A Vestibular Migraine diagnosis can add challenges to getting quality sleep. As a result, sensitivity to movement, tinnitus and vertigo all hinder quality sleep. Read on to learn some usable tips for dealing with these troublesome symptoms while encouraging your best rest.
** While Migraine Strong writes about the latest in migraine treatments, this is not medical advice. We are patient educators and all information you read should be discussed with your doctor.
What to do about tinnitus
Many VMers in our closed Facebook group Migraine Strong reported having difficulty falling asleep due to tinnitus (ear ringing) that is particularly bothersome when it’s quiet. While it goes against other sleep advice, our members with tinnitus feel it’s helpful to mask tinnitus by falling asleep to sound. I agree that falling asleep with a little sound helps me feel more relaxed than I would if I was lying in silence listening to my ears ring. So do what works for you and what makes you feel the most relaxed even if it breaks some of the typical sleep rules. To help ease or mask tinnitus try…
- Listening to a podcast or a TV that shuts itself off with a timer.
- Turn on a sound machine with soothing rain or steams. I recommend this one that won’t drive you crazy by looping the same sound over and over.
- Control the anxiety that likes to tag along with this symptom. Try guided meditations, guided imagery or sleep stories through the Calm App. Try aromatherapy, deep breathing or tense relax exercises as well. Lavender or vanilla scents helps promote sleep.
- Vinpocetine and Ginko Biloba can help ease tinnitus by pushing blood through small capillaries helping to improve oxygen flow and reducing tinnitus intensity. I like Pure Encapsulations Cognitive Factors because it combines the two. An added bonus is that it also helps relieve brain fog.
- Some people find lemon bioflavonoids help to ease ear symptoms. It contains a high concentration of eriocitrin which also helps dilate capillaries and small blood vessels increasing oxygen and blood flow. Only authentic lemon bioflavonoid will work. It can’t be citrus bioflavonoid. I like Lindberg brand which I’ve only seen sold here.
- This Sound Pillow features soft speakers inside to provide you with discreet tinnitus masking without disturbing your partner. Amazon also sells soft speaker mats to place under your favorite pillow.
- Limit your use of ear plugs particularly while sleeping. Earplugs can reduce your ability to hear external noise making tinnitus more noticeable.
- Cognitive Behavior Therapy involves working with a therapist to identify and develop strategies to change negative thought patterns that can happen when dealing with this symptom.
How to avoid sleep-triggered vertigo
It’s important to remember that when most people think of vertigo they think of the spinning sensation that results from “loose crystals” in your inner ear. That type of vertigo is a peripheral vertigo (stemming from your ears) called Benign Paroxysmal Positional Vertigo or BPPV. While those with vestibular migraine can certainly get BPPV and even have a higher prevalence of it, generally vestibular migraine vertigo is different. It’s central vertigo resulting from a disturbance in the brain and not the ears. That means the epley and similar maneuvers are not going to help resolve it. To resolve vestibular migraine vertigo you must get treatment. Please search for an experienced neuro-otologist or neurologist in your area,
Even with treatment, for some VMers sensitivity to movement can make it more difficult for us to get a good night’s sleep. Sometimes turning on our side can make us feel an instant spin, but for others only a side position will do. We can have difficulty rolling over and with various head positions that happen while tossing and turning during the night especially if we’re lying flat. As a result, many of us prefer to sleep upright and on our backs.
Here are a few tips to help avoid sleep-triggered vertigo.
- Most importantly, get treatment for your vestibular migraine. We recommend a multi modal approach of medication, supplements, diet, exercise etc. under the care of an experienced physician.
- Try vestibular rehab to train your brain to compensate for sensitivity to movement.
- Minimize stress. Try deep breathing exercises, meditation, gratitude journaling, forest bathing etc. Whatever helps you feel calm and relaxed…do that!
- Exercise regularly.
- Practice good sleep hygiene. Tips can be found in our part one sleep blog here.
- Train yourself to sleep on your back or the best position that works for you. You can try a wedge pillow, body pillow or adjustable bed to increase success.
- Elevate your head. This travel pillow can help support your neck while your head is elevated.
- Wake up slowly. Rising up quickly after lying down for hours can trigger dizzy symptoms as well.
- Try over the counter meclizine or a very low dose prescription medication like Valium or Ativan before bed. (*Note these should be used short term). Learn more about what Dr. Hain says about benzos and vestibular migraine here.
My personal sleep struggle
Before vestibular migraine I was a tummy sleeper but since my diagnosis, I’ve needed to sleep upright and on my back. It was no easy task to train myself not to flip over during the night. Early on in my diagnosis I was still trying to sleep in bed. At that time we had, a popular brand mattress with an adjustable base. When I raised the head of the bed up, it forced my guy to have to sleep upright too which definitely wasn’t ideal. On top of that, with the head raised up, I’d end up sliding down sometime during the night & I’d wake up squished at the bottom of the bed or I’d keep turning over in my sleep causing quick vertigo spins. I was so nervous that these quick spins would prevent my brain from calming down so I did my best to avoid them. I tried wedges and body pillows to keep myself propped up but, they just were not enough to keep me where I needed to be and my guy was still forced to sleep higher than he liked. I began to accept that the recliner was the only way I could successfully keep from disturbing my guy and keep myself upright during the night. So I slept in a recliner for nearly two years after diagnosis. A freaking recliner…for TWO YEARS!
My sweet guy kept saying we needed to come up with something to get me back to bed and he was right. Neither of us liked sleeping separately away from one another. While I got used to sleeping in the recliner, I didn’t want my sleeping habits to cause us to drift apart and the separate sleeping arrangement was going on too long (for us). That concern began our search for something that might work for us.
After looking at many adjustable bed options we ended up taking a chance and purchasing an inexpensive mattress (we chose two 14 inch twin XLs) and adjustable base from Amazon. This was a bed we didn’t get to lay on before purchasing, we bought it solely based on reviews but, I’m SO happy we did. We chose the split king (two twin XLs) adjustable base so that I can sleep upright at an incline and my guy can lie flat without disturbing each other. We chose a soft cool gel memory foam mattress to go on top of it and it’s totally working! Even though it’s less expensive than the name brand bed we owned before, this mattress is the most comfortable I’ve ever owned. Really, I love it.
I don’t know what the difference is in the way this bed tilts but, I have no trouble staying up at the incline that works for me. I adjust my pillows into an upside down U shape to elevate my head and support my arms and I never slide down to the bottom anymore. Happily, I can report that I’m finally back in bed next to my guy where I belong with no spinning! Now if I could just find something on Amazon that keeps my Weimaraners from squeezing into bed with us…winky face. Sweet dreams.