stroke recovery that worsens lying down

Overview

Some people who have had a stroke notice that their symptoms, such as weakness, dizziness, or speech problems, get worse when they lie down. This can be a sign of a change in blood flow or pressure in the brain. It is important to report this to your healthcare team.

It is not extremely common, but it does happen in some stroke survivors, especially in the first few weeks after the stroke.

It can affect anyone recovering from a stroke, but it may be more common in people with certain types of stroke or those who have other health conditions like high blood pressure or heart disease.

Symptoms

Common symptoms

• Dizziness or lightheadedness when lying down
• Increased weakness on one side of the body
• Difficulty speaking or understanding speech
• Headache that worsens when lying flat
• Blurred vision or double vision

Symptoms in children

• Children may become more irritable or lethargic when lying down
• They may complain of headache or blurred vision
• Parents should watch for changes in alertness or movement

Symptoms in older adults

• Older adults might experience confusion or a drop in blood pressure when lying down
• They may feel faint or have trouble breathing
• Increased risk of falls if they try to get up quickly

Causes

Main causes

• Changes in blood pressure when changing position
• Fluid buildup in the brain (cerebral edema)
• Blood clots or blockages that shift with position
• Problems with the body's ability to regulate blood flow

Risk factors

• High blood pressure
• Heart disease
• Diabetes
• Older age
• Previous stroke
• Use of certain blood pressure medications

When to see a doctor

See a doctor urgently if:

• If your stroke symptoms get worse when you lie down, see your doctor or go to an emergency room quickly.
• Call your healthcare provider if you have a new headache or dizziness that does not improve.

Book a routine appointment if:

• If you have mild symptoms that only happen occasionally, mention it at your next follow-up appointment.

Diagnosis

Your doctor will ask about your symptoms and examine you. They may check your blood pressure while you are lying down, sitting, and standing.

Tests that may be done

• Blood pressure measurements in different positions
• Blood tests to check for anemia or infection
• Imaging tests like CT scan or MRI of the brain
• Echocardiogram to check heart function

What to expect at your appointment

You may be asked to lie flat during some tests. The doctor will explain each step and make sure you are comfortable.

Treatment

Treatment aims to address the underlying cause. This may involve adjusting medications, changing how you move, or treating any new problems like fluid buildup in the brain.

Self-care at home

• Change positions slowly, especially when getting up from lying down.
• Stay hydrated and avoid alcohol or caffeine.
• Use pillows to elevate your head and upper body when resting.
• Keep a diary of your symptoms to share with your doctor.

Medical treatments

Your doctor may adjust your blood pressure medications, prescribe fluids or salt supplements if needed, or recommend wearing compression stockings. If there is fluid in the brain, you may need medicines to reduce swelling.

When is surgery considered?

Surgery is rarely needed but may be considered if there is a large fluid buildup or a clot that needs to be removed.

Living with this condition

Living with this condition means being aware of how your body responds to different positions. You may need to avoid lying flat for long periods. Take breaks and change positions regularly.

Lifestyle tips

• Sleep with your head elevated on pillows.
• Avoid sudden head movements.
• Ask your therapist for safe positions for rest and sleep.
• Keep a routine for taking medications.

Diet and exercise

Eat a balanced diet low in salt to help control blood pressure. Gentle exercises like walking or stretching, as advised by your healthcare team, can improve circulation. Avoid heavy lifting or straining.

Mental health and emotional wellbeing

Noticing your symptoms change with position can be stressful. It is normal to feel anxious or frustrated. Talk to your healthcare team or a counselor if you feel overwhelmed.

Prevention

You cannot always prevent this from happening, but managing your blood pressure, staying active, and following your stroke recovery plan can reduce the risk.

Complications

If left untreated

• Worsening symptoms may lead to falls or injury.
• Increased risk of another stroke.
• Pressure sores from lying in one position too long.
• Blood clots in the legs.

Long-term outlook

With proper care, most people can manage these symptoms. Your recovery may take time, but many people improve with treatment and support from their healthcare team.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.