Rebecca Smith
What Causes Dizziness When You Look Up – Medical Review by Debra Sullivan, PhD, MSN, R.N., CNE, COI – By Jennifer Huizen – Updated March 17, 2023
Inner ear infections, head injuries, and other problems can cause dizziness when lying down. Some of these result from benign paroxysmal positional vertigo (BPPV), in which tiny crystals that help sense gravity in the part of the ear migrate to the part of the inner ear that senses head movements.
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People with benign paroxysmal positional vertigo (BPPV) experience periods of brief episodes of benign or non-life-threatening paroxysmal or sudden dizziness. Vertigo is a type of dizziness that makes you feel like the room is spinning.
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In many cases, BPPV seems to occur randomly. However, several conditions can cause or affect her BPPV, including:
BPPV usually occurs when the calcium carbonate crystals, or otochonia, in the gravity-sensitive part of the ear called the utricle break off. They then travel to fluid-filled semicircular canals, or movement sensors.
Accumulation of enough otoconia in either duct can interfere with the movement of the fluid that the ducts use to detect head movement.
Semicircular canals do not normally respond to gravity. But Otokonia moves according to gravity. As a result, accumulation of otoconia masses within the semicircular canals can lead to fluid kinesthetic movements when they should not. This sends a false message to your brain that your head is moving.
Bppv Overview (benign Paroxysmal Positional Vertigo)
When the brain compares this erroneous message from the inner ear to information from other senses and organs, it cannot match them, so it perceives it as a spinning sensation.
This mistake causes nystagmus. Nystagmus causes the eye to move back and forth or up and down uncontrollably, causing the surroundings to rotate.
People with BPPV experience vertigo, a sudden feeling that everything around them is spinning when it is not. People who suffer from dizziness due to inner ear problems usually also have nystagmus, or uncontrolled eye movements.
A person with BPPV may experience a unique sensation of dizziness in a variety of ways. It also feels different depending on the activity that causes the symptoms.
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A spinning or dizzying sensation may be rotatory, as if you had just stepped out of a chariot. Vertigo feels like the ground is shaking up and down, and may even cause a sensation of being on a boat.
Another explanation for dizziness is that a person trying to get out of bed may feel as if they are falling into it, and a lying person may feel as if they are falling out of bed.
In most cases, BPPV causes dizziness only after certain types of movements or movements that cause changes in head position relative to gravity, such as:
Most people who wake up feeling dizzy tend to have BPPV. The type of dizziness caused by BPPV usually lasts less than a minute. While some people with BPPV are asymptomatic between tides, others continue to feel unbalanced all the time or most of the time.
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Dizziness is the main symptom caused by BPPV. However, restless dizziness can cause other symptoms, such as:
BPPV is usually not a serious condition. The greatest risk is injury from a fall or loss of balance.
However, if dizziness recurs after repositioning the head, a doctor should be consulted. Dizziness that lasts longer than a minute or two should also be discussed with a doctor.
People with dizziness should seek emergency medical care if they experience additional symptoms unrelated to BPPV, such as:
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People can then be referred to medical professionals such as an otolaryngologist or a vestibular rehabilitation therapist.
Experts ask people to move their head in certain ways to see which movements cause symptoms.
Some have experienced dizziness, but the specialist will closely monitor her nystagmus for specific patterns that could confirm her BPPV. This also helps determine which canal in which ear the misaligned ear is.
To properly treat BPPV, the specialist also needs to determine what type of BPPV the person has. This could be canalicular stone disease or stone disease.
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Tubular stone disease is the most common form of her BPPV and involves free movement of the eustachian tube within the ear canal fluid.
Kopp’s stone disease, which is much less common than tubulolithosis, involves ear organs that are attached to nerve bundles that sense the movement of fluid in the duct.
BPPV symptoms tend to lessen over time as the brain adapts to the misinformation coming from the inner ear. In some cases, BPPV goes away on its own after a few days or weeks.
If a professional knows where the eustachian tube detachment is and has canalicular stone disease or calculi, a canalicular repositioning procedure (CRM) can be used to treat her BPPV.
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CRM is a series of specific head movements that allow gravity to guide the auditory organ to a location in the inner ear where it can be reabsorbed.
The Epley method is a method used to treat rhinitis. How the Epley procedure is performed by a doctor or professional:
If a BPPV patient does not experience symptom relief after the Epley procedure, the doctor or professional will usually repeat it until symptoms are relieved.
Stone disease can be improved by release operation. In this technique, the head is rapidly moved in the plane of the affected ear canal to shake the displaced ear canal.
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Once the ear is free, another of her CRM methods is used to move the ear out of the canal and back into the appropriate room.
It may take several sessions to fully resolve her BPPV using CRM techniques, but most people make a full recovery. By some estimates, more than 90% of all her BPPV cases disappear after her 1-3 CRM treatments.
However, people with Kopp stone disease may take longer to successfully treat. Similarly, if more than one semicircular canal is affected, the doctor or therapist must correct each one individually, lengthening the recovery process.
Even after the dizziness itself has subsided, many people recovering from BPPV still experience sensitivity to movement and unsteadiness. Doctors and therapists usually recommend at-home exercises that can help alleviate these residual feelings fairly quickly.
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BPPV cases can be resolved incidentally, and the specialist can also perform her CRM technique on her BPPV patients who cause dizziness when lying down.
However, up to 50% of people will relapse within her 5 years. The sooner and more comprehensive BPPV treatment is delivered, the more successful the long-term outlook.
If her BPPV of the same type occurs repeatedly in the same duct, a doctor or therapist can teach the person how to do her CRM at home.
Medical News Today has strict purchasing guidelines and is based solely on peer-reviewed research, academic institutions, medical journals and medical societies. We avoid using referrals from third parties. Links to primary sources of research, scientific references, statistics, etc. are also provided within each article and in the resources section at the bottom of the article. See our Editorial Guidelines for more information on how to ensure your content is accurate and up-to-date. After a long day at work, you want to lie down in bed and relax. However, as soon as I try to put my head on the pillow, I am attacked by debilitating bouts of dizziness and a spinning sensation. You’ll cry and get frustrated knowing it’s because you have her BPPV. This vestibular disorder has been bothering you for years and you can’t seem to find a solution. You have tried countless treatments for dizziness and vertigo, but no lasting results. So what am I doing wrong? More importantly, what can be done to fix the problem. Explore these topics and why you feel dizzy when you stretch in our blog post. Table of Contents Why Lying Down Makes BPPV Patients Feel Discomfort Vertigo Is Not the Same as Vertigo Attacks What dizziness treatments work for people with BPPV? One Why Lying Down Makes BPPV Patients Discomfort BPPV, or benign paroxysmal vertigo, is one reason patients see doctors, neurologists, and other upper cervical spine health care professionals. This is a widespread concern that affects millions of people. In 2017, the number of clinical consultations in the United States exceeded 5.6 million. Physicians define BPPV as a dysfunction of the vestibular system caused by detachment of calcium crystals, or otoliths. Moving or tilting the head produces a spinning sensation or a false sense of movement. This includes lying down and getting out of bed. If you have BPPV, you should practice simple self-care techniques to minimize the effects of your symptoms. These tactics include: Avoid sudden head movements. Stay in a quiet, dark room during the vertigo attack. If you feel dizzy, sit down and wait for the dizziness to go away. When you get out of bed, get into the habit of sitting slowly before standing or walking. Practice relaxation exercises during attacks to avoid stress.