Feeling dizzy when lying down and closing eyes
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Understanding Dizziness When Lying Down and Closing Eyes
Dizziness is a common complaint, particularly among older adults, and can be exacerbated by certain positions, such as lying down and closing the eyes. This article synthesizes research findings to understand the underlying causes and potential interventions for this condition.
Prevalence and Risk Factors of Dizziness in Older Adults
Dizziness in Middle-Aged and Older Adults
Dizziness affects more than 10% of individuals aged 50 years and older, with a significant portion experiencing unresolved symptoms despite available treatments. Key risk factors for dizziness handicap include vestibular issues, cardiovascular conditions, anxiety, and postural sway. Specifically, a positive Dix Hallpike/head-roll test for benign paroxysmal positional vertigo (BPPV), cardiovascular medication use, high postural sway, and anxiety are significant predictors of moderate to severe dizziness handicap1.
Positional Dizziness and BPPV
A study focusing on elderly individuals aged 70-85 years found that 10% reported dizziness when lying down or turning over in bed. Among those who underwent physical examination, a significant number tested positive for BPPV, indicating that this condition is a common cause of positional dizziness in the elderly3. This highlights the importance of considering BPPV in the differential diagnosis when older adults report dizziness in specific positions.
Symptoms and Severity of Dizziness
Vertigo and Associated Symptoms
Vertigo, a specific type of dizziness, can result from disturbances caused by various factors such as Wind, Fire, Phlegm, blood stasis, or deficiency. Symptoms range from mild dizziness that may subside upon closing the eyes to severe sensations akin to seasickness, accompanied by nausea, vomiting, tinnitus, pallor, and sweating. In extreme cases, vertigo can lead to abrupt fainting2.
Interventions and Rehabilitation
Balance Training and Vestibular Rehabilitation
Interventions such as balance training and vestibular rehabilitation have shown promise in improving clinical balance measures among patients with dizziness. A randomized controlled trial demonstrated that specific rehabilitation programs significantly improved the ability to stand on one leg with eyes closed in individuals aged 50 years and older. These findings suggest that targeted rehabilitation can enhance balance and potentially reduce dizziness symptoms4.
Conclusion
Dizziness when lying down and closing the eyes is a multifaceted issue, particularly prevalent among older adults. Key factors include vestibular dysfunction, cardiovascular conditions, and anxiety. BPPV is a common cause of positional dizziness, and targeted interventions like balance training and vestibular rehabilitation can offer significant improvements. Understanding these factors and implementing appropriate interventions can help alleviate dizziness and improve quality of life for affected individuals.
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Most relevant research papers on this topic
Identifying Key Risk Factors for Dizziness Handicap in Middle-Aged and Older People.
Middle-aged and older people with significant dizziness handicap are identified through assessments of cardiovascular conditions, medications, vertigo, anxiety, and postural sway.
RCT
Large Human TrialInvestigation of self-reported dizziness in the elderly when lying down or turning over in bed, and possible benign paroxysmal positional vertigo
Ten percent of elderly participants reported positional symptoms, and six out of 22 fulfilled diagnostic criteria for benign paroxysmal positional vertigo, suggesting this type of dizziness may not be self-limiting.
Observational StudyDownbeat nystagmus during eye closure
Downbeat nystagmus occurs during eye closure in patients with dizzy spells, but the pathophysiology of this nystagmus remains unclear.
Case ReportSubject posture and hypnotic susceptibility: a comparison of standing, sitting, and lying-down subjects.
Lying-down posture does not facilitate hypnosis, and standing posture does not inhibit it, with no clear evidence linking hypnosis to dizziness or nausea.
Non-RCTMénière's Disease: Treatment and Practical Differentiation and Diagnosis of Various Types of Dizziness
Perhaps 50% of all the cases considered as Meniere's disease prove on further careful examination to be of cardiovascular origin. When a patient who complains of dizziness is examined, the following preliminary classification can usually be arrived at by simple history. (1) If dizziness occurs with a feeling of a blurring or clouding of vision, "black before the eyes," one is usually dealing with a circulatory type of dizziness. If the dizziness often increases on bending or stooping, the patient may have a very high or a very low blood pressure or some general illness. (2) Dizziness which ceases upon closing the eyes suggests an ocular disturbance, and there is no rotation of objects. (3) Dizziness which produces the sensation of giddiness or unsteadiness, without nausea or ataxia, is due to an arteriosclerosis of the cerebral vessels unless otherwise proved and is most frequent in patients past 60 years of
Somatosensory shift of postural control in dizzy patients
Postural control in dizzy patients shifts from visual to somatosensory dependence, suggesting that stable visual references are recommended for rehabilitation.
Observational StudyDistracting attention in phobic postural vertigo normalizes leg muscle activity and balance
Distracting attention in phobic postural vertigo patients normalizes leg muscle activity and balance, potentially preventing attacks in susceptible patients.
Non-RCT
Rigorous Journal