Dizziness and Nausea When Turning in Bed: What to Do?

Dizziness and nausea when turning over?

In the past, I was diagnosed with anemia, so I pay close attention to my daily diet.
However, recently, when I turn from lying on my left side to my right side while sleeping, I experience severe dizziness (the surroundings appear to be spinning with my eyes open).
At this moment, I feel an intense urge to vomit (but nothing comes up), and I have difficulty breathing with a heavy sensation in my chest.
This situation has worsened over the past month.
During the day, I only experience slight dizziness (not as severe as when I turn at night), feeling groggy but still able to carry out normal activities and work.
My eyes feel sore, and pressing on the area near the bridge of my nose significantly alleviates the discomfort.
Recently, I have also experienced breathing difficulties that require me to rest briefly before returning to normal.
I do not have any headache symptoms.
If I need to seek medical attention, which specialty should I consult first?

Yang, 20~29 year old female. Ask Date: 2014/12/01

Dr. Gao Chunde reply Neurology

This is a type of positional vertigo, and you can consult an otolaryngologist or a neurologist.
If there is a detection of otolith dislodgment, it can also be repositioned during the examination.

Reply Date: 2014/12/01

More Info

Experiencing dizziness and nausea when turning in bed can be quite distressing, especially when it interferes with your daily activities and sleep. Based on your description, it seems that you are experiencing significant symptoms that warrant further investigation. Here’s a comprehensive approach to understanding your condition and the steps you should take.

Potential Causes
1. Vestibular Disorders: The symptoms you describe, particularly the sensation of spinning (vertigo) when changing positions, could be indicative of a vestibular disorder. Benign Paroxysmal Positional Vertigo (BPPV) is a common condition where tiny crystals in the inner ear become dislodged, leading to dizziness when the head is moved in certain ways.

2. Anemia: Given your history of anemia, it’s important to consider that low hemoglobin levels can lead to insufficient oxygen delivery to the brain, which may cause dizziness and feelings of faintness, especially when changing positions.

3. Orthostatic Hypotension: This condition occurs when blood pressure drops significantly upon standing or changing positions, leading to dizziness. It can be exacerbated by dehydration, certain medications, or underlying health conditions.

4. Neurological Issues: Although less common, neurological conditions can also present with dizziness and nausea. It’s crucial to rule out any serious underlying issues.

5. Anxiety or Panic Disorders: Sometimes, anxiety can manifest physically, leading to symptoms such as dizziness and nausea, particularly in stressful situations or when changing positions.

Recommended Actions
1. Consult a Healthcare Provider: Given the severity and persistence of your symptoms, it is advisable to seek medical attention. You should start by visiting a primary care physician, who can perform an initial evaluation and determine if a referral to a specialist is necessary.

2. Specialist Referrals: Depending on the findings from your initial examination, your doctor may refer you to:
- Otolaryngologist (ENT): For evaluation of vestibular disorders and inner ear issues.

- Neurologist: If there are concerns about neurological conditions.

- Hematologist: If your anemia is suspected to be a significant factor.

3. Diagnostic Tests: Be prepared for your doctor to order tests such as blood tests to check your hemoglobin levels, imaging studies (like an MRI or CT scan) if neurological issues are suspected, or vestibular function tests to assess inner ear function.

4. Lifestyle Modifications: While awaiting your appointment, consider making some lifestyle adjustments:
- Hydration: Ensure you are well-hydrated, as dehydration can exacerbate dizziness.

- Diet: Maintain a balanced diet rich in iron and vitamins to support your blood health.

- Movement Caution: Be cautious when changing positions; move slowly to minimize dizziness.

5. Symptom Management: If you experience severe nausea, over-the-counter medications like meclizine may help alleviate dizziness, but consult your doctor before taking any new medication.

Conclusion
In summary, your symptoms of dizziness and nausea when turning in bed could stem from various causes, including vestibular disorders, anemia, or other underlying health issues. It is crucial to seek medical attention promptly to identify the root cause and receive appropriate treatment. Starting with a primary care physician will help guide you through the necessary evaluations and referrals to specialists as needed. Remember to take care of your overall health and monitor your symptoms closely.

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