Dizziness and Excessive Sleepiness: A Neurological Perspective

Q: Dizziness and Excessive Sleepiness: A Neurological Perspective

Hello： Dizziness can be classified based on the lesion as peripheral or central. <br>If the dizziness is more indicative of a central type during episodes, it may affect the brainstem's ability to maintain wakefulness (reticular activating system), causing the patient to feel mor

During episodes of dizziness, there may be persistent drowsiness?

My daughter was recently diagnosed with vertigo, and the doctor advised her to avoid certain foods, such as chocolate, citrus fruits, tomatoes, dairy products, and pizza.
She takes medication to manage her vertigo every night before bed.
However, she still experiences occasional episodes, during which she becomes excessively sleepy.
Sometimes this can last for 3 to 4 days, or even more than a week, where she can sleep for 10 to 20 hours straight.
She wakes up to eat but immediately falls back asleep, and it is very difficult to wake her up.
She only gets up when she is hungry or needs to use the bathroom.
This happens approximately once every month or two.
I have researched many issues related to vertigo online, but I haven't found any information about vertigo being associated with excessive sleepiness.
I would like to ask the doctor if this is normal.
Thank you.

Miss Song, 40~49 year old female. Ask Date: 2018/03/08

Dr. Hong Weibin reply Neurology

Hello: Dizziness can be classified based on the lesion as peripheral or central.
If the dizziness is more indicative of a central type during episodes, it may affect the brainstem's ability to maintain wakefulness (reticular activating system), causing the patient to feel more drowsy.
Based on your description, your daughter may have previously experienced headaches or headaches accompanied by dizziness, leading the physician to consider "vestibular migraine." The current treatment for vestibular migraine is similar to that of typical migraines; if the frequency of episodes is too high, preventive medication may be necessary.
It is advisable to discuss this further with the physician.
If there are still concerns, you can talk to the doctor about whether a brain imaging study (MRI) is needed to ensure there are no abnormalities in the cerebral blood vessels.
Wishing for a speedy recovery.

Reply Date: 2018/03/08

More Info

Dizziness and excessive sleepiness can be concerning symptoms, especially when they occur together. Your daughter's experience with dizziness, coupled with prolonged periods of excessive sleepiness, raises several important considerations from a neurological perspective.

Dizziness can manifest in various forms, including vertigo, lightheadedness, and imbalance. It can be caused by a range of conditions, including inner ear disorders, vestibular issues, migraines, or even neurological conditions. The fact that your daughter has been advised to avoid certain foods suggests that her dizziness may be linked to a specific condition, possibly related to vestibular function or migraine-associated vertigo. Foods like chocolate, citrus fruits, tomatoes, dairy products, and pizza can sometimes trigger migraines or exacerbate vestibular symptoms in susceptible individuals.

The excessive sleepiness your daughter experiences, especially following episodes of dizziness, is particularly noteworthy. While it is not commonly documented that dizziness directly causes sleepiness, the two can be interconnected in several ways. For instance, if dizziness is severe enough, it can lead to fatigue and a desire to sleep as the body attempts to recover from the distressing sensation. Additionally, if her dizziness is related to a vestibular disorder, the brain may require more rest to process and adapt to the sensory input it is receiving.

Moreover, the medications your daughter is taking to control her dizziness could also play a role in her excessive sleepiness. Many medications used to treat dizziness, such as antihistamines or vestibular suppressants, can have sedative effects, leading to increased sleepiness. It is essential to review her medication regimen with her healthcare provider to ensure that the benefits outweigh any side effects, particularly regarding her alertness and overall quality of life.

The pattern of excessive sleepiness lasting for several days, followed by a return to her usual state, could suggest a cyclical issue. This might be indicative of a condition such as chronic fatigue syndrome or a sleep disorder, which could warrant further investigation. If she is sleeping excessively but still feels fatigued or unrefreshed upon waking, it could point to an underlying sleep disorder, such as sleep apnea, which can also contribute to dizziness.

Given the complexity of her symptoms, it would be prudent for your daughter to undergo a comprehensive evaluation by a neurologist or a sleep specialist. This evaluation may include a detailed history, physical examination, and possibly imaging studies or sleep studies to assess her brain function and sleep patterns. Additionally, keeping a sleep diary that tracks her sleep duration, quality, and any associated symptoms can provide valuable insights for her healthcare provider.

In summary, while dizziness and excessive sleepiness may not be commonly linked, they can coexist due to various underlying factors, including medication side effects, vestibular disorders, or sleep-related issues. A thorough evaluation by a specialist will help clarify the relationship between these symptoms and guide appropriate management strategies. It is essential to address these concerns promptly to ensure your daughter's well-being and quality of life.

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