Dizziness when lying down

introduction

Dizziness is one of the more common medical concerns. About every tenth patient at the family doctor complains about it. The causes, however, can be extremely diverse.

When determining the cause, the anamnesis of when the dizziness occurs and in what form it is relevant is relevant. As an example, a distinction can be made between vertigo that occurs permanently or in the form of a seizure, always with the same movement or diffuse, and between vertigo (as when driving a carousel) and vertigo (as on a boat).

The dizziness when it occurs when lying down should be examined more closely here.

Why do I feel dizzy when I lie down?

Dizziness that occurs when lying down is often benign in nature. If the dizziness only occurs when the head position changes, such as when lying down, it can be assumed that the cause lies in disruptive factors in the organ of equilibrium itself. In order to understand this one has to call to mind the structure of the same:

Three semicircular canals filled with fluid, each oriented in one direction of space, form the basic structure of the organ. When moving or changing position, the liquid is set in motion and passes sensory cells, which register the movement and then send the signal to the brain. If the movement signal of both ears coincides, a functioning sense of balance results in the brain. However, if the direction of movement is changed too quickly or the information from both ears does not match (or the movement information from the ears does not match that from the eyes), the brain is confused and the result is perceived as dizziness.

In the case of dizziness when lying down, one also speaks of "benign paroxysmal positional vertigo". This means that depending on the position of the head, dizziness can suddenly occur. The cause are small stones (so-called. Otoliths), which detach from a part of the organ of equilibrium and then roll around in the semicircular canals when the head changes position. Usually this is only the case in one ear. There the stones cause incorrect movement signals that cannot be correctly interpreted by the brain. At times dizziness occurs, which subsides again when the head is held still or the stones disappear from the semicircular canals.

In contrast, dizziness is permanent or comes out of the blue. The cause has to be looked for less in the organ of equilibrium than in the nerve that runs from there to the brain. A permanent or unpredictable disturbance of the balance must be associated with irritation of the nerve. The cause of this can be, for example, inflammation of the nerve or tumors that press on the nerve. These are then diseases to be taken seriously, although the benign paroxysmal positional vertigo can also be unpleasant for patients.

For more information, see: Causes of dizziness

How is it diagnosed?

The most common cause of dizziness when lying down is what is known as benign paroxysmal positional vertigo. This type of vertigo is benign and its most important characteristic is that it occurs as a function of a change in the position of the head or the entire body. In order to diagnose the disease, a conversation between the doctor and the person concerned is usually sought first. In this so-called anamnesis, clues for the possible trigger of the complaints are collected.
In addition, there is a special provocation test for positional vertigo, the Dix Hallpike positional test. This is intended to trigger the dizziness in the person concerned. To do this, the person is quickly laid down and the doctor observes the eyes. If a so-called nystagmus occurs, i.e. a rapid back and forth movement of the eyes, this is a clear sign of the onset of dizziness.

Read more on the topic: Diagnosis of vertigo

What therapy options are there for dizziness when lying down?

Often the symptoms go away quite quickly on their own. However, you should consult a doctor if you have recurring or persistent problems.

Therapy for dizziness when lying down consists in removing the otoliths from the semicircular canals of the organ of equilibrium. However, this is not achieved with medication, but with positioning exercises. The stones in the semicircular canals are moved so that they fall out again so that they no longer disturb. There are two maneuvers for this with sequences of targeted head and body movements. The Sémont and Epley maneuvers. They are carried out by a doctor and, once learned, can later be carried out independently by the patient at home.

Read more on the topic: Therapy for vertigo

Homeopathic remedies

The homeopathic remedy Rhus toxicodendron D12 is used for vertigo while lying down. Up to 5 globules of this can be taken three times a day. Kalium phosphoricum is also an effective remedy for dizziness caused by changes in position, and belladonna can also be taken in homeopathic doses. If nausea also occurs, you are often well advised to take Nux vomica. If the dizziness when lying down is caused by changes in blood pressure, the symptoms can be alleviated with Conium macalatum.

For more information, see: Homeopathy for dizziness

Duration vs. Prognosis of dizziness when lying down

The prognosis for benign paroxysmal positional vertigo is, as the name (benign = benign) suggests, extremely good. The cause of this dizziness lies in the disruption of one of the two balance organs. In the organ of equilibrium there are so-called semicircular canals in which a fluid can move. When the head is turned, this fluid moves in the semicircular canals, and the brain receives matching information from the right and left balance organs.

In the case of positional vertigo, small stones are present in one of the two organs. These prevent the normal movement of the fluid and thereby produce incompatible information from the two organs of balance. This disease can be treated with simple positioning methods.

The duration of the complaints depends primarily on how quickly the diagnosis is made and how quickly the therapy is then carried out.

What accompanying symptoms of dizziness when lying down are there?

Typical of dizziness when lying down are attacks of dizziness that last about 30 seconds. However, they do not only occur when lying down but also when moving the head, for example when turning the head. In addition, many affected people complain of nausea and even vomiting. Headaches may also occur in connection with the dizziness.
After such an attack of dizziness, the feeling “like walking on cotton wool” is occasionally reported. Since the vertigo attacks are triggered by a certain movement pattern, namely the rapid change of position or the rapid turning, one can often observe avoidance behavior in the affected persons. So you turn your head very carefully and slowly, even lying down is only done carefully.

nausea

Nausea and dizziness are symptoms that are very often associated with one another. The reason for this is that both feelings are processed in the central nervous system and the two affected brain regions are very closely connected. For example, dizziness can cause nausea, and nausea can cause dizziness itself.
In the case of dizziness when lying down, the cause lies in the organ of equilibrium. This confuses the brain in such a way that it causes dizziness attacks. This sudden onset of vertigo, in turn, can provoke attacks of nausea and even vomiting.

Read more on the topic: Dizziness with nausea - that's behind it

Dizziness when turning your head

Dizziness when turning the head is also a symptom of benign paroxysmal positional vertigo (see above for cause). Turning the head triggers the same movements of the stones in the semicircular canals as when lying down.

Dizziness when looking up or down or dizziness when stooping are also included in the symptoms of positional vertigo. In severe cases, nausea and vomiting can occur.

Vertigo emanating from the cervical spine

Wear and tear on the cervical spine can also cause dizziness. The blood vessels that supply the inner ear run through a canal along the spinal cord through the vertebral bodies and then dip into the base of the skull.

If there are age-related changes in the area of ​​the cervical vertebrae, it can happen that these supplying blood vessels (Vertebral artery) must be pressed. As a result, less blood reaches the inner ear and the organ of equilibrium and this circulatory disorder is mainly perceived as dizziness. This phenomenon is known as vertebrobasilar insufficiency.

In addition, symptoms such as headache at the back of the head, tinnitus and poor hearing, visual disturbance in the form of double vision and other neurological deficits can occur. However, these symptoms can also be indicative of a stroke, so a doctor should be consulted immediately if they occur.

Dizziness on standing up

Dizziness when standing up is usually more attributable to the cardiovascular system.
The body is less active when sitting. The heart falls into its resting pulse and is not used very much. The longer you sit, the more the circulation calms down. If you get up suddenly, this must be adapted to the new load. The heart starts beating a little faster and stronger in order to be able to supply the body with blood for its new activity. If this adaptation reaction is delayed, however, the blood pressure is temporarily too low to supply the brain with sufficient blood.

There are several possible reasons for this. In elderly patients, the aortic valve of the heart should be examined if they are dizzy when standing up. If this is narrowed, the heart cannot pump as much blood from the ventricle into the body's circulation as the exit point is reduced (aortic valve stenosis). As a result, less blood reaches the brain for a short time, and dizziness or blackening occurs in front of the eyes.

Please also read our article on this Aortic stenosis

A heart rhythm that is too slow (Bradycardia), which can occur, for example, due to a rhythm disturbance such as AV block, can lead to dizziness or even fainting.

In younger patients, an error in the adaptive response of the cardiovascular system to increased stress is more likely. This is called orthostatic dysregulation. This can be determined with a so-called tilting table examination.

Read more on the topic: Dizziness and circulation.

Dizziness during pregnancy

Dizziness during pregnancy usually has other causes and nothing to do with the balance system or its nerves.

During pregnancy, the volume of blood that has to be transported through the body changes in many ways. The child's circulation must also be supplied by that of the mother. Water from the bloodstream is stored in the mother's body and the blood vessels are generally widened. This increases the burden on the mother's cardiovascular system, and the mother's heart has to compensate for all these newly added factors.

Occasionally, this can lead to low blood pressure. The low blood pressure can lead to short-term insufficient blood supply to the brain. Dizziness develops in the sense of a momentary "blacking out".

Read more on the topic: Dizziness during pregnancy.