Dizziness and Nausea: Possible Causes and Solutions

Dizziness with mild nausea?

Doctor, for the past two nights, I sometimes feel like I'm not breathing while sleeping, and I experience a bit of chest tightness.
It's like a sudden feeling of emptiness below my chest that wakes me up, and I wake up easily.
I also have to urinate 2 to 3 times at night.
However, I had a chest X-ray and ultrasound last July, and the doctor said my heart was fine, only a mild tricuspid valve prolapse, which has made me fearful of sleeping recently.
Now, I feel slightly dizzy at my temples and have a bit of nausea, and I feel fatigued all day.
I have gastroesophageal reflux disease and am taking medication for it.
Could this be related to acid reflux, or is it a case of autonomic nervous system dysregulation? I don't have much stress, so I'm not sure where the problem lies.
Please advise, thank you.

Yi, 10~19 year old female. Ask Date: 2017/02/05

Dr. Liao Yaopan reply Family Medicine

Hello, regarding your recent symptoms, it is still recommended that you first consult your family physician for an evaluation, and then determine if a referral to a specialist is necessary based on the situation.
Please note that online consultations do not equate to in-person medical visits and cannot provide accurate diagnoses or treatment recommendations.
Changhua Hospital cares about you.

Reply Date: 2017/02/05

More Info

Dizziness and nausea can be distressing symptoms, and it's important to consider various potential causes and solutions. Based on your description, it seems you are experiencing a combination of symptoms that may be interconnected. Let's break down the possible causes and explore some solutions.

Possible Causes
1. Gastroesophageal Reflux Disease (GERD): Given your history of gastroesophageal reflux, it's possible that your symptoms of nausea and dizziness could be related to acid reflux. GERD can lead to discomfort and may cause a sensation of pressure in the chest, which could be mistaken for heart-related issues. The acid can irritate the esophagus, leading to symptoms such as nausea, especially if you are lying down or sleeping.

2. Anxiety and Panic Attacks: The sensation of not breathing and the feeling of pressure in your chest could be indicative of anxiety or panic attacks. These episodes can cause a range of physical symptoms, including dizziness, nausea, and a feeling of impending doom. Even if you feel you have no stress, anxiety can manifest in physical ways, particularly during the night when you are more relaxed.

3. Autonomic Nervous System Dysregulation: The autonomic nervous system controls involuntary bodily functions, including heart rate and digestion. If this system is out of balance, it can lead to symptoms such as dizziness, fatigue, and gastrointestinal discomfort. This dysregulation can occur due to various factors, including sleep disturbances, dietary habits, or underlying health conditions.

4. Sleep Apnea: The sensation of not breathing during sleep could suggest a sleep disorder such as sleep apnea. This condition can lead to disrupted sleep and may cause daytime fatigue, dizziness, and other symptoms. If you are waking up frequently at night (as indicated by your night urination), it may be worth discussing a sleep study with your healthcare provider.

5. Medication Side Effects: If you are taking medications for your reflux or any other condition, consider reviewing them with your doctor. Some medications can cause dizziness or nausea as side effects.

Solutions and Recommendations
1. Consult a Healthcare Provider: Given the complexity of your symptoms, it is crucial to consult with a healthcare provider. They may recommend further tests, such as an upper endoscopy, to evaluate your esophagus and stomach, or a sleep study to assess for sleep apnea.

2. Lifestyle Modifications: Implementing lifestyle changes can help manage GERD symptoms. These include:
- Eating smaller, more frequent meals.

- Avoiding trigger foods (spicy, fatty, or acidic foods).

- Not lying down immediately after eating.

- Elevating the head of your bed to prevent nighttime reflux.

3. Stress Management Techniques: Even if you feel you have no stress, practicing relaxation techniques such as deep breathing, meditation, or yoga can help manage anxiety and improve overall well-being.

4. Monitor Symptoms: Keep a diary of your symptoms, noting when they occur and any potential triggers. This information can be valuable for your healthcare provider in diagnosing the issue.

5. Stay Hydrated and Nourished: Ensure you are drinking enough water and eating a balanced diet. Dehydration and poor nutrition can contribute to feelings of fatigue and dizziness.

6. Follow-Up on Heart Health: Since you have a history of mild tricuspid valve prolapse, it may be worth discussing your symptoms with a cardiologist to rule out any heart-related issues, especially if you experience chest pain or significant discomfort.

In conclusion, while your symptoms may be related to GERD, anxiety, or autonomic dysfunction, it is essential to seek medical advice for a thorough evaluation. Addressing these symptoms early can help improve your quality of life and prevent potential complications.

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