Are you Learning to Live with Vertigo?

Many people who have unresolved BPPV for many years, sometimes 20, 30, or 40 years, tend not to complain of dizziness or vertigo when I interview them. This is because these individuals have learned how to change their movement pattern to avoid the position(s) that make them uncomfortable, essentially they are learning to live with vertigo.

When I meet someone who is falling repeatedly and I ask them, “How do you sleep?”

They often say:

“Well I never lie flat.”

Then I ask them, “Do you ever get dizzy?”

They reply to me:

“No, I never get dizzy.”

If I inquire in more detail, “Why is it that you never lie flat?”

They usually say something like:

“I never lie flat. I prop my head up on at least two pillows so I won’t spin or get dizzy.”

They are learning to live with vertigo and have figured out how to adapt their sleeping position to avoid experiencing the symptom of dizziness or vertigo from lying down or rolling over in bed.

Therefore, they do not complain of vertigo or dizziness because they avoid the provoking positions.

People are really smart and our bodies are inherently intelligent. If we are uncomfortable, we will change a movement pattern to prevent from experiencing that discomfort. This change may be conscious or unconscious.

Even though these individuals have learned how to avoid the position that provokes “positional vertigo,” they still have underlying problems with walking or balancing from chronic, unresolved BPPV.

I often find vestibular issues, like positional vertigo caused by BPPV, when I evaluate older people who are repeatedly falling without a clear explanation, which is a problem I call “unexplained, repeated falls.”

Learning to Live with Vertigo can Cause Mis-Diagnosis of Cognitive Problems

There can also be a mild cognitive impairment that comes along with chronic, untreated positional vertigo.

When I meet older people who are learning to live with vertigo caused by BPPV, they are frequently diagnosed with what is called “mild cognitive impairment” or “MCI.”

MCI a newer diagnosis for early dementia. This diagnosis represents more cognitive changes than are typically associated with normal aging, but the mental changes are not as severe as a diagnosis of dementia.

MCI is typically characterized by difficulty with concentration, reduced short term memory, difficulty with executive level brain function for decision making, and reduced “cognitive stamina.” Reduced cognitive stamina means that they can’t concentrate for long periods of time, such as reading, because they have to take mental breaks.

Untreated positional vertigo (BPPV) can also cause many of the symptoms that are considered MCI, so it can masquerade as “mild dementia.”

There is one major difference:

When the BPPV is treated successfully by a Vestibular specialist, the cognitive impairment from BPPV instantly goes away!

That resolution of cognitive issues caused by BPPV makes it much more easy to function than simply learning to live with vertigo.

Balance Improves when Vertigo is Resolved

The underlying issues with walking and balancing, if they are related to the BPPV, can also be resolved! Some people have an immediate improvement in walking stability. Other people need 4-8 weeks of Vestibular Rehab physical therapy for a full recovery.

The individual may also be able to go back to the sleeping positions that they have avoided for so long, while trying to avoid triggering the positional vertigo symptoms that they were previously experiencing.

If patients are able to resolve these underlying issues caused by chronic, unresolved BPPV, then their quality of life is much better than learning to live with vertigo.

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