Internal Medicine

Dizziness in the morning

introduction

Vertigo in itself is not an independent clinical picture, but an expression or symptom of numerous different clinical pictures from a wide variety of medical specialties. The sense organs are significantly involved in the balance: The eye, the "sense of position" of the muscles and the balance organ in the inner ear are important. Disruption of these systems causes dizziness.
Regardless of whether dizziness occurs as a result of an external influence, such as when driving around a carousel, or as dizziness caused by illness (lesion dizziness), it is characterized by a combination of similar symptoms. Difficulties arise in the area of perception (dizziness), gaze stabilization ("nystagmus", eye tremors), the regulation of posture (tendency to fall and uncertainty when standing and walking) and the vegetative system (nausea).

Forms of dizziness

The complaints are described very differently by those affected. One form of vertigo is that Vertigothat feels like driving a carousel.
A short-term and very violent dizziness is called Attack vertigo. Often the dizziness is so severe that the Tendency to fall very pronounced, whereas nausea occurs less often. Persistent vertigo lasts longer than the vertigo attack, often even for several hours or even days.
Another form of vertigo that Positional vertigo, arises when the head is tilted to one side. Even with this form of vertigo, the vertigo attacks are rather short.
There is also the Vertigowhich is compared to a boat trip by those affected. In addition to feeling dizzy, patients also complain of difficulty walking and standing and a tendency to fall.
Another form of vertigo is that Lightheadednesswhich occurs primarily in the event of drug overdose or excessive alcohol consumption.

Causes of morning dizziness

Often the causes of dizziness lie in the sensory organs, which are responsible for balance (especially the inner ear and eye). However, also can cardiological (heart) or neurological (brain) Illnesses make you feel dizzy.

Dizziness in bed

The most common cause of dizziness while lying down is benign positional vertigo (benign paroxysmal positional vertigo, BPLS for short) that occurs when you turn your head or change your body position. This form of dizziness occurs particularly often in the following situations: When turning over in bed, when turning to the affected side and when sitting up on the bed.
After getting up in the morning, the patient may also suffer from nausea and visual disturbances. The cause can be made out of small "ear stones" which are deposited in the balance organ in the inner ear and can irritate it. With small exercises with the upper body and head, the stones can be removed from the ear and the spontaneous attacks of dizziness do not reappear for the time being.
In connection with excessive alcohol consumption, a typical vertigo also occurs, especially when you lie down in bed and turn off the light. This dizziness is a sign of the onset of alcohol intoxication and occurs very often with nausea and vomiting. Alcohol addiction damages the body in numerous places and with withdrawal dizziness can also occur.
If dizziness occurs together with balance disorders, hypoglycaemia should always be considered in diabetics. In this case, the person concerned should be fed sugary food or drinks as soon as possible and the blood sugar should be checked regularly.

Dizziness after getting up

Young or slim people, especially those growing up, often have low blood pressure. This low blood pressure (hypotonicus) can lead to dizziness attacks, especially when you get up in the morning. The blood sinks in the lower part of the body when you stand up. This leads to a drop in blood pressure when you stand up and the brain is supplied with too little blood for a moment. In addition to dizziness, impaired consciousness and ringing in the ears also occur.
To avoid this type of dizziness, the process of getting up in the morning should be slowed down. Specifically, this means that you shouldn't get up too quickly; between lying and standing, a seat break should be built in, in which the body can adapt to the changed body position.
Another possibility for dizziness in the morning in connection with getting up quickly and jerkily is tension or problems in the cervical spine. Tense neck and shoulder muscles can compress the nerves in this area and thus have a sensitive effect on the balance system.

You can also read more about dizziness after coffee here such as Dizziness from low blood pressure

Morning dizziness in pregnancy

In addition to morning sickness, the early symptoms of pregnancy also include dizziness in the morning. Such attacks of dizziness arise during pregnancy due to the changes in the cardiovascular system during pregnancy. The cardiovascular system also has to take care of the child, which means that such low blood pressure attacks can occur more frequently. However, dizziness during pregnancy can also be triggered by hypoglycaemia.
In order to avoid such attacks of dizziness and the associated risk of falls as much as possible, it is important to get up as slowly as possible during pregnancy. To avoid the dizziness and nausea caused by hypoglycaemia, it is important to eat small meals regularly to keep blood sugar levels constant.

Please also read:

Dizziness during pregnancy

Concomitant symptoms

Very often dizziness in the morning is caused by low blood pressure (hypotension). After getting up, the blood pressure first drops because a large part of the blood sinks into the legs. As a result, the brain is temporarily supplied with too little oxygen and harmless symptoms of failure occur, which are noticeable through black vision in front of the eyes and eye flickering.

The heart tries to pump the blood back out of the body quickly and therefore beats faster, which is why those affected often experience palpitations. The body takes further counter-regulation measures and constricts the vessels and activates the sympathetic nervous system. This can lead to sweating and tremors.

The rapid lowering of blood pressure makes patients feel drowsy and, in rare cases, may even faint. If diseases of the heart or the brain are the cause of the dizziness in the morning, further symptoms such as cardiac arrhythmias, nausea with vomiting, fever or shortness of breath can occur.

You might also be interested in these topics:

What to do if you have low blood pressure

nausea

Severe dizziness in the morning that is accompanied by severe nausea may indicate the presence of so-called benign paroxysmal positional vertigo (BPPV).

This is a benign disease that can occur especially in the morning when the head changes position, for example when the person concerned turns to the other side or stands up in bed. In the fluid-filled equilibrium organ of the inner ear there are small crystals (otoliths) that can peel off and thus cause balance problems. Most of the time, simple exercises are enough to remove the pebbles and put an end to dizziness.

In addition, morning sickness with dizziness can be a sign of pregnancy.

Vomit

Dizziness in the morning is often associated with feeling sick (nausea). This can be due to harmless causes, such as low blood pressure or excessive alcohol consumption the day before.

However, there are also a number of different clinical pictures, such as migraines or Menière's disease, with which there are similar symptoms. A stroke can also manifest itself through dizziness, unsteadiness of gait and vomiting. A stroke is an absolute emergency that requires immediate medical attention. But dizziness in the morning, which is accompanied by vomiting, should be clarified by a doctor, unless there is a harmless explanation (alcohol consumption, known low blood pressure) behind it.

Visual disturbances

Visual disturbances can be symptoms of morning dizziness.

Often the cause of the symptoms is that the blood pressure drops too quickly after getting up and the brain can therefore no longer be adequately supplied with oxygen. This leads to a short-term failure of certain functions in the brain and visual disturbances. Most of the time, the affected person goes black or the eyes flicker, in which small, glowing flashes can be seen.

The symptoms usually go away after a few seconds and are harmless. However, if severe headaches occur in addition to dizziness and visual disturbances, it can be a vestibular migraine (dizziness migraine). This is a form of migraine in which dizziness and vision problems occur as part of an aura. However, there are also forms that occur without a headache, which is why frequent visual disturbances and recurring dizziness should definitely be examined by a doctor.

tinnitus

Ringing in the ears (tinnitus) can go hand in hand with dizziness in the morning and can be a sign of a neurological disorder. These complaints often occur in the event of sudden hearing loss or Menière's disease, which is why a doctor should be consulted promptly.

diagnosis

Recurring dizziness in the morning must be diagnosed by a doctor.

First, the doctor asks the patient detailed questions about the type, duration and accompanying symptoms of the vertigo. The doctor also goes into previous illnesses, allergies and medications that are taken regularly in order to find possible clues as to a cause of the dizziness. Blood pressure and pulse are also checked.

This is followed by a physical examination, in which the doctor primarily focuses on the patient's neurological status. These neurological tests primarily include walking and vision tests that test the balance system. Using electroencephalography (EEG), the brain waves are measured and checked whether there is a connection with the morning dizziness. If it is suspected that structural changes in the brain are responsible for the dizziness, the doctor will arrange a magnetic resonance scan (MRI) of the skull.

therapy

Most morning dizziness attacks are harmless and short-lived. You do not need any drug therapy. Gently standing up or doing balance exercises can reduce dizziness. In the case of benign positional vertigo, a doctor can recommend simple exercises that remove the ear stones from the troublesome places.
Persistent symptoms with accompanying symptoms should be clarified by a doctor. Not every attack of dizziness is harmless or a sign of temporary weakness, but can also be an expression of a serious illness. In these cases, however, the dizziness does not usually appear in isolation in the morning, but also throughout the day.

You may also be interested in this topic:

Vertigo training

Forecast and duration

In most cases, occasional dizziness in the morning is harmless and goes away within ten to 30 seconds. Even in patients suffering from benign positional vertigo (BPPV), the vertigo should not last longer than a few seconds.

In the event of prolonged attacks of vertigo, a neurologist or an ear, nose and throat specialist should be consulted in order to rule out serious illnesses.