Most of us feel a little ‘woozy’ when waking up in the morning but this quickly subsides once we get up and moving. Dizziness that persists for long periods after you awake needs to be taken seriously. It can be an important symptom of many diseases. This type of symptom is more of a problem if it occurs daily, and especially if it occurs after having a good night’s sleep. It is even more significant if there are episodes of falling, confusion, poor memory, difficulty recognizing people, irritability or depression.
Why do we feel dizzy?
Dizziness is a sensation of severe lightheadedness where a person feels like they will fall or faint. At times both may occur. There are many different reasons why we feel dizzy. It is a sensation meaning that brain makes us feel like we are about to fall or faint. Often it is transient, lasts for a short period of time and resolves within seconds to minutes. These instances are not usually a problem and the cause is largely unknown. However, most cases of recurrent or persistent dizziness occurs for one or more of these reasons – abnormal blood oxygen levels, abnormal blood glucose levels, abnormal blood pressure and inner ear disturbances.
It is important to note that the abnormalities discussed above refer to either high or low levels. However, it is usually at low levels that dizziness is expected, like with low blood oxygen levels (hypoxemia), low blood glucose levels (hypoglycemia) and low blood pressure (hypotension). All of these factors either directly or indirectly affect the brain. Oxygen is needed in optimal quantities by the brain cells as is blood glucose. Blood pressure maintains the flow of oxygen and glucose to the brain cells. The inner ear is responsible for balance and sends signals back to the brain.
Causes of Morning Dizziness
The causes of dizziness in the morning can be broadly divided into low oxygen levels, low blood glucose levels, low blood pressure and inner ear disturbances. However, there may be other conditions involved like in psychogenic cases where dizziness may be associated with mental health conditions like anxiety and depression. Similarly many cases of morning dizziness are due to unknown conditions and this is termed idiopathic. An important cause for morning dizziness is substance use and abuse.
Low Blood Oxygen
- Anemia is a condition where the red blood cells (RBCs) is abnormal or too few in number which reduces the ability of blood to carry oxygen. The most common type is iron-deficiency anemia.
- Lung diseases includes a range of different conditions where the lungs are not functioning optimally. Proper gas exchange between the blood and environment cannot occur effectively. Chronic obstructive pulmonary disease (COPD) is one such cause.
- Sleep apnea is where breathing stops momentarily while asleep. This occurs several times throughout the night. There is insufficient oxygen in the bloodstream and it can affect all aspects of life.
Low Blood Glucose
- Hypoglycemia is a condition where the blood glucose level falls below the normal range. Some people have metabolic disorders where the blood glucose levels cannot be controlled normally but it can also occur with shock, extreme fasting and with certain drugs.
- Diabetes mellitus is a common disease where there is an inability to control the blood glucose levels and it rises beyond the normal range. This is due to either a deficiency of insulin or the body’s intolerance to the action of insulin.
Low Blood Pressure
- Heart attack (myocardial infarction) where a portion of the heart tissue is damaged and the heart can therefore no pump efficiently. A heart attack is a very serious condition but it is not always fatal. It is often associated with underlying coronary artery disease.
- Heart failure is where the heart can no longer pump effectively and a heart attack is one of the possible causes. As a result the blood cannot be pushed out with the same force as normal.
- Heart valve disease like aortic stenosis is a condition where one of the heart valves fail to open or close as it should. These valves help prevent back flow of blood.
- Other heart diseases:
– Atrial fibrillation
– Supraventricular tachycardia
– Pulmonary hypertension
It is important to remember that dizziness may also be due to hypertension (high blood pressure) especially when the pressure is very high.
Inner Ear Disturbances
The organ of balance (semicircular canals) are located with the inner ear. When there is a problem with this organ or surrounding tissue, dizziness may be one of the symptoms that are reported. Disturbances can occur with inner ear infections, labyrinthitis and Meniere’s disease. Sometimes the area of the brain responsible for processing the signals from the semicircular canal may instead be the source of the problem while the semicircular canals are healthy and functioning optimally.
A number of different substances can cause dizziness. This includes certain pharmaceutical drugs, alcohol and illicit substances. For example, drugs like sleeping pills often causes a range of symptoms in the morning like dizziness. Excessive alcohol intake before bedtime can also cause dizziness. Most illicit substances cause dizziness when used. Addicts may experience dizziness as a withdrawal symptom in the morning and crave the substance.
With regards to substances sometimes dizziness may be present with inhaled toxins. It may not always be evident that these substances are being inhaled, like with a gas leak or air pollution. Not all gases have a noticeable odor. Dizziness, blurred vision, confusion and nausea are some of the symptoms associated with a range of oral, injected and inhaled substances. Exposure to these substances may be accidental or intentional. Dizziness may also be present in poisoning.
Persistent dizziness should always be investigated by a medical professional. It may require further diagnostics investigations such as a blood test, CT scan or MRI even if other symptoms like nausea, headaches or blurred vision are not present. Never stop any prescription drug if dizziness starts after using it and is suspected as a side effect. Always ask a doctor or pharmacist before changing or stopping any treatment.