Does how you feel in the AM

… pretty much predict how you will be rest of day?

I’m fairly sure what happens during my sleep and in the morning determines how I feel for the rest of the day:

  • I no longer get migraines due to successful prophylaxis, but my other symptoms still fluctuate (level of nausea, imbalance, tinnitus, ear pressure).
  • I’ve noticed that imbalance and nausea usually only gets better during the day and never worsens and are often improved with exercise.
  • Tinnitus and ear pressure can worsen by evening (my hiss can turn to a pulsating cicada sound) but how they start out is a good indicator for the day.
  • I can (if rarely) get a headache by evening but these don’t feel like vestibular migraines (which are completely dreadful).

I wonder therefore if how you sleep and what position you sleep in has a significant impact on how you feel. Thoughts?


I feel exactly the same about how I sleep and feel in the morning being a foreshadowing of how the rest of the day will be for me. I currently can’t sleep on my left side because it makes me too dizzy, and can’t really sleep on my back as I get dizzy after 10 minutes or less. So that leaves my right side, which gets extremely sore night after night. But if I wake up multiple times, lay there awake and dizzy, or get less sleep in any way I generally feel worse the next day. Also if my neck hurts more (probably from sleeping position) I have a worse day. I also don’t get many headaches, if I do it seems related to neck pain and TMJ issues I have. But my imbalance is extreme and 24/7, but some days are worse than others. You’re so lucky yours gets better with exercise, I can barely walk!

I still wonder if a different mattress or pillow (I have tried A LOT of pillows) would change everything for me. I can’t seem to fall asleep on another pillow yet, and keep going back to the ones that make my neck sore. :frowning:

I have had TMJ too brought on from the stress and I’m sure from ‘relaxation’ exercises I was given which involved clenching then releasing different muscles in turn. Worked very well but then one of my jaw muscles went into spasm and has taken months to calm down. Yeah I had a patch where I would get dizzy turning to the side but I challenged myself to do it (call me crazy) and it’s got better. I’m sure most of us have chronic BPPV which is the cause of all this!

Wow way to go for being able to make yourself turn to the side! I haven’t been able to lay on my left side for 1 year now. Interesting that you developed TMJ during the exercises, I’m sorry to hear that. I can’t do any of that “relaxation” technique with any of my facial or neck muscles, too tight and too much of a dizziness trigger! I’ve been tested over the past 5.5 years for BPPV by sooooo many doctors and no one has found evidence of it…I have no idea.

I look forward to them improving scanning techniques. Thank goodness for the med tech we have though. My life was unbearable without Amitriptyline. I was getting migraines every two days at one point. We are so lucky to have these things. Imagine getting this only 50 years ago!

Have they tested you with the special goggles?

yes, multiple times tested with the goggles. Ugh it was horrible. I’ve tried to start Amitriptyline 3 times now but keep having a hard time tolerating it. But I don’t have any distinctive migraine “episodes,” mine is consistent off balance and dizziness. I would have never been able to answer, and still can’t, how many “migraines” I get in a week, month, etc.

Ah, so you haven’t had any clear ‘migraine’ episodes but they have diagnosed you with MAV?

Mine were really obvious (and the attacks were HORRENDOUS, thank goodness for the efficacy of the prophylaxis!!)

that’s right, no clear episodes. It’s interesting to me that yours and many others seem to be more clear. I did go to the vestibular clinic at Johns Hopkins though. But it seems to me from my reading that some doctors will only diagnose MAV if there are clear episodes where others will not. But, either way, most of the same medicines are used for chronic dizziness, off balance, headaches, etc. I do have some days that are worse than others that seem to clump together, like this weekend when both days I woke up with vertigo attacks right away, but then the symptoms come and go in a gradual fade, so it’s really hard to say.

Yes. Ami and Nori are both vestibular suppressants so makes sense. SSRI’s presumably help you relax and not exacerbate the dizziness with anxiety. Not sure what anti convulsants do for those without true migraine episodes though? I can tell you that vestibular migraines are the absolute pits and out of all the symptoms they are by far the worst, although I don’t mean to belittle chronic dizziness, nausea, anxiety nor tinnitus.

Yes my worst vertigo is always in bed in the morning. That’s why I think it’s positional, i.e. BPPV. But the migraines always occurred late evening or night time, especially when I’d recently performed complex VRT (which is worse than useless when you still get frequent migraines)