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==Treating orthostatic hypotension== | ==Treating orthostatic hypotension== | ||
The concept of '''head-up tilt sleeping''' to manage [[orthostatic hypotension|orthostatic hypotension]] is based on the clinical observations by MacLean and Allen almost 70 years ago <cite>5</cite>. These clinical investigators observed that [[orthostatic hypotension]]in patients with pure autonomic failure appeared to improve symptomatically and objectively during daytime and that this improvement had disappeared in the morning after sleeping in bed at night. The observation of diurnal changes in orthostatic tolerance led MacLean and Allen to the suggestion that patients with [[orthostatic hypotension]] should not sleep in a flat bed but should lie in a semi inclined or head-up position <cite>5</cite><cite>6</cite>. Definite symptomatic and objective reversible changes were documented. | The concept of '''head-up tilt sleeping''' to manage [[orthostatic hypotension|orthostatic hypotension]] is based on the clinical observations by MacLean and Allen almost 70 years ago <cite>5</cite>. These clinical investigators observed that [[orthostatic hypotension]] in patients with pure autonomic failure appeared to improve symptomatically and objectively during daytime and that this improvement had disappeared in the morning after sleeping in bed at night. The observation of diurnal changes in orthostatic tolerance led MacLean and Allen to the suggestion that patients with [[orthostatic hypotension]] should not sleep in a flat bed but should lie in a semi inclined or head-up position <cite>5</cite><cite>6</cite>. Definite symptomatic and objective reversible changes were documented. | ||
The beneficial symptomatic and objective effects of postural treatment at night in patients with debilitating [[orthostatic hypotension]] due to autonomic failure were confirmed in several case series <cite>7</cite><cite>8</cite><cite>9</cite>. A consistent finding in these reports is that if a high salt diet or fludrocortisone were added to head-up sleeping the beneficial effects on orthostatic tolerance were enhanced. | The beneficial symptomatic and objective effects of postural treatment at night in patients with debilitating [[orthostatic hypotension]] due to autonomic failure were confirmed in several case series <cite>7</cite><cite>8</cite><cite>9</cite>. A consistent finding in these reports is that if a high salt diet or fludrocortisone were added to head-up sleeping the beneficial effects on orthostatic tolerance were enhanced. | ||