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Thursday, February 15, 2007

IBT Therapy And Postural Hypotension

Incline Bed Therapy is heralded for its ability to help the body detoxify by keeping the organs a more active in their processes than they would otherwise be at night. This is done by raising the head of one's bed by four to eight inches.

Though the results of this therapy can be amazing, for a Lyme disease sufferer with postural hypotension or POTS (postural orthostatic tachycardia syndrome), IBT may be less than ideal. Why?

In postural hypotension, a person's blood pressure drops whenever he/she is raised to a seated, or more commonly, standing position. If this position is maintained for a significant period of time, the resultant decrease in blood pressure leads to breathing problems, chest pain, dizziness and other accompanying symptoms. The same dangerous drop in blood pressure can occur with IBT, as one's body is partially raised to a vertical position.

I am a POTS sufferer and I didn't perceive any problems in raising the head of my bed four inches; however, when I attempted to raise it to seven inches, I had severe breathing problems during the night and awakened fatigued and sore the next day.

IBT can be a great therapy for increased detoxification, but for those with postural hypotension, caution should be exercized when propping up the bed for this purpose.


Andrew K Fletcher said...

Hi Connie

Inclined Bed Therapy does not make the organs more active. In fact it lowers the heart rate by 10-12 beats per minute sleeping compared to flat bedrest. It lowers respiration rate by 3-4 breaths per minute. Yet circulation and metabolism increase.

You were comfortable at a 4 inch raise and the suggested height is a 6 inch raise, although when applying to a spinal cord injury or other neurological conditions the bed can be raised to a maximum of 8 inches after slowly easing into the full incline.

A seated posture or a standing posture cannot be compared to a five degree angle from head to toe. Seating causes a compression on the spine, so does standing. IBT decompresses the spine.

High blood pressure and low blood pressure have both been observed to normalise over several weeks of IBT. Respiration definatly improves and so does oxygenation of the blood. The reason the respiration rate slows is due to the lungs inflating and deflating so moving a greater capacity of air. I suspect this may have caused you some discomfort intially but should have improved within the first week.

You may also have been experiencing higher than normal humidity at the time, which can seriously affect respiratory function so should not be ruled out.

Anyone considering testing this theory should research it thoroughly by using "inclined bed therapy"

Andrew K Fletcher

Connie Strasheim (aka Killabugger) said...


Thank you for the information.
I am sure that incline bed therapy is beneficial for many people.
However, I believe that in order to know whether it is beneficial under certain conditions of illness that it is necessary to understand the particular illness in question. One of the most highly recognized sites on POTS (Postural Orthostatic Tachycardia Syndrome) states that incline bed therapy can be dangerous for people with POTS. I don't know if you have done any research on POTS but you might want to check it out. It is a neurological condition whereby the body does not compensate properly for changes in posture, and for people with severe POTS, small elevations in posture can exacerbate symptoms. If you find any evidence to the contrary, however, I would be most happy to post it. Thanks for your comments.

Andrew K Fletcher said...

I have done a search for the site you mentioned that states IBT might be dangerous to people with POTS. Could you provide me with a link or tilte of the site please?

Obviously, moving from a flat position to sitting or standing can induce postural hypotention, especially following prolonged horizontal bedrest. People with spinal cord injury often have a problem with moving from a sitting posture to a standing frame. Yet Inclined Bed Therapy helps this group of people to avoid blacking out from orthostatic hypotension.

I have seen this improvement using IBT at first hand with both a paraplegic and a tetraplegic that found IBT helped avoid this problem.

I really am interested in finding this information you refer to.



Andrew K Fletcher said...

2008 Dec;18(6):318-24. Epub 2008 Oct 15.
Head-up sleeping improves orthostatic tolerance in patients with syncope.
Cooper VL, Hainsworth R.
Cardiorespiratory Unit, St James's University Hospital, Leeds, UK.
OBJECTIVES: This study was designed to examine the effect of head-up sleeping as a treatment for vasovagal syncope in otherwise healthy patients. Treatment for syncope is difficult. Pharmacological treatments have potential side effects and, although other non-pharmacological treatments such as salt and fluid loading often help, in some cases they may be ineffective or unsuitable. Head-up sleeping may provide an alternative treatment. METHODS: Twelve patients had a diagnosis of vasovagal syncope based both on the history and on early pre-syncope during a test of head-up tilting and graded lower body suction. They then underwent a period of 3-4 months of sleeping with the head-end of their bed raised by 10 degrees , after which orthostatic tolerance (time to pre-syncope during tilt test) was reassessed. RESULTS: Eleven patients (92%) showed a significant improvement in orthostatic tolerance (time to pre-syncope increased by 2 minutes or more). Plasma volume was assessed in eight patients and was found to show a significant increase (P < 0.05, Wilcoxon signed-rank test). There was no significant change in either resting or tilted heart rate or blood pressure after head-up sleeping. INTERPRETATION: Head-up sleeping is a simple, non-pharmacological treatment which is effective in the majority of patients. However, it may not be tolerated by patients or bed-partners long term and whether the effects continue after cessation of treatment remains to be determined.

Connie Strasheim (aka Killabugger) said...

Hi Andrew,

Thank you for your comments, they are much appreciated, and I am sure my readers will appreciate your research, too.

At some point, I may try IBT again.

Best regards,


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Andrew K Fletcher said...

Hi Connie

Have you been following the work of Poalo Zamboni on Chronic Cerebrospinal Venous Insufficiency in people with multiple sclerosis?


Sandra said...

Does anyone know of any good doctors in Denver for treatment of POTS? THanks