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Vertigo and dizziness in bed caused by otoliths

Last update on Jun, 30, 2023

Unless you’re stepping off a tilt-a-whirl at a carnival or spinning on a merry-go-round at the playground, spells of dizziness are generally unwelcome—especially in the middle of the night. While this likely doesn’t point to a serious problem, experiencing vertigo in bed can disrupt an otherwise pleasant sleep. Understandably, this is likely something you hope to avoid in the future, which is where we can help. Read on for tips to reduce symptoms and learn about benign paroxysmal positional vertigo (BPPV), which could be responsible for these unpleasant episodes.

What is paroxysmal positional vertigo (BPPV)?

If you’ve ever experienced the feeling that the room or inside of your head is spinning, that’s likely benign paroxysmal positional vertigo—also called BPPV. And if you’ve experienced this, you likely know that the mild to intense dizziness doesn’t last all that long.

To get a little more technical, BPPV occurs when calcium carbonate crystals in the otoliths—organs in your inner ear responsible for balance—loosen and make their way into the ear’s semicircular canal. This movement is especially prone to happen when lying down; this makes the semicircular canal sensitive to head movement, resulting in one of the primary benign paroxysmal positional vertigo symptoms: dizziness. Keep reading for benign paroxysmal positional vertigo treatment options.

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When can BPPV occur?

When those crystals are in the semicircular canal, any movement to the head can cause dizziness, such as:

  • Turning over while sleeping
  • Looking up toward an object
  • Bending down to tie shoes or put on slippers
  • Shifting from lying down to sitting up

Other benign paroxysmal positional vertigo symptoms include nausea, vomiting and a loss of balance.

Is BPPV a serious disease?

Benign paroxysmal positional vertigo is not considered a grave disease. However, that last symptom mentioned above—loss of balance—can potentially cause problems if you take a severe fall. More good news; specialists can often treat BPPV using physical maneuvers like the Epley or Semont maneuvers, which help redistribute the crystals and create some relief.

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What are otoconia or ear crystals?

Otoconia (or ear crystals/ear stones) are the calcium carbonate crystals inside the sacculus and utricle, or the otolith organs. And what is an otolith? The otolith organs are part of the labyrinth in the inner ear and have hair cells embedded into a membrane on which the otoconia rest. The otoconia gives the membrane some weight, so when the head moves, gravity comes into play and causes the membrane to shift, pulling on the hair cells and cuing to the brain where the head is.

What are the common causes of dizziness in bed?

Experiencing vertigo in bed can happen when otoconia shift from their normal spot and flow into other spaces of the inner ear, like the semicircular canals that detect the rotation of the head. When this happens, the otoconia start to cause issues when someone moves their head—think rolling over in bed or sitting up after lying down.

The reasons otoconia shift vary and can be from ear infections, head trauma, excessive or abrupt head movement or severe stress.

How long until otoconia (aka ear crystals) heal?

Over time, otoconia usually return to their natural place, but to help resolve the issue quicker, or if you’re experiencing severe dizziness, consider visiting an experienced otolaryngologist. They can perform an otolith maneuver to help move the otoconia back to their original spot and resolve the dizzy spells.

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When should I call a doctor?

If the dizziness worsens when moving your head or your otolith vertigo doesn’t subside over time, it’s time to see an ear specialist. They can help perform one of the maneuvers mentioned in the next section. If you experience any of the following along with your dizziness, seek emergency care right away:

  • A fever
  • Hearing loss
  • Double vision
  • Falling or trouble walking
  • Loss of consciousness

What maneuvers can I do to reposition otoconia?

Only a physician, an audiologist or a physical therapist can perform the Epley or Semont maneuvers to help move the otoconia back into place. The benign paroxysmal positional vertigo Epley maneuver involves no surgery or special equipment. During this maneuver, the specialist turns the head in a sequential manner that helps encourage the crystals to move out of the semicircular canal and back into their normal spot.

Like the Epley maneuver, the Semont maneuver only requires a series of body movements. In this maneuver, you’ll move quickly from laying on one side of the body to the other with the head facing down toward the bed, then returning to a sitting position. Again, only the professionals noted above can provide expert guidance for effective results.

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