Why Mornings Are So Hard?

[cma]

Hi all,

So for me I am feeling my worst in the morning. I take beta bloker in the morning at 7.30am and the go back to sleep for another hour or so. I usually stay in bed until 9.30am. Then take a shower and have breakfast and my heart starts speeding up. I don't understand why is this that once I am out of bed it isn't that bad, but at about 11am every day it starts speeding up. It is so weird, because beta blockers sould be working already. And then towards the end of the day everything slows down and in the evening my heart rate is normal. I take only a tiny dose of bisoprolol 1.25mg in the morning and then haft that dose in the afternoon. Any thoughts on this experience?

cma

[Broken_Shell]

Hi all,

So for me I am feeling my worst in the morning. I take beta bloker in the morning at 7.30am and the go back to sleep for another hour or so. I usually stay in bed until 9.30am. Then take a shower and have breakfast and my heart starts speeding up. I don't understand why is this that once I am out of bed it isn't that bad, but at about 11am every day it starts speeding up. It is so weird, because beta blockers sould be working already. And then towards the end of the day everything slows down and in the evening my heart rate is normal. I take only a tiny dose of bisoprolol 1.25mg in the morning and then haft that dose in the afternoon. Any thoughts on this experience?

cma

Hi cma,

I don't take a beta-blocker, but I do have a circadian pattern to my symptoms too. I am very bad in the morning and my body can't get itself together at all. Things generally become more tolerable towards the mid-afternoon, with my best time being 9 to 11 pm. The only exception is that eating dinner usually sets off another flare in symptoms. I wrote a post when I joined the forum about a circadian pattern where symptoms are worst in the morning and got many responses. I think that our unbalanced autonomic systems just have a difficult time transitioning to being up and having our bodies moving... our systems want to get going after the night, but they are unable to because of our dysautonomia and this creates a lot of stress on the body. Also, catecholamine levels are naturally highest in the mornings, so this may contribute to our difficult mornings as well.

~ Broken_Shell

[Radha]

mornings are a nightmare! feel so so hyper and so so anxious and feel like my skin is too tight! takes too long to settle down and heart rate to beat more

softer and slower, its all so exhausting, every morning is exactly the same, i always feel terrible but i would say late nite is the best time for me, i also have

adrenal problems which i guess adds to the mornings being so unbearable, hope you get some relief

Radha

[ana_22]

Try drinking 2 glasses of water before getting out of bed.

whilst we are sleeping we dont drink (obviously ) so you may need that boost iin hydration to make it a bit easier on your heart?

[icesktr189]

i have a totally different reaction. Mornings seem a lot easier for me.. its when around 3 pm hits that i totally crash. Pretty much until 8 or 9 at night i feel like poop. I do all day but that time is the worst for me.

[bizbiz]

Mornings are hard for me too. When I get out of bed my heart rate jumps up pretty high (too high!!).

I never wake up feeling like I have had a good nights sleep, I cant think properly for a few hours and all my joints and back are sore.

I usually start feeling more normal around 4 pm, and it generally starts getting better from then on. I feel my best in the evening - I'm usually not the slightest bit tired till around 1am.

Since joining this forum I have read a bit about circadian rhythms and am now wondering if mine is a few hours behind normal, or if its just a POTS thing of feeling bad in the morning.

[ramakentesh]

yeah mornings are my bad time - and a period about two hours after rising seems to be when my symptoms are worst.

One reason is that generally a person's blood pressure is lowest a few hours before waking and then steadily rises, and as it rises this may reduce symptoms because more blood is getting to the brain and heart, reducing overactivity of the nervous system.

Dr Stewart also believes that in the low-flow form of pots, bedrest excacerbates the blood flow abnormalities that are caused by impaired nitric oxide bioavailability and that movement improves them. The muscle pump system is impaired because blood flow all around the body is impaired and movement improves this, but bedrest makes it worse basically.

[summer]

i have a totally different reaction. Mornings seem a lot easier for me.. its when around 3 pm hits that i totally crash. Pretty much until 8 or 9 at night i feel like poop. I do all day but that time is the worst for me.

Interesting. Usually I feel terrible for about the first hour after I get up and my BP is often in the 70's -80's systolic. After I have some coffee, my meds and salt/fluids, I feel much better and the rest of my morning is the best part of my day. I go down hill from noon time on.

Like Dani, I then crash around 3 until 8pm or so. Unfortunately, this is the time my kids come home from school and there is homework, supper, after school activities etc. I wish I could have that "early day" energy when I need it most - in the late afternoon. It's interesting to me that after I can't go any longer and I HAVE to lie down, I actually feel a bit better later in the evening after being flat out for several hours. I guess this shouldn't surprise me, but it still is hard to believe that this is all due to being upright!

[janiedelite]

Before I go to bed each night I mix 1/2 a tsp of salt into 20 ounces of G2 (along with some benefiber for GI issues..). Every morning I wake up so tired, sore, and my throat and head feel like when you have a hangover. The G2 helps with some of the fatigue and orthostatic symptoms. Now I'm just laying here at 10:30am knowing I need to take a quick bath and get dressed. The pain and fatigue are the worst. But I know that once I get up, take a luke warm quick bath and get my compression hose on, I'll feel a bit better. Ugh... here I go!

For me, I know that I get super dehydrated easily and I tend to stay in bed for a good 11-12 hours a night. I also have a lot of pain due to dysautonomia mostly, but also due to a car accident and back/hip injuries so laying in bed makes my muscles get all sore and tight. Also I never feel rested even if I sleep 9+ hours. Getting hydrated first thing on waking, getting my compression hose on, and taking a slow walk in the mornings usually help me feel a bit better.

[tinkerbella]

mornings are the worst since being put on meds. I hate early morning appointments, so are unavoidable. I have to shower the night before, pack my bags sleep all dressed as the cab comes so early for my hospital infusions. I set the alarm for 5 just so by 6 thirty I'll be able to try to get out of bed. I's like a nightmare on hospital days. I pretend I'm going to a SPA, so then it's becomes fun.

But honestly, most days I open my eyes, roll over grab a thyroid pill drink water and pass out. If the water is gone when I wake I know I took the pill. Then there are days I can't stand till 10 or later. When I stand it hurts to walk so bad.

[MomtoGiuliana]

I am guessing a lot of this has to do with volume loss during the sleep period. My EP had initially told me that I should not go longer than 2 hours without drinking fluids. I know I almost always feel worse in the AM on days when my symptoms are noticeable.

[futurehope]

yeah mornings are my bad time - and a period about two hours after rising seems to be when my symptoms are worst.

One reason is that generally a person's blood pressure is lowest a few hours before waking and then steadily rises, and as it rises this may reduce symptoms because more blood is getting to the brain and heart, reducing overactivity of the nervous system.

Dr Stewart also believes that in the low-flow form of pots, bedrest excacerbates the blood flow abnormalities that are caused by impaired nitric oxide bioavailability and that movement improves them. The muscle pump system is impaired because blood flow all around the body is impaired and movement improves this, but bedrest makes it worse basically.

Boy, your explanation hit the spot with me. I need my sleep, but I feel like a dead person sometimes at the tale end of the night and after I wake up. I hope they come up with a "cure" for this impaired nitric oxide bioavailability.

For me, it's not only bedrest that makes me worse, it's sitting in one place too long, like at church for 2 1/2 hours. It takes so much out of me. I know my circulation is not working well because I can tell by my cold hands and feet. I often keep gloves on inside the church to avoid feeling like I have dead cold hands.

So what is Dr. Stewart's recommendation for this low-flow POTS? Any ideas?

[ramakentesh]

LOL. Yeah Im the same - sitting still or standing still is always my worst time. Infact Im better when i walk around my local area on weekends than when i go to work and sit - sitting in front of a comptuer all ay under neon lights makes half my healthy workmates motion sick, so ive got no hope. I literally cant sit still when my POTS gets bad at work.

Sure even if i walk around I still feel dizzy at times when standing too long or in busy environments, but it seems that the sitting still scenario always gets me.

Infact, when i was pretty well last year I was swimming and running and the benefit was enormous for my POTS symptoms.

On Dr Stewart's website he states that moving around (ambulation) helps symptoms while bedrest makes them worse in LOW FLOW POTS.

If doctors are correct, LOW FLOW POTS is caused by one of two states:

1. Elevated Angiotensin II levels causing excessive vasoconstriction and impaired blood flow around the body

2. impaired reuptake of norepinephrine, basically keeping it at the synaptic cleft for longer, heavily constricting the body and resulting in POTS symptoms.

In theory, either of these forms could be helped through an increase in the vasodilator nitric oxide. Problem is, if you had another form of POTS more nitric oxide would make you worse rather than better.

[firewatcher]

LOL. Yeah Im the same - sitting still or standing still is always my worst time. Infact Im better when i walk around my local area on weekends than when i go to work and sit - sitting in front of a comptuer all ay under neon lights makes half my healthy workmates motion sick, so ive got no hope. I literally cant sit still when my POTS gets bad at work.

Sure even if i walk around I still feel dizzy at times when standing too long or in busy environments, but it seems that the sitting still scenario always gets me.

Infact, when i was pretty well last year I was swimming and running and the benefit was enormous for my POTS symptoms.

On Dr Stewart's website he states that moving around (ambulation) helps symptoms while bedrest makes them worse in LOW FLOW POTS.

If doctors are correct, LOW FLOW POTS is caused by one of two states:

1. Elevated Angiotensin II levels causing excessive vasoconstriction and impaired blood flow around the body

2. impaired reuptake of norepinephrine, basically keeping it at the synaptic cleft for longer, heavily constricting the body and resulting in POTS symptoms.

In theory, either of these forms could be helped through an increase in the vasodilator nitric oxide. Problem is, if you had another form of POTS more nitric oxide would make you worse rather than better.

Let me throw this in this NO mix too. There is a theory that migraines are caused by a massive NO dump in the brain and it's subsequent massive systemic depletion. where would POTS fit in that one? What if you have both?

[ramakentesh]

yeah good question.

When my POTS is better I tend to get bad migraines and can literally feel the vessels on one side of my head going up and down. Weird eh? Also my aura symptoms are always the worst and I even feel anxious before a migraine which my doc told me is 'unusual'.

Anyway - maybe its a signaling problem in both cases - veins or arteries releasing inappropriate and too much nitric oxide either in the head area during migraines, or in the stomach region during POTS symptoms in Normal flow POTS. Im just guessing here though. Or could it be that the patient has elevated hormones that may mediate the levels of nitric oxide??

My friend who is a medical researcher reckons that nitric oxide's role in the body is just being understoof and its a popular area of research: they think that it controls all sorts of things - even making your hangovers worse if you have too much of it in your system.