{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T16:55:33Z","timestamp":1792083333804,"version":"4.4.0"},"reference-count":32,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2023,8,9]],"date-time":"2023-08-09T00:00:00Z","timestamp":1691539200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000864","name":"Michael J. Fox Foundation for Parkinson\u2019s Research","doi-asserted-by":"publisher","award":["MJFF-020200"],"award-info":[{"award-number":["MJFF-020200"]}],"id":[{"id":"10.13039\/100000864","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biology"],"abstract":"<jats:p>To systematically summarize the evidence of head-up tilt sleeping (HUTS) on orthostatic tolerance, we conducted a systematic, predefined search in PubMed, OVID Embase, Cochrane and Web of Science. We included studies assessing the effect of HUTS on orthostatic tolerance and other cardiovascular measures and rated the quality with the American Academy of Neurology risk of bias tool. We included 10 studies (n = 185) in four groups: orthostatic hypotension (OH; 6 studies, n = 103), vasovagal syncope (1 study, n = 12), nocturnal angina pectoris (1 study, n = 10) and healthy subjects (2 studies, n = 58). HUTS duration varied (1 day\u20134 months) with variable inclinations (5\u00b0\u201315\u00b0). In two of six OH studies, HUTS significantly improved standing systolic blood pressure. Orthostatic tolerance was consistently enhanced in OH studies with higher angles (\u226512\u00b0), in 2 out of 3 with smaller angles (5\u00b0) but also in one studying horizontal sleeping. In vasovagal syncope, HUTS significantly augmented resilience to extreme orthostatic stress. One study was rated as a class II risk of bias, one of Class II\/III and eight of Class IV. The evidence favouring HUTS to improve orthostatic tolerance is weak due to variable interventions, populations, small samples and a high risk of bias. Despite this, we found some physiological signs suggesting a beneficial effect.<\/jats:p>","DOI":"10.3390\/biology12081108","type":"journal-article","created":{"date-parts":[[2023,8,9]],"date-time":"2023-08-09T10:08:59Z","timestamp":1691575739000},"page":"1108","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["The Impact of Head-Up Tilt Sleeping on Orthostatic Tolerance: A Scoping Review"],"prefix":"10.3390","volume":"12","author":[{"given":"Amber H.","family":"van der Stam","sequence":"first","affiliation":[{"name":"Department of Neurology, Donders Institute for Brain Cognition and Behavior, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9413-6125","authenticated-orcid":false,"given":"Sharon","family":"Shmuely","sequence":"additional","affiliation":[{"name":"Department of Neurology, Donders Institute for Brain Cognition and Behavior, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1972-2703","authenticated-orcid":false,"given":"Nienke M.","family":"de Vries","sequence":"additional","affiliation":[{"name":"Department of Neurology, Donders Institute for Brain Cognition and Behavior, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bastiaan R.","family":"Bloem","sequence":"additional","affiliation":[{"name":"Department of Neurology, Donders Institute for Brain Cognition and Behavior, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland D.","family":"Thijs","sequence":"additional","affiliation":[{"name":"Department of Neurology, Leiden University Medical Centre, 2300 RC Leiden, The Netherlands"},{"name":"Stichting Epilepsie Instellingen Nederland, 2130 AM Hoofddorp, The Netherlands"},{"name":"UCL Queen Square Institute of Neurology, University College London, London WC1N 1PJ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1093\/gerona\/gly188","article-title":"The prevalence of orthostatic hypotension: A systematic review and meta-analysis","volume":"75","author":"Saedon","year":"2020","journal-title":"J. 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