Difficulty Swallowing While Lying Down
I am a 34-year-old female residing in Greece, standing at 154 cm and weighing 42.5 kg. Four months after giving birth, I experienced weight loss during my pregnancy. My mother passed away at 59 due to early-onset dementia. I do not smoke or drink alcohol. I have been diagnosed with Postural Orthostatic Tachycardia Syndrome (POTS) by both a cardiologist and a neurologist, although this was during my pregnancy without formal testing. There are no specialists available in my area, but I believe I have experienced symptoms of POTS my entire life. Additionally, I have hypermobility and very translucent skin. For the past decade, I was prescribed beta-blockers, initially with no clear reason other than managing my fast heart rate. Subsequently, I started taking SSRIs, which helped improve my condition, allowing me to reduce and eventually discontinue the beta-blockers. However, during my pregnancy, my POTS symptoms significantly worsened, leading me to resume beta-blocker treatment. Currently, I am taking 12.5 mg of metoprolol twice daily due to episodes of my blood pressure plummeting below 80/50 when I lie down, and I cannot increase the dosage any further. Recently, I have noticed that when I lie down to sleep, I often struggle to swallow, and at times, it feels as if my airflow is obstructed. I conducted a sleep study using a finger device at home, which revealed a few minor instances of sleep apnea. However, a troubling sensation arises when I make a concerted effort to swallow while lying down; it is followed by a dizzy spell, resembling an interruption or restriction of blood flow to my brain as I swallow. Is there anyone who might have insights into this issue? Thank you in advance for your help!
Answers (1)
4/3/2025, 6:20:50 PM
OpenHealth AI
It sounds like you are experiencing concerning symptoms related to swallowing and airflow when lying down, particularly in the context of your existing condition, POTS. Your symptoms of difficulty swallowing, dizziness, and feelings of airflow obstruction could be linked to several potential factors, including physiological responses to position changes, the effects of your medication, and underlying conditions.
Explanation
When you lie down, especially if you have POTS, your body may struggle to adequately manage blood flow and heart rate, which can affect various bodily functions, including swallowing. The sensation of obstruction could potentially stem from changes in airway dynamics or muscle control while in a horizontal position. Your history of hypermobility might also contribute to atypical sensations in muscle and connective tissue function, complicating your symptom picture.
Next Steps
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Adjust Sleep Position: Try elevating your head and upper body while you sleep, which may help improve swallowing and airflow by reducing pressure on the diaphragm and esophagus. Using multiple pillows or a wedge pillow can be beneficial.
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Hydration & Consistency: Ensure you’re well-hydrated and consume moist foods when you eat, as dryness can exacerbate swallowing difficulties.
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Monitor Symptoms: Keep track of when these swallowing difficulties occur, their severity, and any accompanying symptoms. This record will be useful for healthcare discussions in the future.
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Medication Review: Consult with a healthcare provider about your current medications, especially the beta-blockers and SSRIs. The dizziness and blood pressure fluctuations might merit a reassessment of drug dosages or alternatives.
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Explore Breathing Exercises: Gentle breathing exercises can help you learn to manage any sensations of airflow difficulty. Practicing these while sitting upright may ease discomfort.
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Consider Professional Guidance: If accessible, consider discussing your swallowing and POTS symptoms with a speech therapist or a specialist who focuses on dysphagia (swallowing difficulties). They can provide exercises that may help.
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Be Alert for Worsening Symptoms: If you notice increased frequency or severity of dizziness, fainting, or continued swallowing difficulties, it’s crucial to seek medical attention promptly.
Your situation is complex, and I recommend you keep advocating for your health needs. If local specialists are limited, exploring telemedicine options might provide access to the care you require. Take care!
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