Neurogenic Disorders: Dizziness, Sleep Issues, and Blood Pressure

Q: Neurogenic Disorders: Dizziness, Sleep Issues, and Blood Pressure

Hello： Your symptoms have been present for a while, and it is recommended to first improve your sleep hygiene. <br>If there are issues with sleep disorders, it is advisable to undergo a polysomnography. <br>In a sleep center, during the polysomnographic examination, patients are

Hypoxia? Orthostatic hypotension?

Hello, doctor! I have been experiencing issues with autonomic nervous system dysregulation for the past year, with symptoms that vary.
Recently, I often feel dizzy when I stand up after sitting, experiencing a sensation of pressure in my head, blurred vision, and muffled hearing.
I try to stand and move around a bit, but when I sit for about three minutes and then stand up, the dizziness returns.
There was even one instance where I felt vertigo (the world spinning) while sitting and had to collapse onto the sofa.
This usually happens at night, and if I go to sleep right away, I feel a bit better, although I do experience some tinnitus when I first lie down.

In the mornings, I feel lethargic and can't seem to yawn, often needing to take deep breaths to relieve a strange sensation in my chest.
I also have sleep disturbances; despite sleeping more than eight hours, I still feel extremely tired.
My smart bracelet consistently shows that my deep sleep is short and my sleep score is low.
Could this be related to oxygen deprivation due to sleep issues? Would this qualify as orthostatic hypotension? Additionally, I just finished my menstrual period a week ago; could that also have an impact? Thank you!
Supplement: I have mitral valve prolapse and am taking medications for it, including Heart Care and Urokinase.

Yue, 10~19 year old female. Ask Date: 2021/02/26

Dr. Jiang Junyi reply Neurology

Hello: Your symptoms have been present for a while, and it is recommended to first improve your sleep hygiene.
If there are issues with sleep disorders, it is advisable to undergo a polysomnography.
In a sleep center, during the polysomnographic examination, patients are asked to sleep as normally as possible in the sleep study room, while the equipment records brain waves, eye movements, muscle activity, heart rate, breathing, and blood oxygen levels.
It is suggested that you consult a sleep medicine specialist to discuss the examination and treatment.
Wishing you good health and peace.
Dr.
Jiang Junyi, Department of Neurology, Taoyuan Hospital, cares about you.

Reply Date: 2021/02/26

More Info

Your symptoms suggest a complex interplay between neurogenic disorders, sleep disturbances, and possibly autonomic dysfunction. Let's break down your concerns and explore the potential connections between these issues.

Neurogenic Disorders and Dizziness
Neurogenic disorders can affect the autonomic nervous system, which regulates involuntary bodily functions, including blood pressure, heart rate, and digestion. Your experience of dizziness upon standing, known as orthostatic hypotension, could be a sign of this dysfunction. When you stand up, gravity causes blood to pool in your legs, and if your autonomic nervous system isn't responding appropriately, your blood pressure may drop, leading to dizziness, lightheadedness, or even fainting.

Sleep Issues and Fatigue
Your sleep disturbances are particularly concerning. Despite sleeping for over eight hours, you still feel fatigued, which could indicate poor sleep quality rather than quantity. Sleep disorders, such as sleep apnea, can lead to fragmented sleep and insufficient oxygenation during the night, resulting in daytime fatigue. The fact that your sleep tracker shows low deep sleep could further support this idea. Sleep apnea is characterized by repeated interruptions in breathing during sleep, which can cause significant drops in oxygen levels and lead to symptoms like morning headaches, excessive daytime sleepiness, and cognitive impairment.

Blood Pressure and Autonomic Dysfunction
The symptoms you describe, including the feeling of pressure in your chest and the need to take deep breaths, could be related to your autonomic nervous system's regulation of blood pressure and heart rate. The presence of mitral valve prolapse (MVP) can also contribute to these symptoms, as it may lead to palpitations or anxiety, which can exacerbate feelings of dizziness and fatigue. MVP is often benign, but it can sometimes be associated with autonomic dysfunction, leading to symptoms like those you are experiencing.

Hormonal Influences
You mentioned that your menstrual period just ended, which can indeed affect your overall well-being. Hormonal fluctuations can influence mood, energy levels, and even sleep quality. For some individuals, the week following menstruation can lead to changes in energy and mood, potentially exacerbating feelings of fatigue or anxiety.

Recommendations
1. Medical Evaluation: Given the complexity of your symptoms, it is crucial to consult with a healthcare provider who can conduct a thorough evaluation. This may include blood tests, a sleep study, and possibly an echocardiogram to assess your heart function and rule out any serious conditions.

2. Monitor Blood Pressure: Keep track of your blood pressure at different times of the day, especially when changing positions (sitting to standing). This information can help your doctor assess for orthostatic hypotension.

3. Sleep Hygiene: Focus on improving your sleep hygiene. This includes maintaining a regular sleep schedule, creating a restful environment, and avoiding stimulants like caffeine close to bedtime.

4. Stress Management: Engage in stress-reducing activities such as mindfulness, yoga, or gentle exercise, which can help regulate your autonomic nervous system and improve overall well-being.

5. Diet and Hydration: Ensure you are well-hydrated and consuming a balanced diet. Sometimes, dehydration can exacerbate dizziness and fatigue.

6. Follow-Up: Regular follow-up with your healthcare provider is essential to monitor your symptoms and adjust any treatments as necessary.

In summary, your symptoms are likely interconnected, involving aspects of neurogenic disorders, sleep disturbances, and possibly hormonal influences. A comprehensive evaluation by a healthcare professional is essential to determine the underlying causes and appropriate treatment strategies.

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