The Autonomic Nervous System’s Role in Symptoms of Vertigo

Vertigo, a sensation of spinning or dizziness, can be a distressing experience. For many individuals, understanding the root causes of vertigo is the first step toward effective management. One often-overlooked component is the role of the autonomic nervous system (ANS). This blog will explore how the ANS contributes to vertigo symptoms and what this means for your treatment plan.

What Is the Autonomic Nervous System?

The autonomic nervous system is a division of the nervous system that controls involuntary bodily functions, such as heart rate, blood pressure, digestion, and respiratory rate. It has two main branches:

1. Sympathetic Nervous System (SNS): Often referred to as the “fight or flight” system, it prepares the body for stressful or emergency situations.
2. Parasympathetic Nervous System (PNS): Known as the “rest and digest” system, it helps the body recover, relax, and conserve energy.

A balanced interplay between these two systems is essential for maintaining homeostasis and overall well-being.

How the ANS Influences Vertigo

The ANS can affect vertigo in several ways:

1. Regulation of Blood Flow:
   • The vestibular system, located in the inner ear, requires a consistent blood supply to function correctly. Disruptions in blood flow, often regulated by the ANS, can contribute to vertigo symptoms.
   • For example, individuals with dysautonomia, a dysfunction of the ANS, may experience orthostatic intolerance, where blood pressure drops upon standing, leading to dizziness and vertigo.
2. Vestibular Migraine:
   • The ANS plays a significant role in migraine mechanisms, including vestibular migraines, a condition that can cause vertigo alongside other migraine symptoms.
   • Dysregulation of the ANS may trigger or exacerbate these migraines, causing periods of dizziness or spinning sensations.
3. Stress and Anxiety:
   • Stress activates the SNS, increasing heart rate and altering blood flow. Chronic stress or anxiety can lead to heightened SNS activity, potentially exacerbating vertigo symptoms.
   • Anxiety itself is a common trigger for vertigo, creating a feedback loop where the fear of dizziness can worsen ANS dysfunction and perpetuate symptoms.
4. POTS and Other Dysautonomias:
   • Postural Orthostatic Tachycardia Syndrome (POTS) is a type of dysautonomia characterized by an abnormal increase in heart rate upon standing. POTS frequently causes dizziness and vertigo-like symptoms due to impaired blood flow and ANS regulation.

Identifying ANS-Related Vertigo

If you suspect that your vertigo symptoms are related to ANS dysfunction, consider the following:

• Do your symptoms worsen with changes in position, such as standing up quickly?
• Do you experience episodes of rapid heart rate, lightheadedness, or fainting?
• Do you have a history of migraines, especially vestibular migraines?
• Are your symptoms triggered or worsened by stress or anxiety?

Treatment Options

Addressing the ANS’s role in vertigo often involves a multifaceted approach:

1. Lifestyle Modifications:
   • Stress management techniques, such as mindfulness, meditation, and breathing exercises, can help regulate the ANS.
   • Staying hydrated and maintaining a balanced diet can improve blood flow and overall autonomic function.
2. Mindfulness Techniques:
   • Five-Finger Breathing:
     1. Hold one hand up in front of you with fingers spread.
     2. Use the index finger of your other hand to trace up and down each finger of the raised hand.
     3. As you trace up a finger, take a slow, deep breath in.
     4. As you trace down, exhale slowly.
     5. Repeat for all five fingers, focusing on the sensation and rhythm of your breath.
   • Body Scans: Lie down or sit comfortably and focus on each part of your body, moving from your toes to your head, to release tension and promote relaxation.
3. Physical Therapy:
   • Vestibular rehabilitation therapy (VRT) can improve balance and reduce vertigo symptoms. It can also help the body adapt to ANS-related changes.
4. Medications:
   • Beta-blockers, calcium channel blockers, or medications aimed at treating migraines may help regulate ANS activity.
5. Specialized Care:
   • For conditions like POTS or other dysautonomias, a specialist in autonomic disorders may recommend tailored treatment options, including compression garments, increased salt intake, or medications.

Research and Resources

Numerous studies have examined the connection between the ANS and vertigo. Key findings include:

• A 2017 study published in the Journal of Neurology highlighted the role of ANS dysfunction in vestibular migraines and dysautonomias.
• Research in the European Archives of Oto-Rhino-Laryngology (2018) emphasized the importance of vestibular rehabilitation in managing ANS-related dizziness.

For further reading, check out resources from organizations such as Dysautonomia International and the Vestibular Disorders Association (VeDA).

Final Thoughts

Understanding the role of the autonomic nervous system in vertigo can provide valuable insights into your symptoms and treatment options. If you’re struggling with vertigo, consider speaking with a healthcare professional experienced in vestibular and autonomic disorders. Together, you can create a comprehensive plan to regain your balance and improve your quality of life.

McKenzie DiStefano PT/DPT

References

1. Beh, S. C., & Friedman, D. I. (2017). Autonomic nervous system dysfunction in vestibular migraine and other vestibular disorders. Journal of Neurology, 264(1), 63-66. https://doi.org/10.1007/s00415-016-8313-6
2. van de Berg, R., van Tilburg, M., & van der Stouwe, N. M. (2018). Vestibular rehabilitation therapy in autonomic nervous system-related dizziness. European Archives of Oto-Rhino-Laryngology, 275(3), 659-667. https://doi.org/10.1007/s00405-018-4891-5
3. Dysautonomia International. (n.d.). Resources for patients and clinicians. Retrieved from https://www.dysautonomiainternational.org
4. Vestibular Disorders Association (VeDA). (n.d.). Understanding vestibular disorders. Retrieved from https://vestibular.org