POTSNASA Lean Test for POTS: How to Do It at Home
The NASA 10-minute lean test explained: the protocol, why the wall helps, how to measure, and how to run it at home.
What the NASA Lean Test is
A 10-minute standing test that looks for an abnormal heart rate response to standing. You rest lying down, then lean against a wall while someone records heart rate and blood pressure. Clinics need only a wall and a monitor.
Why lean on a wall
The wall takes work out of your legs, cuts movement, and lowers the chance of a fall if you feel faint. It also keeps your posture the same from test to test, so repeat results compare fairly.
The published criteria were built mostly on active standing and tilt testing. Your clinician decides how much weight a wall-supported result carries, so write down which stance you used.
The protocol
LYING DOWN · MINUTE 1 OF 10
Lie flat, stay still and quiet.
Rest lying flat (protocols vary from 5 to 10 minutes; this guide uses 10), record resting heart rate and blood pressure, then lean and stay still for 10 minutes. Record at minutes 1, 2, 3, 5, 7 and 10.
What the numbers mean
In adults, POTS calls for a sustained rise of at least 30 bpm within 10 minutes of standing, or at least 40 for ages 12 to 19, without the blood pressure drop of orthostatic hypotension (Freeman 2011, CCS 2020, HRS 2015). Orthostatic hypotension means a fall of 20 mmHg systolic or 10 mmHg diastolic within 3 minutes of standing (Freeman 2011). Your doctor reads your rise alongside blood pressure, symptoms and history.
Running it at home
The home stand test guide covers setup and safety. The POTS app can time each phase and graph your heart rate.
Safety
Stand near something to hold, and sit down at the first sign of fainting. If you have fainted before, have someone with you.
This page informs and does not diagnose. Only a clinician who can examine you and see your whole history can interpret your numbers.
- Freeman R, Wieling W, Axelrod FB, et al. Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome. Autonomic Neuroscience. 2011;161(1-2):46-48.
- Raj SR, Guzman JC, Harvey P, et al. Canadian Cardiovascular Society position statement on postural orthostatic tachycardia syndrome (POTS) and related disorders of chronic orthostatic intolerance. Canadian Journal of Cardiology. 2020;36(3):357-372.
- Sheldon RS, Grubb BP, Olshansky B, et al. 2015 Heart Rhythm Society expert consensus statement on the diagnosis and treatment of postural tachycardia syndrome, inappropriate sinus tachycardia, and vasovagal syncope. Heart Rhythm. 2015;12(6):e41-e63.
- Plash WB, Diedrich A, Biaggioni I, et al. Diagnosing postural tachycardia syndrome: comparison of tilt testing compared with standing haemodynamics. Clinical Science. 2013;124(2):109-114.
- What Is POTS? A Plain-Language Explanation
- How to Test for POTS at Home: The 10-Minute Stand Test
- POTS Symptoms: The Common Ones and What They Mean
- How POTS Is Diagnosed: Criteria, Stand Test and Tilt Table
- Do I Have POTS? What to Check Before You See a Doctor
- Tests to Ask For When You Suspect POTS
- Why Does My Heart Race When I Stand Up?
- POTS Heart Rate: How to Graph It with Apple Watch
- Orthostatic Intolerance: Types and How POTS Fits In
- Why Blood Pressure Matters in a POTS Stand Test
- What Is Dysautonomia, and How Does It Relate to POTS?
- What Causes POTS? Subtypes, Triggers and What the Evidence Shows
- POTS and Long COVID: What the Research Shows
- POTS in Teens, Young Adults and During Pregnancy
- POTS Treatment Overview: What Guidelines Recommend First
- Fluids and Salt for POTS: What the Trials Show
- Compression and Exercise for POTS: Two First-Line Treatments
- POTS Medications: What Each One Does and What the Trials Show
- Living With POTS: Triggers, Pacing, Heat, Meals and Sleep
Want a record to bring to your visit? The POTS app guides the stand test at home and graphs your heart rate. See the app