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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 31330
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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I woke up in the middle of the night feeling dizzy. Feels like

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I woke up in the middle of the night feeling dizzy. Feels like everything is spinning around me. Open my eyes and the dizziness disappear in couple of seconds. Try to close my eyes in bed and the symptoms come back. Also feel dry mouth and weakness. Got scared, went downstairs into the kitchen, and drank a little water. Went back to bed but once closed my eyes and tried to relax the dizziness came back. What should I do, go to ER or wait hoping the symptoms disappear? Now I feel a little dizzy even sitting.

Greetings Andrew.


I am Dr. Phophalia and would assist you today.


The causes of dizziness according to the decreasing incidence are;


1) Benign paroxysmal positional vertigo (BPPV) 20%

2) Vestibular 15%

3) Migraine and motion sensitivity 15%

4) Anxiety and depression 10%

5) Meniere's disease 7%

6) Cerebellar disease 6%

7) Transient ischemic attacks 5%

8) Orthostatic hypotension 4%

9) Other.


Any sudden onset significant dizziness which is persisting even with an eye closure and lying down should be evaluated at ER. If you are on medications, have history of diabetes, high blood pressure, migraine, ear issues; again a significant dizziness should be evaluated at urgent care clinic or ER. Internal ear disease vertigo is termed true vertigo in which one feels rotational movement of self or the surroundings. The false vertigo or nonvertigo has feeling of light-headedness, unsteadiness, motion intolerance, imbalance, etc. You may be referred an ENT specialist to exclude the diseases of internal ear. They will perform some clinical tests (vestibular diagnostic tests) to establish the cause. Often, dizziness can be a multisensory disorder due to any combination of peripheral neuropathy, visual impairment, and musculoskeletal disease. Many patients who have thyroid dysfunction can present with dizziness as an initial complaint. In individuals who have migraine, dizziness and vertigo can occur as part of the aura or separately.


Dizziness associated with the floating, rocking and light headedness and is induced by eye movements (head being still) should be also investigated or correlated to anxiety and depression, If you are on any medications, their side effects also should be ruled out for lightheadedness, as drugs are quite a common cause for this symptom. Dizziness may be provoked by only certain movements, such as standing up after lying down for at least 10 minutes in orthostatic hypotension, or may occur after vertical or oblique head movements, such as lying down, turning over in bed, or sitting up in benign paroxysmal positional vertigo (BPPV). Simply moving the eyes with the head stationary causes dizziness and there is no eye movement disorder (ocular misalignment or an internuclear ophthalmoparesis), then dizziness is likely to be the result of anxiety. When dizziness occurs without provocation (spontaneous) and is vestibular (ear disorder) in origin, it frequently is exacerbated by head movements.

The causes can be divided on the system, which is involved;


1) Inner ear or internal ear disease

2) Central nervous system

3) Cardiovascular, or

4) Systemic diseases


Please feel free for your follow up questions.


Dr. Arun

Customer: replied 3 years ago.



It does feel like the surroundings spinning around once I close my eyes lying down. This is the first time I feel such symptoms. After a couple of attempts I am uncomfortable to go back to bed. I also felt a little dehydrated and just drank a glass of water. Should I go to ER now or drink a lot of water and wait?

You are very welcome, Andrew.

If your symptoms are mild and got better after drinking water, you may wait and watch.

You may go to ER if;

1) symptoms are moderate to severe.
2) increasing
3) accompanied by headache and vomiting.
4) you are on any medications.
5) you have diabetes and/or high blood pressure.

It is privilege assisting you.

Dr. Arun
Customer: replied 3 years ago.

I went to ER that night and it was a vertigo. With a prescription Meclizine a felt much better and stopped taking the medicine after one full day.





You are very welcome, Andrew.

Thanks for the update. I really appreciate it.

Best wishes and kindest regards

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