to the rest room, but I have been able to confirm that my blood pressure is that low at night lying down (without even getting up).

My basal blood pressure at 7 am (lying down) is 95-55

Any idea? Have you gone through this?

Why is the minimum so low?

Thank you in advance for your help,

Love,

Tessa

[mkoven]

this is EXACTLY what I've been experiencing since August-- chest pain after lying down on my back after having gotten up to go to the bathroom late at night. No clear understandings, though my current cardio thinks I"m having vasospasms triggered by autonomic shifts. I've been taking midodrine at night (usually contraindicated) and sleep in my stockings. It's a little better, but still happens. It helps to lie on my side. If it is vasospasm, this is not really benign. we may try some new meds. I'm not sure what my bp is, but it is often quite low lying down.

[mkoven]

I should add that those bp numbers don't sound excessively low for someone lying down. I've had 80/40 lying down and felt okay-- as long as it adapts when I get up. My current cardio thinks that all the blood rushes to my heart when I lie down again and sort of overwhelms it. It's hard to get an answer, because this type of chest pain is "atypical" so no one knows what to do with it! I've been to the ER numerous times for this nocturnal cp--and nothing shows up.

[Ernie]

Hi,

My BP is low at night and when I feel bad I take Midrodine (even lying down).

[mkoven]

My current cardio has me take 5mgs before bed, and another 5 halfway through the night, as long as it's 3-4 hours after the first dose. My supine blood pressures haven't been high.

[EarthMother]

My BP tends to go low also especially at night. Over the summer when I was having terrible issues with hypoglycemia the nights were the worst! I would wake up tachy and drenched in sweat. Walking to the bathroom just made everything worse. I finally decided to use a rolling office chair (and sometime even had my husband push it for me) to get to the commode.

You may want to check to see if your blood sugar is dropping, or try a protein/complex carb snack right before bed.

Good luck finding something that helps.

~EM

[MelissaCrystal]

How do you feel at 90 over 50? I'm just wondering because 90 over 50 feels fine for me and I don't mind being at that pressure at night even though it is technically the start of hypotension. It's when it drops below 70 that I get scared in the morning--and usually I feel really weak.

I noticed that my BP doesn't drop low if I eat right before bed (yeah I know, that isn't a great idea if you don't want to gain weight, but it does make me feel better). Especially if it is something salty. Be careful with taking salt tablets before bed though, at least I have to be careful of that because for some reason the horizontal position makes the salt tablets irritate my stomach and give me more heart burn than usual. Or maybe it's acid reflux, I really don't know. I don't have the best advice, but my goal in eating before bed is just to get my blood sugar at a good reading and my BP as high as possible.

A lot of us also keep saltines next to the bed and if we wake up feeling nauseous (also a sign of low BP) we eat some and it can help you get up better in the morning.

Btw--here's something that my doc recently taught me. Subtract the top number of your BP from the bottom (systolic-diastolic) and that will give you your pulse pressure. Anything below 25 is a sign of low cardiac output (not enough blood pumping through your body) and something between 60-80+ is mostly associated with the dangers of hypertension. My BP was 110 over 98 the other day and I felt like I was dying---my doc said that can happen at night often and that is what I should worry about the most, not low blood pressure. In us, our docs don't worry as much about the low BP (unless of course you go wayyy low), mostly just the low pulse pressure. We could have a heart attack or go into shock if it goes too low, and we could have organ damage or a hemorrhage if it goes too high while we sleep. I hope that helps. Wikipedia says a normal pulse pressure is around 40, so I think you might be overall pretty safe in that area, but if that diastolic number gets too low and your PP gets too high, you may need to get that under control so that it doesn't stretch out your veins for the morning-time.

In case you were wondering what a low and high pulse pressure is like--- a low pulse pressure you can barely feel your pulse, and no matter how fast your heart is pumping, not as much blood is flowing through your veins. A high pulse pressure is easy to feel when taking your pulse, because your veins will be tight and stiff and pumping a large amount of blood through your system. High pulse pressure is associated with hypertension because it causes the same kind of damage---so you can have hypertension even if your systolic number is in the normal range. Low pulse pressures are associated with hypotension no matter if your systolic number is high or not, because people with blocked arteries and whatnot have low PP and can go into shock or states of hypotension if the PP dips too low.

(systolic) - (diastolic) = (pulse pressure) which is more critical to know for a POTS patient worrying about a crash.

[firewatcher]

My BP is always low at night (usually 90's/50's) and I feel fine. Dr. B at Vandy said that as long as your HR and BP drop at night that's fine, if it loses its variation over the day/night you've got a problem.

Pulse pressure is a real indicator of feeling awful. When I have felt my worst, my PP has been very narrow. A pulse pressure of anything under 18 is considered abnormal, some even say less than 25.

"In case you were wondering what a low and high pulse pressure is like--- a low pulse pressure you can barely feel your pulse, and no matter how fast your heart is pumping, not as much blood is flowing through your veins. A high pulse pressure is easy to feel when taking your pulse, because your veins will be tight and stiff and pumping a large amount of blood through your system."

This is NOT necessarily true, when I had my ANS testing at Vandy last month, my BP was high (148/98) and my PP was high and low at times, but the technician could not find a pulse in my wrists (this is very common with me, some nurses completely freak out.) BP is not always an indicator of volume status, it depends on your "flavor" of POTS.

[MelissaCrystal]

This is NOT necessarily true, when I had my ANS testing at Vandy last month, my BP was high (148/98) and my PP was high and low at times, but the technician could not find a pulse in my wrists (this is very common with me, some nurses completely freak out.) BP is not always an indicator of volume status, it depends on your "flavor" of POTS.

Definitely depends on your dilation (which changes) and the thickness of your skin/fat too---soooo many variables, especially for us. Was just going by the general rule of thumb though, and then the POTS person can add their special variables, hehe. My veins are very small, so most doctors can't do the pulse in my wrist---but I guess my neck is still good. When my PP is low though, it's freaky, I might as well be dead. If I pass out during low PP I'd really fear what the medics would think if they picked me up. Scary.

With high PP sometimes your veins can be so stiff, there's barely a quiver of a pulse. So it's definitely complicated!

[firewatcher]

This is NOT necessarily true, when I had my ANS testing at Vandy last month, my BP was high (148/98) and my PP was high and low at times, but the technician could not find a pulse in my wrists (this is very common with me, some nurses completely freak out.) BP is not always an indicator of volume status, it depends on your "flavor" of POTS.

Definitely depends on your dilation (which changes) and the thickness of your skin/fat too---soooo many variables, especially for us. Was just going by the general rule of thumb though, and then the POTS person can add their special variables, hehe. My veins are very small, so most doctors can't do the pulse in my wrist---but I guess my neck is still good. When my PP is low though, it's freaky, I might as well be dead. If I pass out during low PP I'd really fear what the medics would think if they picked me up. Scary.

With high PP sometimes your veins can be so stiff, there's barely a quiver of a pulse. So it's definitely complicated!

No kidding! I have "good" veins, large and springy according to the nurse/vampires. When they can't find my pulse, my hands are usually white and ice cold. I'm a super-constrictor! I was surprised by Vandy's readings, I usually have crazy-low pulse pressure <18 mm/hg! I think if any of us were out cold with a PP like we "normally" have, they would be looking for a pool of blood or massive internal bleeding (which is what usually causes that sort of thing.) I have freaky super-sensitive vagal response in my neck, I had a nurse play with it once just to see what it did to my heart-rate while I was hooked up to a monitor, so now they just use the pulse-ox meter or a stethoscope.

[ramakentesh]

I'm a super-constrictor

As am I - you get raynauds?

I thought it was due because of getting up at night and walking to the rest room, but I have been able to confirm that my blood pressure is that low at night lying down (without even getting up).

My basal blood pressure at 7 am (lying down) is 95-55

Any idea? Have you gone through this?

Why is the minimum so low?

I can kinda help - when i was taking butchers broom I found that it doesnt cause supine hypertension as suggested on most websites, but it did dramatically improve my nighttime autonomic issues that would keep me awake. Infact it was really good before bed. I assume this was helpful because it helped to maintain and regulate blood pressure.

[Heiferly]

Add me to the chorus of people taking Midodrine overnight. It doesn't give me high BP when supine at all either, just keeps me from getting icky low BP symptoms that ruin my ability to sleep well. Has really been one of my biggest helps, switching to round-the-clock dosing so it never wears off!

[Tessa]

Thank you all for your inputs, for sharing your experiences and answering my post.

I have got a cold... And have been unable to post before.

I am still not 100 % recovered, but here I am.

I agree that it could be my treatment not being taken at the right times. I have to consider the night too.

Thank you for your information, firewatcher

Melissaread, I was feeling chest discomfort/pain and tachycardia when it happened.

Since I?ve changed the times of taking my medication, it has improved.

Eartmother, I have also taken a protein/complex carb snack right before bed, and it helps too.

You now, sometimes I am really hungry when I get up in the morning...

Thank you, Mkoven for telling me that I should not worry about the figures.

And thank you all for adding your own experience.

It has been of great help,

I would say that my bp is better now and I am sleeping better, too. I?ll keep monitoring.

Love,

Tessa