How to manage a vertigo attack?

While a vertigo episode can arise suddenly and violently, its symptoms can be reduced by adopting appropriate responses. Developing the correct behaviors for vertigo attack management can help reduce stress and anxiety in future episodes.

Simple tips to adopt in case of a vertigo attack

• Lie still in a quiet, dark room to reduce the sensation of spinning.¹ Some patients with vertigo might experience sensitivity to light. Bright lights can increase the chance of developing a migraine, which can cause head and eye pain.²
• If driving, pull over, park the car safely, and relax.³
• Move your head carefully and slowly during daily activities.¹
• Avoid triggers that can provoke a new attack, such as bright lights and loud sounds. In addition, visual stress (which can be provoked while watching TV, working on a computer, or using a tablet) and telephone use are not recommended.^{2, 4}
• Sit down right away if you feel dizzy.¹
• Turn on the lights when getting up at night.¹
• Sleep with your head slightly raised on two or more pillows.¹ Sleeping on one side can worsen the vertigo, especially if it is due to an inner ear disorder. Sleeping with your head elevated prevents small debris from entering your ear and affecting the nerves responsible for maintaining balance.⁵
• Get out of bed slowly and sit on the edge of the bed for a while before standing up.¹
• Try to relax—anxiety can make vertigo worse.¹

Install safety features within your home

If you experience recurring vertigo attacks, the following safety features are recommended to decrease the risk of falls while you are at home:⁶

• Install grab bars
• Install ramps or handrails
• Use a cane or walker
• Provide clear paths throughout your house (e.g., remove any rugs and items lying on the floor)
• Use stable surfaces (e.g., avoid carpets that may increase the risk of tripping)

Call for medical help

When vertigo is accompanied by a severe headache, nausea, vomiting, or a very high temperature, call for medical help.¹ You will be advised about specific actions to take.

In case of very severe symptoms,¹ such as trouble speaking, hearing loss, double vision or loss of vision, difficulty walking or standing, or leg or arm weakness, it is necessary to seek medical help immediately; call an ambulance if necessary.
Do not hesitate to discuss with your doctor the ways you should behave in case of a vertigo attack.

References

1. New Health Service. Vertigo. https://www.nhs.uk/conditions/vertigo/. Published 2020. Accessed October 21, 2020.
2. Vestibular Disorders Association. How Light Sensitivity & Photophobia Affect Vestibular Disorders. https://vestibular.org/blog/how-light-sensitivity-photophobia-affect-vestibular-disorders/. Accessed October 21, 2020.
3. Lakeline NeuroVisual Medicine. Dizzy While Driving. https://www.neurovisionaustin.com/about-binocular-vision-dysfunction/dizzy-while-driving/. Published 2020. Accessed October 21, 2020.
4. Hopkins Medicine. Recent Findings. https://www.hopkinsmedicine.org/otolaryngology/research/vestibular/recent_findings.html#:~:text=VERTIGO%20DUE%20TO%20AN%20OPENING,the%20inner%20ear%20balance%20canals Published 2020. Accessed October 21, 2020.
5. Horinaka A, Kitahara T, Shiozaki T, et al. Head‐Up Sleep May Cure Patients with Intractable Benign Paroxysmal Positional Vertigo: A Six‐Month Randomized Trial. Laryngoscope Investig Otolaryngol. 2019;4(3):353-358.
6. Stross K. Fall Prevention & Home Safety for Those with Vestibular Disorders. Vestibular Disorders Association. https://vestibular.org/sites/default/files/page_files/Documents/Fall-Prevention-and-Home-Safety_101.pdf . Accessed October 21, 2020.