How to sleep with vertigo -Amelia Willson

About 40% of people over 40 will…

experience vertigo at least once in their lives. Even if you only experience vertigo for a few minutes, the sensation can be very unsettling.

If you experience vertigo at night, it can interfere with your sleep. 

What is vertigo?

Vertigo is a sudden onset of dizziness that may last anywhere from a few minutes or even days. It tends to be more common in women and those over age 50.

How do you know if you’re experiencing vertigo? Vertigo is more than slight dizziness. When you’re experiencing vertigo, you feel like no matter how hard you try, you can’t seem to regain your balance. You may feel like you’re spinning, or a strong tilting sensation which keeps swaying you to one side. Additional symptoms that accompany vertigo can include nausea, vomiting, irregular eye movements, headache, tinnitus, and sweating. 

What causes vertigo?

Thanks to Alfred Hitchcock’s famous film Vertigo, many people mistakenly believe that vertigo describes a fear of heights. This is incorrect. While a fear of heights may accompany a sensation of vertigo, vertigo can happen anywhere.

Actually, vertigo is typically caused by an issue with the inner ear. Your inner ear is responsible for helping you stay balanced, so when something impairs its functioning, you feel unbalanced and experience vertigo as a result. 

Due to its association with balance, inner ear issues are known as balance disorders. Common balance disorders that have vertigo as a symptom include:

  • Benign paroxysmal positional vertigo (BPPV) is a condition affecting 2% of people where small calcium deposits (also called canaliths, calcium crystals, or inner ear rocks) develop in the inner ear canals. The vast majority (80%) of vertigo cases are BPPV.
  • Meniere’s disease is a condition where fluid builds up in the inner ear. The resulting pressure causes vertigo, as well as hearing loss and tinnitus.
  • Labyrinthitis and vestibular neuritis are conditions where the inner ear becomes inflamed from a viral infection, interfering with the its communication with the brain.

Vertigo and sleep

When you fall asleep and when you wake up, you tend to change the position of your head. This change in position can trigger vertigo, especially in cases of BPPV.

If you experience vertigo as you’re lying down to sleep, it disrupts the process, making you extremely uncomfortable and delaying your sleep. Until your vertigo goes away, it will be difficult to fall asleep. Without adequate sleep, you’re likely to experience the effects of sleep deprivation the following day. 

Sleep deprivation, even after just one night, is much more than mere grogginess. It impairs your focus, makes you moodier, and increases your likelihood of drowsy driving. In turn, sleep deprivation can also worsen the effects of vertigo.

Waking up from sleep can also trigger vertigo, in both cases of BPPV and Meniere’s disease. Rising from bed changes your head position, potentially triggering BPPV. The supine position also allows fluid to buildup in your ear while sleep, potentially triggering Meniere’s vertigo.

Scientists are also currently looking into where there may be a link between vertigo and sleep apnea, although the studies thus far are inconclusive. 

Vertigo is an extremely uncomfortable experience that interferes with the sufferer’s quality life, during both their waking and sleeping hours. Even if you experience a mild case of vertigo and it goes away on its own, it’s worth visiting with your doctor. Vertigo may be a warning sign of another, more serious issue, such as low blood pressure or a brain tumor.

If you start experiencing multiple, severe symptoms of vertigo, you should see a doctor immediately. Depending on the severity of your vertigo, your doctor may recommend surgery, medication, or supplements. 

How to prevent vertigo during sleep

Fortunately, there are ways to reduce your risk of vertigo. Try the following tips to help prevent vertigo and get better sleep.

1. Get physical therapy.

Vestibular rehabilitation is a form of physical therapy focused on the vestibular system. The vestibular system is made up of sensory organs, like the inner ear, that communicate with your brain. Vestibular rehab helps your organs learn to compensate for a loss of balance by using your other senses. 

Your physical therapist will work with you on exercises that promote better hand-eye coordination, stronger joints and muscles, and overall improved fitness and balance. Since vertigo can get worse with inactivity, vestibular PT also helps prevent vertigo simply by making you stronger and more fit overall.

2. Try canalith repositioning maneuvers (CRP).

Also known as the Epley maneuver, CRP are head exercises (pictured below) designed to shift and break up the calcium deposits that characterize BPPV. The American Academy of Neurology recommends that you visit first with a trained professional to learn the correct way to perform these exercises, pictured below:

canalith repositioning procedure for vertigo
CRP for vertigo

CRP relieves vertigo symptoms in a painless way in just a matter of minutes. Even better, for 80% of people, they cure their BPPV. Even in cases where CRP doesn’t cure vertigo, it drastically reduces the recurrence rate. For the other 20% of people, they can try Brandt-Daroff exercises

After CRP, the American Hearing Research Foundation recommends sleeping in a semi-recumbent position for the following two nights. Use a recliner or adjustable bed frame to tilt yourself upwards about 45 degreeS.

3. Sleep on your back.

Speaking of sleep position, the best sleep position for vertigo sufferers is on the back. Back sleeping prevents the calcium deposits from shifting in cases of BPPV, or the fluid deposits from building up in cases of Meniere’s disease. 

Tilting your head to the side or rolling onto your side can trigger BPPV, especially if you end up on the side with your bad ear down. Unfortunately, studies show people with vertigo tend to gravitate towards sleeping in this position, which is why it’s important to use pillows to strategically place yourself.

Switching from another sleep position can be tough, so consider using body pillows to prevent you from shifting while you train yourself to sleep in the new position.

4. Elevate your head.

Elevating the head helps prevent vertigo occuring when getting into and out of bed, because it keeps the inner ear rocks in place. You have plenty of options for elevating your head:

  • Wedge pillows are recommended for vertigo sufferers because they’re designed to elevate the head slightly. 
  • Travel pillows can also be helpful for vertigo sufferers as they retrain to a new position. 
  • Finally, you might look into an adjustable bed that props you up as you sleep. 

5. Wake up slowly.

People with vertigo also have to be thoughtful about how they wake up. The key is to generally move slowly as you get out of bed, allowing your inner ear to adjust to the new head position. Gradually rise up, then sit for a minute on the side of the bed before getting up to walk. Then walk slowly to the bathroom. 

If you wake up in the middle of the night, the same guidance applies. Also avoid walking in the dark, as you’re even more prone to injury if vertigo strikes. Turn on a light to illuminate your way, but use a lower wattage so it’s not too bright to wake you back up.

6. Minimize stress.

Stress is linked with insomnia, as well as a higher incidence of vertigo. In one study, those with BPPV were significantly more likely to both suffer from anxiety or depression, and to report experiencing life stressors or trauma in the year prior to the onset of their vertigo.

Reducing your stress will help minimize your vertigo, but it will also help you sleep better. Pack a one-two punch with these calming activities that are also shown to promote restful sleep:

7. Exercise regularly.

Speaking of exercise, not only is it a wonderful stress-reliever, but it also helps physically tire out your body by the time bedtime rolls around. Just be sure to schedule your workouts for earlier in the day. If you exercise too late at night, you might not have vertigo, but you’ll be so energized it will still be difficult to fall asleep.

People with vertigo should avoid high impact sports that involve sudden movements or would cause you to lower your head beneath your shoulders. Instead, choose lower-impact options like jogging or brisk walking. Whenever bending over, do it at the knees, not the waist.

8. Eat well.

A healthier diet tends to correlate with better sleep, but anti-inflammatory foods in particular can stave off vertigo. Examples include leafy greens, bananas and avocado, and healthy fats like fish. Good news: all of these foods are also good for sleep.

Dehydration can contribute to vertigo, so stay hydrated with plenty of water, and limit your caffeine and alcohol. These also interfere with your sleep.

9. Practice good sleep hygiene.

Just as vertigo prevent you from falling asleep at night, that lack of sleep can worsen your vertigo. Set yourself up for success by following sleep-healthy behaviors like:

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