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Morning Dizziness: What You Should Do Before You Get Up

Do you often feel dizzy when you first wake up in the morning?

There are many reasons why people can feel dizzy in the morning, but the most common reason for people to feel dizzy and fall is when their blood pressure drops too low when they stand up. This is called orthostatic hypotension, a condition characterized by a sudden drop in blood pressure when you stand up after sitting or lying down.

In this article, I will discuss morning dizziness caused by orthostatic hypotension and what you can do to decrease its symptoms!

What is morning dizziness caused by orthostatic hypotension?

Morning dizziness caused by orthostatic hypotension.

Morning dizziness can be caused by a sudden drop in blood pressure.

This condition, known as orthostatic hypotension, is most common in older adults. When you wake up in the morning and sit or stand up too quickly, your blood rushes down to your legs and feet, causing your blood pressure to drop suddenly.

The blood pooling down in your legs and feet results in decreased blood flow and oxygen supply to your brain. This can cause you to feel lightheaded or dizzy.

Dehydration, heart disease, or medication side effects can all induce orthostatic hypotension.

Download a list of medications with known side effects affecting your blood pressure here.

How do you know if your morning dizziness is caused by orthostatic hypotension?

How to check for orthostatic blood pressure.

To check if you have orthostatic blood pressure, you should measure your blood pressure in three positions:

  1. First, when you are lying down (for at least 5 minutes).
  2. Second, when you change position to sitting or standing.
  3. Finally, after about 3 minutes of sitting or standing.

A decrease of more than 20mm Hg in systolic or more than 10 mm Hg in diastolic blood pressure after 3 minutes of sitting or standing is indicative of orthostatic hypotension.

What does morning dizziness caused by orthostatic hypotension feel like?

Orthostatic hypotension can be a very disorienting and unpleasant experience.

When you first wake up and start to get out of bed, you may feel lightheaded, cold and clammy, and unsteady on your feet. You may also feel like the room is spinning, or that you are going to faint. These symptoms can be quite alarming and may cause you to fall back into bed or completely lose your balance and fall.

In some cases, morning dizziness caused by orthostatic hypotension may last for several minutes, while in others it may go away after a few seconds.

What is the most effective exercise to avoid morning dizziness?

Ankle pump exercise to prevent morning dizziness symptoms.

In my book, The Book of Balance, I teach my patients a very simple exercise called ankle pump exercise.

This exercise technique assists your heart in circulating blood flow that has collected in your legs and feet and return oxygen-rich blood to your brain.

How to perform an effective ankle pump exercise to avoid morning dizziness

  1. While still lying in bed, pump your ankle up and down for 10-15 repetitions.
  2. Add a few deep breathing exercises while performing your ankle pump exercise.
  3. Get up into a sitting position and repeat the ankle pump exercise for another 10-15 repetitions, adding a few deep breathing exercises in the process.
  4. Finally, get up into a standing position, stay still, and breathe deeply for 30 seconds, or until the lightheadedness disappears.

Make this exercise an important part of your getting-up routine and you will avoid the symptoms of morning dizziness!

If you’re looking for more exercise ideas to improve your balance and decrease your falling, this article has over 45+ exercise ideas!

What happened to my patient and how it can help you avoid the symptoms of morning dizziness:

I first saw Barry in a skilled nursing and rehabilitation facility where he was admitted after staying in a hospital for 7 days.

While his vital signs (i.e. blood pressure, pulse rate, respiratory rate, etc.) were being monitored in the hospital, they noticed that his blood pressure was unusually high.

He was referred to a cardiologist and was prescribed a hypertension medication to control his blood pressure.

When I started my evaluation, I checked Barry’s blood pressure while he was laying down in bed. Seeing that his blood pressure was normal, I proceeded to ask Barry to get up from the bed to assess how much assistance he would need. 

Barry could get up into a standing position by himself, but after standing for a few minutes, he reported feeling lightheaded and clammy.

I had Barry lie back down with his head flat on the bed. After a few minutes, Barry reported feeling back to normal again.

When I asked him if it was the first time he’d had that experience, Barry replied, “I’ve had these feelings like I’m about to pass out on several occasions; especially when I first get up in the morning.”

Patient with morning dizziness related to orthostatic hypotension.

After 5 minutes of lying down in bed, I checked Barry’s blood pressure again. Again, his blood pressure was within the normal limits for his age. 

I explained to Barry that I suspect he was having orthostatic hypotension and that I would be measuring his orthostatic blood pressure. 

I checked Barry’s blood pressure in 3 different positions using the method I described above.

Barry’s blood pressure while lying down in bed was 120/80 mm Hg.

After standing for about 3 minutes, his blood pressure dropped to 90/60 mm Hg.

No wonder Barry got lightheaded and clammy every time he stood up; he was experiencing orthostatic hypotension! 

I taught Barry the ankle pump exercise I described above to help decrease the symptoms of orthostatic hypotension and decrease his risk of falling each time he gets up.

I discussed my findings with Barry’s physician, and the physician proceeded to adjust the dosage of the blood pressure medication Barry was taking.

Since the adjustment of his medication, Barry has been able to participate in standing activities without experiencing any lightheadedness or dizziness.

It gave him confidence that he can stand up and walk without fear of falling. 

What to do next?

If you are suffering from morning dizziness and believe it could be related to orthostatic hypotension, review the steps here:

  1. Measure your blood pressure in 3 different positions.
  2. A decrease of more than 20mm Hg in systolic or more than 10 mm Hg in diastolic blood pressure after 3 minutes of sitting or standing is indicative of orthostatic hypotension.
  3. Incorporate the ankle pump exercise into your morning routine to avoid the symptoms of morning dizziness.
  4. Download the QUICK and EASY Guide to review a list of medications affecting your blood pressure and balance.
  5. Ask your doctor to review your medications and adjust as needed.

Do you know somebody who may be having morning dizziness because of orthostatic hypotension? Consider sharing this article and help them avoid catastrophic or injurious falls!

‘Til then, stay healthy and live fully!

Dr. Lex Gonzales
Dr. Lex Gonzales, PT, DPT is an author and speaker who has been a physical/physiotherapist for over 24 years. On he provides quality information and practical solutions you can use to improve your health and function.