Travel with POTS: Tips and Considerations

by  Vai Patel MScPT;   Kim Hanson BScOT;   Nicci Jasmins (Patient Partner)
updated June 16, 2025

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Traveling with Postural Orthostatic Tachycardia Syndrome (POTS) can present unique challenges, whether you’re flying or driving. However, with the right preparation and strategies, you can make your journey more comfortable and manageable. Here are some helpful tips to ensure your trip goes smoothly while managing your POTS symptoms.

 

Travel by Plane with POTS

Air travel requires extra attention due to the potential for extended upright activity, dehydration, and busy, overstimulating environments. Here are some key considerations and tips:

Medication and Hydration

• Medications: Keep medications in their original containers (for airport security) or use a labeled pillbox for convenience. Always pack extra doses in case of delays. Store them in your carry-on or personal item for easy access.
• Hydration and Salt: Bring a refillable water bottle and salty snacks or salt supplements (e.g., LMNT packets or Nuun tablets). If you run out, carry extra salt from home to dilute in water throughout the day.
• Compression wear: Wear compression leggings, socks, or shorts to minimize blood pooling. Some people find wearing firm shapewear (like Spanx) helpful during flights.

Special Considerations

• Sunflower Lanyard Program: https://hdsunflower.com/ca/
  The Sunflower Lanyard identifies invisible disabilities and alerts staff at airports, and hotels that you require assistance. You can register in advance and have the lanyard mailed prior to your trip. The sunflower program raises awareness while reducing the energy costs of self-advocating in busy spaces.
• Wheelchair Assistance: Consider arranging wheelchair assistance with your airline before departure. This service can help conserve energy by transporting you from check-in to your gate (and sometimes even onto the plane) without the need to walk or stand in long lines. It’s especially helpful for connecting flights and can ease stress if you’re feeling anxious about traveling with POTS.
• Mobility Aids: If wheelchair assistance isn’t your preference, consider using a cane or rollator. Most airports treat rollators like strollers, allowing easy navigation through security and onboard storage.
• Shuttle Service: In addition to shuttles/trains between terminals, most airports also offer in-terminal shuttles. Don’t be afraid to use these, especially if you have a far walk to your gate. Pick-up points (like bus-stops) are usually marked with signs displaying the accessibility icon.

Seating and Circulation

• Premium Economy or Aisle Seat: Choosing a seat with extra legroom (such as in Premium Economy) or selecting an aisle seat can greatly improve comfort during your flight. Extra space allows you to move your legs frequently (e.g., ankle pumps), while an aisle seat gives you easier access to the restroom and more freedom to stand or walk around. Both options help manage blood pooling and reduce the risk of urinary retention.
• Move Often: Perform ankle pumps, gentle leg stretches, or occasional leg crossovers. If space allows, consider a kneeling position or sit cross-legged to shift pressure and support circulation. Try to do 20 ankle pumps every 30 mins while you are awake during your journey on the plane.
• Minimize Standing Time: Prolonged standing can increase fatigue and blood pooling, so consider boarding the plane last and exiting last to avoid long waits in lines. Alternatively, if you’ve arranged wheelchair assistance, you may qualify for pre-boarding. This allows you to bypass lines and settle into your seat before the main crowd boards, which can ease stress and make the process more comfortable.
• Lounge Access: If possible, get access to the airport lounge. Many lounges have lounge chairs where you can lie down and elevate your legs
• Elevate Your Feet: Use a carry-on bag, scarf, or neck pillow to elevate your feet while waiting at the gate or during the flight. Some travelers create a foot hammock using a scarf tied around the seat tray.

Comfort Tools and Environmental Support

• Wear a Mask: To reduce the risk of reinfection or illness during travel, wear a well-fitted mask throughout your flight;  especially in crowded airports and enclosed cabins.
• Sensory Supports: Flights can be overwhelming, so pack sensory aids like earplugs, noise-cancelling headphones, sunglasses, a baseball hat, or tinted glasses to reduce overstimulation. An eye mask and neck pillow can also support rest and regulate sensory input, especially on longer journeys.
• Cooling Tools: If you’re traveling to a warm destination, bring a portable fan or neck fan to keep cool, which can help reduce POTS-related discomfort. There are also instant ice packs and adhesive cooling gel pads, which can be helpful during travel. If needed, you can run cold water over your wrists in the restroom for quick relief. Dress in thin, breathable layers that can be easily added or removed;  airports and planes can vary in temperature, and walking long distances to your gate can quickly make you overheat. If you have long hair, bring a clip or hair tie to keep it off your neck and shoulders. Don’t forget to use the overhead air vent (located near the call button) to direct cool airflow during the flight.

Pre-Travel Preparation

• Reduce Exertion: Scale back physical and cognitive demands 3–4 days before travel to build energy reserves and avoid crashes mid-trip.
• Map Your Route: If you’re unfamiliar with the airport, use interactive airport maps to plan your route and identify refill stations, accessible bathrooms, or lounges.
• Mobile Passport App: Where available, this can help speed up customs clearance and reduce time spent standing in line.

Post-Travel Recovery

• Rest Time: Have at least 4-5 days of low activity days after travel to allow your nervous system to recover and prevent post-travel flares.

 

Travel by Car

Long car trips can be just as challenging as flying, but with thoughtful planning and strategy, you can make the experience more comfortable. Here are a few tips:

Medication and Hydration

• Hydration: Just like when flying, it’s essential to stay hydrated while traveling by car. Always keep a water bottle within easy reach, along with salty snacks or salt pills. These help maintain your electrolyte balance during the drive.

Breaks and Movement

• Elevate Your Feet: During fuel stops or bathroom breaks, elevate your feet on the dashboard to promote circulation and reduce swelling.
• Counter-maneuvers: To reduce blood pooling and improve circulation during your flight, try incorporating simple counter-maneuver strategies. If space allows, sit cross-legged or kneel on your seat: both positions can support venous return. Regularly perform ankle pumps while seated to keep blood moving through your lower limbs. You can also bring one knee toward your chest (seated marching) at a time to further encourage circulation and reduce discomfort.
• Recumbent Breaks: Take breaks lying down in the car (or on a yoga mat/picnic blanket) every 30-50 mins of upright sitting.
• Be a Passenger: If possible, try to avoid driving and be a passenger instead. This can help conserve cognitive energy that would otherwise be used for driving, allowing you to focus on other aspects of your trip.

Route Planning

• Stay with Friends/Family: Plan overnight stops during long trips.
• Break Up the Drive: If it’s more than 5–6 hours, consider driving over two days instead of one to reduce exhaustion.

 

General Tips for Both Travel by Car and Plane

• Take Regular Breaks: Whether you’re traveling by car or plane, don’t forget to take breaks regularly to stretch and move around. This helps reduce fatigue, blood pooling, and stiffness.
• Pack Smart: In addition to your medications and hydration supplies, make sure you have your essentials like earplugs, sunglasses, a baseball hat, and mobility aids as required.
• Limit Alcohol & Increase Hydration: Minimize/Avoid alcohol consumption and drink plenty of water to help manage symptoms and prevent dehydration.
• Use Vagus Nerve Stimulation & HRV Devices: Consider bringing vagus nerve stimulation devices (such as Pulsetto or Dolphin stimulation) and/or HRV devices (such as HeartMath). These can help regulate your nervous system.
• Pacing and Recovery: Build in quiet time each day of your trip to rest and reset. Monitor early warning signs of flare-ups and adjust your activity level accordingly.
• Use weight and deep pressure to regulate the nervous system: Weighted blankets, lap pads, stretching, self-massage are all excellent ways to give yourself deep pressure. Deep pressure is known to down-regulate the nervous system and reduce autonomic dysfunction: https://pubmed.ncbi.nlm.nih.gov/25871605/    It can be helpful to consult with an Occupational Therapist.

 

Traveling with POTS can be challenging, but with proper planning and some adjustments, it can be more manageable. Preparing in advance, paying attention to your body’s signals, and taking breaks as needed can help reduce symptoms. By making thoughtful choices and adapting to your environment, you can navigate travel more comfortably.