Not every person can be bright, happy and bursting with energy in the morning. Some people are able to ‘recharge’ fully after a good night’s sleep while others just roll along till they get going later in the day. Neither of these extremes are considered to be a problem unless the latter is accompanied by symptoms like dizziness, mental impairment and irritability or depression are present. Probably the most concerning is when a person actually feels dizzy in the morning upon waking as it may be a symptom of various diseases.
Dizziness After Sleeping
The reasons why we feel dizzy is extensive. While dizziness may be a common symptom the causes among different people can vary greatly. It can be due to:
- Inadequate blood oxygen levels
- Low or high blood glucose levels
- Low blood pressure or other circulatory disturbances
- Inner ear disturbances
These are just some of the likely causes of waking up dizzy after sleeping adequately for the night or even after a short nap. The odd bout of dizziness after sleeping is not a reason for concern. It happens to many of us every now and then and resolves in a few minutes. However, repeated dizziness upon waking should be a cause for concern especially when the dizziness is to the point that it leads to incoordination, poor balance and may even result in fainting.
Dizziness is one of those generalized symptoms that can arise with a wide array of diseases. It is not always easy to isolate, and it is also highly subjective. What is known though is that dizziness tends to arise with one or more of the physiological abnormalities mentioned above. At times dizziness occurs for unknown reasons or with psychological conditions. Furthermore it is important to note that dizziness after waking may arise with inadequate sleep, the use of certain medication, alcohol and other substances.
Causes of Morning Dizziness
A person who awakes feeling dizzy in the morning, after a good night’s sleep and without medication, should consider one or more of the following conditions. These are not the only diseases where morning dizziness may present but it is among the more common causes. Sometimes symptoms like dizziness after sleeping or upon waking are not as prominent in these conditions. Instead a person may experience non-specific symptoms like morning fatigue.
Abnormalities in blood glucose
There are several conditions where abnormal blood glucose levels can lead to dizziness in the morning.
For diabetics (type 1 and type 2 diabetes mellitus), the morning can be a time of abnormalities in glucose levels due to natural changes in the hormone levels and also from poor management of the condition. The former is known as the dawn phenomenon where cyclical changes in hormone levels usually between 3 a.m. and 8 a.m. causes the blood sugar levels to increase significantly. The latter is known as the Somogyi effect and is often associated with poor diabetes management resulting in very low blood glucose levels and then a subsequent rise.
Hypoglycemia or low blood glucose levels arises in some people where the body is unable to maintain the blood glucose levels within a narrow range. Due to not eating while asleep, the lack of food intake results in low blood glucose levels which are only noticed upon waking with symptoms like dizziness being present. It subsequently resolves after breakfast in most instances although in reactive hypoglycemia the symptoms may start a few hours after eating.
Impaired oxygen levels
Low blood oxygen levels upon waking is may be seen with blood abnormalities as well as airway, lung and heart diseases.
Iron-deficiency anemia is the most common type and in this condition the oxygen-carrying capacity of blood is impaired due to lower levels of hemoglobin. Coupled with the reduction in respiratory rate and depth as well as the lower blood pressure and heart rate during sleep, a person may have abnormally low oxygen levels upon waking which may in part present with morning dizziness.
Studies have show that the blood oxygen levels of people with obstructive sleep apnea were lower in the morning than in the evening. Sleep apnea is a condition where breathing momentarily stops while sleeping. The more common type, obstructive sleep apnea, is due to the collapse of throat tissue during sleep thereby blocking the airway.
Chronic Obstructive Pulmonary Disease
COPD is a chronic respiratory condition where the flow of air is hampered due to a narrowing or blockage of the airways and inadequate lung function. It is often associated with long term cigarette smoking. COPD patients awaken with low oxygen and high carbon dioxide levels although this imbalance is fairly consistent even during the day.
Some of the diseases discussed below may impair blood pressure, heart rate and rhythm and oxygen levels in various ways. Not all these conditions originate in the heart or blood vessels but ultimately affect the working of the cardiovascular system.
Hypotension (low blood pressure) can occur for a number of reasons. It may be seen with heart failure, anemia, blood loss, dehydration, hormone imbalances and pregnancy among other causes. Hypotension often leads to dizziness and may be more pronounced in the morning as the heart rate and pressure are usually lower when sleeping. Orthostatic hypotension is where the body cannot maintain an adequate blood pressure when standing upright from a sitting position or when lying flat (supine).
There are several diseases that can cause dizziness due to disturbances in blood flow throughout the body. It may not be specifically morning dizziness but it may be worse when standing up suddenly from a lying position or after sleeping. In fact just about any heart disease can lead to dizziness. Some of these conditions include:
- Myocardial infarction (heart attack)
- Aortic stenosis (heart valve disease)
- Atrial fibrillation (arrhythmia)
- Cardiac failure
- Pulmonary hypertension
- Supraventicular tachycardia
People with hypertension may also suffer with dizziness especially when the blood pressure is uncharacteristically high. It may not be specific to waking up in the morning. However, sometimes dizziness is more obvious when standing up from a lying position. Hypertensives who fail to take their medication as prescribed may also notice morning dizziness until they take their pills.
Inner ear disease
The inner ear contains the organs of balance and when these organs are diseased or dysfunctional, dizziness may be one of the symptoms. As with other conditions, the dizziness may not be specifically only in the morning. However, these organs have to be functioning optimally when standing or walking in order to maintain balance, failure of which may lead to dizziness and even falls. Labyrinthitis and Meniere’s disease are two such conditions but it can also arise with infections of the middle ear.
Dizziness may also be experienced with:
- Liver disease
- Psychiatric conditions – anxiety, depression, grief, psychological stress.
- Poisoning – cyanide, arsenic, carbon monoxide, aspirin.
- Infections – mengitis, encephalitis, sometimes sinusitis.
- Headaches and migraines.