Why do I feel so woozy at night?

August 25, 2010 4:48 PM

Every once in a while, I go through a few days of persistent wooziness in the evening. Is anyone familiar with these symptoms?

I know you're not my doctor, but I've been doctors. Mostly they just sit there and say, "I dunno." I still plan to go to a doctor, but I'm hoping if someone has had similar symptoms I can go in with a particular suggestion for them to investigate.

My medical background is quite checkered. I suffered chronic migraines as a teenager and young adult, to the point that I was hospitalized for them. I dropped out of school repeatedly, and it's only been the last few years that my migraines have changed to "occasional" rather than "most of the time why can't I just die."

I've had just about every test imaginable done, and nothing unusual was found.

I'm also extremely prone to motion sickness. My mother is the same. She was diagnosed with a chiari malformation about ten years ago, and had a serious operation to relieve her symptoms. As soon as she was diagnosed my own doctors rushed to my old tests because my own symptoms were similar, but again--nothing unusual was found.

My current problem may be unrelated, but I thought I would mention that history just in case.

For the past few years, I've suffered intermittent episodes of wooziness in the evening. They last a few days. I'll be going about my business, when I suddenly feel kind of... odd, similar to how I feel when I'm in the backseat of a car. It doesn't seem to matter what I'm doing at the time. Watching teevee or using the computer becomes gradually unbearable, as I can't stand the moving screen. I feel generally bad as well; hot, sometimes short of breath.

The only way to relieve the symptoms is to go lie down flat on my back, neck in a particular straight position, in a dark and cool room. If I can take a short nap, I'll often wake up feeling better--for an hour or two.

There are two really striking things going on:

First, I only experience these symptoms in the evening. In the morning I feel perfectly fine. In the afternoon, fine. It's only later in my day that these symptoms start to take hold. I'll struggle to continue my day and eventually go to bed. Once I wake up in the morning, it's as if I wasn't sick.

Second, I have a strong sensation that the wooziness is emanating from the back of my neck. I feel a little better if I hold my head in a particular way. Bending my head backwards makes it much, much worse. I don't know if that's just an odd interpretation my mind is making of the symptoms I'm experiencing, or what.

One of the theories that my doctor had was that this is a sinus issue. I haven't ruled it out. This feeling is often accompanied by a sort of stuffiness--not blocked, but a kind of heaviness that makes me think I might have allergy or sinus problems. Based on that, I've tried taking OTC allergy medication to see if it helps, but it hasn't. (Antihistamine and decongestants both, of various kinds.) I went to an ENT specialist, but she didn't find anything. They did some testing of my inner ear by shooting water at it, which resulted in me being profoundly ill for several days, but my results were apparently normal.

I went to an allergist, but she turned out to be a kook.

Anyway, I'm in a new town now and have to find a new doctor. I don't want more of the same "I dunno," being sent to a new guy, and him saying "I dunno." I'd like to have a plan of action. I'm asking a lot, I know--this is really a shot in the dark.

Has anyone suffered similar symptoms and had success treating them?

posted by Kutsuwamushi to health & fitness (13 answers total)

Yeah, I have chronic migraines and developed benign vertigo this summer. It blows, but it's something a good neurotologist-- an ENT with extra neurology training-- can address. In my case, my vitamin D was crap-all low. Supplementing (not something you should do without a doc's supervision, you can take too much) has helped me.

Also, I think that water test just barely scrapes by under the Geneva Convention. I didn't enjoy it, and usually I'm game for any weird thing my docs ask me to do.
posted by fairytale of los angeles at 5:10 PM on August 25, 2010 [2 favorites]

Vertigo can often be caused by migraines.
posted by cecic at 5:10 PM on August 25, 2010

I have somewhat similar symptoms in the evening—I'm not sick, but sometimes, always in the evening, the room will start moving around, or I'll feel like I'm not upright. The reason why I think it may not be plain, regular vertigo is because, like you, this happens primarily in the evening. I'm also better after sleeping. I've found that what helps is not staring at my computer screen as much as I usually do (at least four hours a day, often more when I'm out of school). This might help you until you find a real diagnosis.

PS I'm sorry about your crappy doctors—I know *exactly* how that is. Apparently, every ailment I've ever had baffles them.
posted by lhude sing cuccu at 5:15 PM on August 25, 2010

Yeah, I suspect it's time to spin the Neuroulette Wheel again, and see what comes up.

Congested nasal passages might not be allergies so much as altered blood flow in your head. Your nose and sinuses are lined with erectile tissue and your nasal passages cycle through phases of congestion and openness through the day, and this is why sometimes it's easier to breathe through one or the other, and it shifts throughout the day, even when you don't have a head cold. Vasodilation=stuffy head.

(Disclaimer: I suggest asking a neurologist, or a neurotologist, to do the actual spin for you. They're usually better at it. I think they know how the wheel is loaded. I am neither.)
posted by Uniformitarianism Now! at 6:26 PM on August 25, 2010

Sorry, bad edit: it should just be the nose/nasal passages, not the sinuses, too. I need to hit 'preview' more often.
posted by Uniformitarianism Now! at 6:32 PM on August 25, 2010

I wonder if it might be a different type of migraine than the others you've had. My migraines usually last for three or four days, and they often go away before I get up in the morning and then come back in the afternoon or evening. Migraines often bring a stuffiness that feels like sinus trouble along with them, and my migraines often seem to start at a certain point on the back of my neck. Looking at the computer screen tends to make these migraines worse after they've started, and lying down flat in a dark room is a very common reaction to migraines.
posted by Ery at 6:58 PM on August 25, 2010

This may seem quite mundane but could you be dehydrated? I get episodes of dizziness/wooziness in the afternoon if I haven't been diligent about hydration. My doctor noticed that I was orthostatic at a recent visit and told me to increase my water intake and the episodes went away.
posted by otherwordlyglow at 7:49 PM on August 25, 2010

I've been having similar issues, including other neurological symptoms, and I have had to deal with a bunch of useless doctors and one so-so doc. I finally got brave enough for a second opinion and firmly requested a referral for a private MRI from the second doc because there was some concern about possible Multiple Sclerosis diagnosis. Fortunately for me, my brain scan came back fine as well as every single blood test, which were all in the "perfect" ranges (including thyroid, glucose, all major nutrients/vitamins and electrolytes, liver function, etc.). So, on paper I'm extremely healthy (other than being a few pounds overweight).

I've had a few people suggest that I look into a certain type of migraine (I have suffered from migraines but they are usually mostly "ocular" migraines with visual auras, dizziness, sensitivity to light/sound/sometimes touch, but not always an actual headache). Anyways, three separate people (both online and in person) have told me to look into Hemiplegic Migraines. Apparently, it can come in varying severity and my issues have included other symptoms such as ataxia, periods of fogginess or confusion, slurred speech, balance/vertigo issues, etc., so this may or may not be your issue but since you already suffer from migraines, it might be something to check out.

*IANAD, IANYD, yada yada
posted by 1000monkeys at 7:55 PM on August 25, 2010 [2 favorites]

A good way to handle a medical issue that isn't straightforward is to find a good, interested internist. The internist, acting as your primary care doctor, can seek out good specialists and make useful referrals (as compared to seeing so-so specialists or kooks or docs who'd rather just blow you off). If you can get a recommendation for a really good internist in your area, that's a great place to start.
posted by galadriel at 8:23 PM on August 25, 2010

Galadriel has a good point. One thing I tend to forget is that I had the excellent sense to be born into a family full of physicians. Not because they diagnose me, but because they have the 'knows their subject' mental lists when it comes to finding medical providers. I end up starting a few links down the referral chain because of this, and that's not how it works for most people.

I had no idea how precious these mental lists and gathering of general local medical opinion on a particular practitioner's work really were until I was out on my own.

If you don't have a local internist yet, start there.
posted by Uniformitarianism Now! at 9:55 PM on August 25, 2010

Just throwing this out since no one else has mentioned it, Chiari Malformation. IANAD, this is merely another item to bring up to your doctor to be considered and looked into. Doctors are human and don't always think of everything that could possibly be wrong, and this is one of those more subtle, less common, maladies.

I wish you all the best and hope you and your doctor can find the cause and solution to your health problems.
posted by batikrose at 10:31 PM on August 25, 2010

batikrose, OP's Mom has that and so it was ruled out early on.

Great advice about finding a good internist and upping your levels of hydration. All I can add is a somewhat tangental "do NOT under any circumstance take Viagra" due to its effects on the erectile tissue in the nose. Last thing you need is any complication with the blood supply. Good luck and focus on the fact that there are a multitude of eminently treatabale things it could be. "When you hear hooves, think Horses not Zebras!"
posted by Wilder at 1:06 AM on August 26, 2010

thanks for pointing that out wilder ... my oops, I didn't catch that.
posted by batikrose at 11:34 PM on August 26, 2010