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Dizziness When Lying Down

Dizziness When Lying Down

Dizziness, which occurs when lying down, can be a troubling and inconvenient symptom affecting sleep. This disturbing feeling is also known as positional vertigo and can have several different causes. It is, therefore, essential to understand the causes of dizziness when in a reclining position or when changing positions to enable proper management.

At FYZICAL North Hills in Raleigh, NC, their team is focused on identifying the root issues and providing solutions. This comprehensive guide will discuss the causes of dizziness when lying down and standing up and briefly discuss the management strategies.

What Causes Dizziness When Lying Down?

It is possible to have a number of causes for dizziness while lying down. Here are some of the most common culprits:

Benign Paroxysmal Positional Vertigo (BPPV) 

BPPV is one of the most common causes of dizziness when lying down, and it appears when calcium carbonate crystals move to the inner ear. BPPV results in spinning vertigo when changing from one position to another, like lying down, rolling from one side to the other, looking upwards, and bending forward. 

Inner Ear Problems 

The person’s balance and spatial orientation are managed by the vestibular system situated in the inner ear. Again, conditions affecting the fluid pressure in the inner ear, infection, inflammation or even nerve disorder are causes of extreme dizziness when lying down. Conditions including labyrinthitis or vestibular neuritis could be to blame.

Low Blood Pressure 

Some patients develop hypotension when they are in a supine position from sitting or standing position. This sudden drop in blood pressure may cause some of the patient to feel dizzy, lightheaded and may faint when lying down. Some drugs are also known to cause low blood pressure as well Some of the drugs include beta-blockers and drugs used in cancer treatment.

Postural Hypotension 

Known as orthostatic hypotension, this is a condition that makes the blood pressure to drop when one is standing, sitting or lying down after some time. Whenever the blood supply to the brain is restricted, dizziness exclusively when lying down and vertigo may happen.

Mal de Debarquement Syndrome 

Some people who have traveled by cruise, boat, or by air may experience off balance, light headedness or dizziness even after the trip. This feeling is called the mal de debarquement syndrome, which is a result of the poor adaptation to non-motion after being exposed to it for a long time. Laying down can actually increase the rocking dizziness, which is a feeling that some people get when they lie down.

Diagnosing the Cause

To get to the root of sudden dizziness when lying down, a doctor will perform a physical exam and use diagnostic testing. They will look inside the ears with an otoscope and test eye movements for signs of inner ear dysfunction. They may order blood work to check for anemia and other medical issues. Imaging tests like CT scans or MRIs allow doctors to visualize the brain and inner ear anatomy. 

The hallmark test for assessing vertigo is called the Dix-Hallpike maneuver. This procedure looks for nystagmus (involuntary eye movements) as the patient moves from sitting to lying back with the head turned to one side. If nystagmus occurs, it indicates benign paroxysmal positional vertigo (BPPV). Vestibular function testing may also be used to evaluate the inner ear's balance system.

Treatment Options for Dizziness When Lying Down

The appropriate treatment will depend on the specific cause of dizziness when lying down and rolling over when reclining:

BPPV Treatments

  • Canalith repositioning maneuvers - These guided movements by a physical therapist reposition debris in the inner ear.
  • Vestibular rehabilitation - Physical therapy exercises help strengthen balance and reduce vertigo.

Low Blood Pressure Treatments

  • Increase fluid and salt intake - This helps improve blood volume.
  • Compression stockings - These encourage blood flow to the upper body and brain.
  • Medication changes - Adjusting or discontinuing medications that lower blood pressure.

Inner Ear Disorder Treatments

  • Medications - Steroids, anti-nausea, and anti-dizziness medications provide symptom relief.
  • Surgery - In severe cases, surgery can repair inner ear problems.
  • Balance therapy - Exercises performed with a physical therapist help retrain the brain's ability to process balance and spatial information.

Lifestyle measures such as avoiding caffeine, alcohol, and tobacco, staying well hydrated, and slowly moving from lying to sitting up can also minimize dizziness when lying down on right side episodes.

Conclusion

Dizziness when getting out of bed and lying down can significantly disrupt quality of life. However, diagnosing the root cause of positional vertigo through a medical evaluation can get you on the path to relief. 

If you live in Raleigh, NC and want a customized treatment plan for your dizziness and balance issues, you can contact FYZICAL North Hills for Balance Therapy North Hills an evaluation with vestibular therapy specialists. Their expertise can help identify the source of your reclining dizziness and design targeted therapy interventions to help resolve symptoms.