Managing Dizziness While Sitting or Lying Down: Tips and Insights

Feeling dizzy when sitting or lying down?

Hello Doctor: I experience dizziness when sitting or lying down (feeling like I'm swaying but without nausea), while standing feels more comfortable.
I went to a clinic and took medication (Diphenidol, Cinnazine, Valium) but it didn't help much.
Then I went to the hospital where a doctor performed an auditory brainstem response test, which came back normal.
In the end, the doctor couldn't determine the cause and said it shouldn't be serious, so I wasn't asked to return for follow-up.
I initially felt like I was getting better, but recently the dizziness has returned to the point where I have trouble sleeping.
I often wake up startled by my limbs twitching just as I'm about to fall asleep.
Are there any methods to improve this condition? Thank you!

Touyun, 30~39 year old female. Ask Date: 2021/08/05

Dr. Jiang Junyi reply Neurology

Dear Ms.
Rita,
Your symptoms may warrant consideration of vestibular disorders and hypnic jerks.
Benign paroxysmal positional vertigo (BPPV) should be prioritized, characterized by episodes of dizziness lasting a few seconds, related to changes in head position, such as bending over, leaning back, lying down, getting up, turning over, or sudden head movements.
This may be accompanied by symptoms such as nausea, vomiting, palpitations, cold sweats, and feelings of weakness.
For pharmacological treatment, antihistamine antiemetics, prokinetic agents, and anxiolytics are typically helpful.
The addition of corticosteroids may enhance treatment efficacy, but be mindful of the potential side effects associated with corticosteroid use.
Hypnic jerks may be caused by several factors: 1.
Sleep deprivation leading to premature entry into the rapid eye movement (REM) phase; 2.
Excessive stress preventing relaxation at sleep onset; 3.
Calcium deficiency; 4.
Iron deficiency.
I recommend that you consult a neurologist for further evaluation and follow-up.
Please ensure to practice self-protection, maintain cleanliness and disinfection, and adhere to new preventive health measures before and after your medical visits.
Thank you for your inquiry, and feel free to discuss any related questions further!
Wishing you good health, safety, and happiness.
Dr.
Chih-Yi Jiang, Taoyuan Hospital

Reply Date: 2021/08/05

More Info

Managing dizziness, especially when sitting or lying down, can be a challenging experience, particularly when the underlying cause remains unclear despite medical evaluations. Dizziness can stem from various factors, including vestibular disorders, blood pressure fluctuations, anxiety, or even medication side effects. Given your symptoms and the fact that you feel more comfortable standing, it’s essential to explore several strategies to manage your dizziness effectively.

Understanding Dizziness
Dizziness is a term that encompasses various sensations, including lightheadedness, unsteadiness, and the feeling of spinning (vertigo). In your case, the dizziness occurs predominantly when sitting or lying down, which could suggest a vestibular issue or a postural problem. The fact that you feel more stable when standing might indicate that your body is better able to maintain balance in an upright position.

Possible Causes
1. Vestibular Disorders: These affect the inner ear and brain, leading to balance issues. Conditions like Benign Paroxysmal Positional Vertigo (BPPV) can cause dizziness when changing positions.

2. Orthostatic Hypotension: This condition involves a drop in blood pressure when standing up, which can lead to dizziness. However, your symptoms seem to be more pronounced when sitting or lying down.

3. Anxiety and Stress: Psychological factors can also contribute to dizziness. Anxiety can lead to hyperventilation, which may cause lightheadedness.

4. Medication Side Effects: The medications you mentioned (Diphenidol, Cinnazine, Valium) can have side effects that include dizziness or sedation, which might exacerbate your symptoms.

5. Sleep Disorders: The mention of experiencing jerking movements while falling asleep could indicate a sleep disorder, such as periodic limb movement disorder or even sleep apnea, which can contribute to feelings of dizziness upon waking.

Management Strategies
1. Postural Adjustments: When sitting or lying down, try to maintain a neutral spine and avoid positions that may exacerbate your symptoms. Gradually changing positions can help your body adjust better.

2. Hydration and Nutrition: Ensure you are well-hydrated and maintain a balanced diet. Dehydration and low blood sugar can contribute to dizziness.

3. Vestibular Rehabilitation Therapy (VRT): If a vestibular disorder is suspected, VRT can help retrain your brain to process balance signals more effectively. This therapy involves specific exercises designed to improve balance and reduce dizziness.

4. Cognitive Behavioral Therapy (CBT): If anxiety is a contributing factor, CBT can help address the psychological aspects of dizziness. Learning relaxation techniques and coping strategies can be beneficial.

5. Sleep Hygiene: Improving your sleep environment and routine can help reduce nighttime disturbances. Consider establishing a calming pre-sleep routine and ensuring your sleeping area is comfortable.

6. Follow-Up with a Specialist: Since your symptoms have persisted and worsened, it may be beneficial to consult a neurologist or an ear, nose, and throat (ENT) specialist. They can conduct further evaluations, such as imaging studies or more specialized vestibular testing.

7. Medication Review: Discuss your current medications with your healthcare provider to determine if any adjustments are necessary. Sometimes, switching medications or adjusting dosages can alleviate side effects.

Conclusion
Dizziness can significantly impact your quality of life, and it’s essential to approach it holistically. By understanding the potential causes and implementing management strategies, you can work towards reducing your symptoms. Always consult with your healthcare provider before making any changes to your treatment plan, and do not hesitate to seek further evaluations if your symptoms persist or worsen. Your health and well-being are paramount, and addressing dizziness effectively can lead to a more comfortable and active lifestyle.

Similar Q&A

Understanding Dizziness: Insights from a Neurology Perspective

Hello Dr. Jiang, I previously sought help from a neurologist due to sudden dizziness. The symptoms began while sitting, with a sensation starting from the back of my head. The surroundings did not appear distorted or spinning. Later, the condition worsened, but lying down allevia...

Dr. Jiang Junyi reply Neurology
Based on your description, the symptoms you mentioned are more likely due to syncope. Syncope is more likely to occur when a person is standing, as this position results in the least blood flow to the brain. Often, there is not enough time to react, leading to fainting. The chanc...

Experiencing Dizziness While Sitting and Lying Down: Possible Causes and Solutions

Hello doctor, starting from a certain day, I suddenly feel very dizzy while sitting, and it often occurs. However, it doesn't happen when I walk or exercise, and I experience vertigo when lying down. Could this be cervical spondylosis? I sometimes look down at my electronic ...

Dr. Jiang Junyi reply Neurology
Dear Mr. YY, You mentioned that "one day I suddenly felt very dizzy while sitting, and it often occurs, but not when walking or exercising, and I experience vertigo when lying down." Benign Paroxysmal Positional Vertigo (BPPV) should be considered first. The characteri...

Understanding the Sensation of Head Pressure and Balance Issues

In the past month, I have occasionally felt a sensation of pressure in my head, and sometimes I feel like my body is leaning to one side. There was also an instance when I felt like the floor was spinning, making it difficult to stand, but it quickly resolved. Sometimes, when lyi...

Dr. Jiang Junyi reply Neurology
Hello, Sir: You mentioned that "sometimes I feel like my body is tilting to one side, and once I felt like the floor was spinning, making it hard to stand, but I quickly recovered." These symptoms are more indicative of Benign Paroxysmal Positional Vertigo (BPPV). The c...

Understanding Dizziness: Causes and Solutions for Mental Health Issues

Sometimes when I stand up from sitting, I feel dizzy for a few seconds. During the dizziness, my hands sometimes feel a bit numb, and my body tends to lurch forward.

Dr. Chen Meizhu reply Psychiatry
Hello: It may be due to a change in posture, transitioning from sitting to standing, which can cause orthostatic hypotension leading to dizziness. Therefore, it is advisable to slow down the pace of posture changes to allow the body time to adjust. If dizziness persists despite t...