Why Does Insomnia Cause Vestibular Disorders?

Insomnia is a common issue in daily life, but insomnia combined with vestibular disorders is a sign of poor health. So, what causes insomnia to lead to vestibular disorders?

1. Why Does Insomnia Cause Vestibular Disorders?

We all know that sleep is crucial—it’s the time needed for the body to recover, support the immune system, repair tissues, and even process the information we’ve interacted with throughout the day.

Therefore, insufficient rest can make us feel sluggish, irritable, and hinder our memory and motor skills. Lack of sleep not only causes drowsiness the next day but can also make us feel disconnected from our bodies. Some individuals might even experience insomnia accompanied by vestibular disorders.

Sleep issues are closely linked with vestibular disorders and concussions. Insufficient sleep and irregular sleep schedules can exacerbate symptoms of dizziness during recovery from a concussion or in individuals with chronic vestibular conditions like Meniere’s disease or vestibular migraines.

In fact, studies show that among all types of vestibular disorders, vestibular migraines are most significantly triggered by lack of sleep. Patients may feel unwell and dizzy due to chronic vestibular conditions, leading to poor sleep quality and insufficient rest. This creates a cycle of vestibular disorder-induced insomnia, triggering symptoms and worsening sleep quality.

Concussions and chemical changes in the brain can lead to difficulty falling asleep or maintaining sleep. Reports indicate that up to 60% of concussion patients struggle with sleep issues. Similarly, vestibular disorders can worsen symptoms of a concussion.

2. Signs of Vestibular Disorders Related to Insomnia

Sleep issues can include trouble falling asleep, difficulty maintaining sleep (i.e., waking up during the night), waking up too early in the morning, poor or shallow sleep, or excessive sleep.

Sleep disorders are common among those with vestibular disorders. Individuals experiencing dizziness, imbalance, or vertigo due to vestibular issues are at higher risk for both insufficient and excessive sleep. Sleep disturbances are particularly common in people with vestibular migraines or persistent postural-perceptual dizziness (PPPD).

Some studies have found that people with vestibular migraines are more likely to have poor sleep quality, reduced sleep efficiency (the proportion of time actually asleep while in bed), decreased REM and slow-wave sleep, higher rates of light sleep, longer times to fall asleep, and frequent night awakenings.

One study found that individuals with chronic unilateral vestibular dysfunction (e.g., following vestibular neuritis or labyrinthitis) sleep less and take longer to fall asleep.

The study also observed that those with peripheral vestibular dysfunction and poor sleep quality exhibited worse balance and a higher risk of falls. Sleep disorders can occur with benign paroxysmal positional vertigo (BPPV), as symptoms may arise during movements in bed, leading to more frequent nighttime awakenings. Individuals with obstructive sleep apnea also have a higher incidence of peripheral vestibular disorders.

Sleep disorders are also very common after injuries and concussions, including problems with sleep onset, maintenance, and overall sleep quality. Excessive daytime drowsiness, increased sleep needs, and changes in sleep-wake cycles are also common after a brain injury. Following a mild traumatic brain injury (mTBI) or concussion, it is very common to experience increased sleep in the first few weeks, followed by insomnia.

Changes in activity levels and sleep routines are common with vestibular disorders, as you might be unable to engage in usual daily activities. Reduced activity and disruptions to daily routines negatively impact your sleep.

Fatigue is a common issue with both brain injuries and vestibular disorders. When the vestibular system is not functioning correctly, the brain has to work harder to interpret sensory signals, maintain balance, and keep the eyes focused (due to loss of vestibulo-ocular reflex). This increased demand for energy can lead to greater fatigue, and poor sleep can exacerbate fatigue problems.

3. How to Improve Insomnia Related to Vestibular Disorders

• Maintain Consistent Sleep and Wake Times: Try to keep a regular schedule—go to bed and wake up at the same time every day.
• Optimize the Sleep Environment: Keep the bedroom dark, cool, and comfortable.
• Follow a Relaxing Pre-Sleep Routine: Dim the lights, minimize screen time before bed, and set devices to “Do Not Disturb.” Try relaxing with gentle yoga or stretching. If you can’t sleep after 20 minutes, keep the lights dim but get up and do something light in the room. Mindful breathing, guided meditation, or muscle relaxation can help you unwind before bed. There are many apps, sound recordings, videos, and online resources you can try.
• Minimize or Avoid Napping During the Day: Long naps or napping too close to bedtime can affect nighttime sleep. Avoid late afternoon or evening naps; keep naps short—about 20 minutes.
• Don’t Check the Time: If you wake up during the night, resist the urge to check the clock.
• Exercise Regularly: However, avoid exercising right before bed.
• Spend Time Outdoors During the Day: Exposure to sunlight, especially in the morning, helps set your body’s sleep-wake cycle.
• Use White Noise: If environmental noise disrupts your sleep, consider using white noise.
• Minimize or Avoid Caffeine: If you have sleep issues, try to avoid caffeine after 1 p.m. Caffeine remains in your system longer than you might think, with a half-life of about 5 hours. Caffeine can make it harder to fall asleep, reduce overall sleep time, and decrease the amount of deep sleep.
• Reduce or Avoid Alcohol Before Bed: Alcohol can disrupt sleep cycles, leading to changes in REM sleep stages.

Being proactive about managing insomnia can help you improve your condition, maintain health, and enjoy a longer, healthier life.

Sources: vestibularhealth.ca, smithptrun.com