How To Sleep With Vertigo – Causes, Symptoms, and Treatments

What is Vertigo?

Vertigo¹ is the feeling of being dizzy, off balance, or in a spinning room, even if you’re moving slightly or not at all. It is different from feeling lightheaded in that you’ll actually feel like you are spinning or moving, or that the world is spinning around you.¹ While not life-threatening in and of itself, vertigo can be disorienting and cause other symptoms like nausea and vomiting.¹ Also, if it sets in while you’re driving, operating heavy machinery, or participating in an athletic sport, serious injury could occur to you and others.

What Causes Vertigo?

There are two types of vertigo, and the causes of each are different. The first type of vertigo is called peripheral vertigo, which is caused by issues in the inner ear, where balance is controlled.¹ The second type of vertigo is called central vertigo, which is caused, not by the inner ear, but by the brain or brainstem itself.¹ 

Below, we’ll get into some of the most common causes of both peripheral and central vertigo.

Benign Paroxysmal Positional Vertigo

One of the most common causes of peripheral vertigo is called benign paroxysmal positional vertigo² (BPPV). Often BPPV is caused by an injury to the ear area, but sometimes the origin of BPPV is unknown. 

We all have small calcium “crystals” inside our ears that make us sensitive to gravity.² Sometimes (like in the case of a head injury), these crystals can become dislodged and move into one of the ear’s canals when lying down or moving your head in certain positions, causing a spinning sensation.² 

BPPV can usually be treated by a healthcare provider³, who will do a physical maneuver to reposition the calcium crystals that have become dislodged.

Meniere’s Disease

Another potential cause of peripheral vertigo is Meniere’s disease⁴. Unlike calcium buildup, the cause of Meniere’s disease is a buildup of fluid in the ear that leads to pressure changes.⁴ There is some debate as to what causes this buildup of fluid in some people – some believe it is the result of constricted blood vessels, others believe it is due to viral infections or autoimmune reactions, and others believe it is genetic.⁴ 

Aside from vertigo, symptoms of Meniere’s disease can include tinnitus (a ringing in the ears), hearing loss, and a feeling of congestion in the ears.⁴ 

This disease typically sets in between the ages of 20 and 50 and often results in some degree of permanent hearing loss.⁴

Infections/Labyrinthitis

A viral infection⁵ could be to blame for symptoms of peripheral vertigo. Certain viruses can cause inflammation in the nerves around the inner ear, which will result in the feeling of spinning. The part of the inner ear where the infection occurs is called the labyrinth, hence the term labyrinthitis.⁵

Oftentimes, labyrinthitis follows a viral infection like a cold or the flu. However, it can also be caused by many other factors, including head trauma, allergies, alcohol abuse, bacterial infections, tumors in the middle ear, or taking high doses of aspirin.⁵

Certain Drugs

Certain drugs like anti-seizure medications, aspirin, and alcohol can cause central vertigo.¹ These drugs have an impact on the brain and brainstem⁶, and when taken in a toxic amount, can cause the brain to perceive feelings of spinning.

Multiple Sclerosis

Multiple sclerosis (MS) is one of the more common reasons for central vertigo in younger patients.⁶ Areas in the brain that coordinate balance (aside from the inner ear) can become damaged due to MS, thereby creating a sense of dizziness and lack of balance.

Tumors

A brain tumor located in the cerebellum, which is the part of the brain that controls movement, may cause central vertigo.⁶ These tumors can be either benign or malignant.

Other causes of central vertigo include strokes, vestibular migraines, blood vessel disease, and, rarely, seizures.¹ Even though central vertigo is far less common than peripheral vertigo, the underlying issue may be serious and should be addressed by a doctor.

Vertigo Symptoms

Whether it is peripheral or central vertigo, the most common symptoms include¹: 

• Extreme, prolonged dizziness 
• A feeling like you’re spinning or tilting
• Difficulty maintaining your balance

Other symptoms that can occur with either type of vertigo include¹: 

• Nausea
• Vomiting
• Headaches
• Tinnitus
• Hearing loss in one or both ears

If you’re experiencing central vertigo, you may also have the following symptoms¹: 

• Difficulty swallowing
• Blurred vision
• Eye movement problems
• Facial paralysis
• Slurred speech
• Weakness in the limbs

Sleeping Tips for Vertigo

Research¹² shows that not getting enough sleep can make symptoms of vertigo more frequent and pronounced. Additionally, episodes of vertigo can cause disruptions in sleep¹³, resulting in something of a cycle. 

The best thing to do is to try treating both your vertigo symptoms and any sleep dysfunction at the same time, so hopefully, both will improve. Below are some ways you can improve your sleep, which, hopefully, will improve your vertigo symptoms as well.

Before Bed

– Avoid eating spicy food: Hot and spicy food can disrupt your digestive processes¹⁴ and make it harder to sleep through the night. In the several hours before you go to bed, stick to milder options.

– Avoid looking at bright screens: The light from your television or phone delays the production of melatonin, a crucial hormone to help you fall and stay asleep. Instead of looking at electronics, try reading a book instead.

– Avoid caffeine: In addition to keeping you awake, the acid in caffeine¹⁵ could wake you up at night with heartburn. Caffeine’s diuretic nature could also make you feel like you have to go to the bathroom in the middle of the night.¹⁵ If you’re making a concerted effort to sleep through the night, abstain from caffeine eight hours¹⁶ before bedtime.

– Breathing exercises and meditation: Breathwork and meditation may help you fall asleep faster and sleep more deeply through the night by helping you relax. One of the most popular breathing exercises for sleep is called the 4-7-8 Breathing Exercise¹⁷, designed to move your body and mind into a more relaxed state. Here’s how it works¹⁷:

• Inhale through your nose for a count of four
• Hold your breath for a count of seven
• Exhale completely with a whooshing sound for a count of eight

This deep breathing technique oxygenates your blood and produces a relaxing effect that can encourage sleep.

Meditation is also helpful for clearing your mind. There are many different types of meditation, but one of the most basic is to sit with your eyes closed and focus inward on your bodily sensations. If you have thoughts come up (which you likely will), try to let them pass by. You can start with five minutes of meditation in the morning and at night, and then increase from there if you’d like.

Want to learn more? Read our complete guide to bedtime rituals.

Sleeping Position

You’ll probably find that lying on one side, in particular, can make your vertigo worse. That’s most likely going to be the side with your “bad” ear. The best thing to do in that scenario is to sleep on the other side and make it difficult to roll over in the night, with a barrier of pillows, for example.

You can also experiment with back and stomach sleeping to see if that makes the situation either better or worse. There’s no one-size-fits-all solution, so the best way to find the sleeping position that’s right for you is through trial and error.

Head Positioning

The important thing to keep in mind with head positioning is to strategically place your head at an angle that prevents pressure from fluid buildup or the settling of inner ear debris. This buildup can commonly happen when people with vertigo tip their head too far back, or change positions suddenly.² 

If you sleep on only one pillow, try adding a second pillow to prop your head up further. You may also want to get a wedge pillow to keep your head at an incline naturally. Again, finding the right setup may take some trial and error to find out what position is the least triggering for your vertigo.

Use Higher Pillows

The higher your pillow, the better an angle¹⁸ you’ll be able to achieve. The wedge pillow mentioned above is helpful. Airplane travel pillows, which offer extra support to keep the head at an even higher angle, may also help.

Body pillows are also useful if you’re trying to prevent yourself from rolling over to your bad side.

Change Your Diet

If you love salt, you may want to consider cutting back until your vertigo symptoms improve because high amounts of sodium can increase water retention¹⁹. This water retention may affect the fluid balance in the ear and make vertigo worse. 

In general, the healthier you eat, the better your body will be at adapting and healing itself, so if you eat a lot of junk food and processed food, try switching to a more natural and plant-based diet. This should improve both your vertigo symptoms and your sleep.

Take Medication or Supplements Before Bed

As we mentioned, some medications can help improve symptoms of vertigo. If your vertigo is causing you nausea before bed, for example, you might take an anti-nausea medication like Dramamine in order to get some better sleep. In addition, supplements²⁰ such as magnesium and L-lysine are thought to improve both vertigo symptoms and sleep quality. Recent studies²¹ also point to vitamin D and calcium as promising effective treatments for vertigo, and they could help improve sleep²². 

Even though supplements are over-the-counter, we recommend always speaking to your doctor first to make sure it’s a good fit for you.