It can be easy to blame a missed meal or not drinking enough water for sudden waves of dizziness. But, for some people, feeling dizzy can be traced back to sleep apnea.

Sleep apnea is a type of sleep-disordered breathing in which breathing stops for short periods during sleep. Common symptoms of sleep apnea include loud snoring, gasping or choking for breath, and disrupted sleep from waking often.

While awake, people with sleep apnea may notice excessive daytime sleepiness, trouble focusing, headaches, and anxiety. Even though it’s not usually listed as a symptom of sleep apnea, dizziness is often reported by people with the sleep disorder.

Here, we’ll explore the link between sleep apnea and dizziness.

Can Sleep Apnea Cause Dizziness?

Dizziness can refer to a range of feelings. People may say they’re dizzy if they feel like they’re about to faint, vomit, or be sick. The term can also be used to describe feeling unbalanced or unsteady while standing or disoriented within an environment.

Evidence linking sleep apnea to dizziness is limited. However, the research that is available points to a connection between the sleep disorder and dizziness.

A 2024 study that looked at 1,490 adults 70 or older found that people who felt very sleepy at least five days per month were about twice as likely to experience dizziness. People who had sleep apnea also had a higher chance of feeling dizzy compared to those without the sleep disorder.

One small study linked sleep apnea to several types of dizziness and balance-related symptoms. Vestibular migraine — migraine headache with nausea and dizziness — was found to be ten times more common among people with sleep apnea than the general population.

Migraine dizziness was often brought on by movement, similar to motion sickness. Meniere’s disease — an inner ear disorder where fluid buildup affects balance — was found to be 115 times more likely among people with sleep apnea. Meniere’s disease dizziness is defined by vertigo (spinning or swaying sensations) that can last hours and often comes with loss of hearing.

In the study, other types of dizziness, such as vertigo with sensorineural hearing loss (SNHL) and persistent postural perceptive dizziness (PPPV) were also found at higher rates among people with sleep apnea:

• SNHL vertigo attacks, which happened around the time of an abrupt loss of hearing, were about 200 times more common in people with sleep apnea.
• PPPV — or swaying-type dizziness that’s more severe while sitting up or standing and persists for three months or longer — was also common among people with sleep apnea.

How Does Sleep Apnea Contribute to Dizziness?

Most people with sleep apnea have obstructive sleep apnea (OSA). With OSA, the airway becomes blocked when the muscles in the throat relax too much during sleep, preventing air from reaching the lungs.

The other main type of sleep apnea, central sleep apnea (CSA), isn’t caused by a blockage. Instead, the brain doesn’t communicate as it should with the muscles that control breathing.

Breathing pauses during sleep cause oxygen levels in the blood to drop. There are several ways that frequent dips in blood oxygen levels are thought to contribute to dizziness.

Brain Tissue Damage

Oxygen deprivation can damage the brainstem and cerebellum — the areas of the brain that help control balance. OSA has also been linked to gradual damage in other parts of the brain like white matter and the hippocampus. Over time, this damage can make it harder for your brain to process balance and position.

Impaired Blood Flow

Low oxygen can also disrupt the body’s automatic processes, such as blood pressure control. Sleep apnea puts extra strain on the heart and blood vessels, causing blood pressure to rise each time breathing restarts.

Untreated sleep apnea often leads to high blood pressure, which can impact blood flow to the vessels in the inner ear. Reduced blood flow can cause damage to parts of the inner ear. Damage to the inner ear can result in vertigo.

Nerve Inflammation

Frequent dips in oxygen can also trigger nerve inflammation. When nerves in charge of sensing movement and surroundings become inflamed or damaged, the messages they send to the brain can become jumbled. Distorted signals sent from these nerves to the brain may result in feelings of dizziness.

Can Treating Sleep Apnea Help With Dizziness?

Low oxygen levels are thought to be the main cause of dizziness in people with sleep apnea. Sleep apnea treatment can help you breathe better, improve sleep quality, keep oxygen levels from dropping, and improve your overall quality of life.

Effective treatment of sleep apnea may also help reduce or resolve feelings of dizziness that are caused by the sleep disorder.

Treatment options for sleep apnea, such as continuous positive airway pressure (CPAP) therapy and oral devices, can help keep your airways open at night. But evidence on their effect on dizziness is limited.

A review of 21 studies found that use of CPAP machines improved or cured dizziness among people with sleep apnea. However, many of the studies were limited by their small sample size and limited study design.

Another small study found that treatment with CPAP therapy or surgery helped resolve dizziness in people with OSA. The study authors noted that sleep apnea treatment was most effective at resolving recurring episodes of dizziness that weren’t brought on by position changes.

Other sleep apnea management strategies might also help dizziness. Lifestyle changes like weight management, limiting alcohol, quitting smoking, and sleeping on your side instead of your back can help promote overall health and manage sleep apnea.

What Else Could Cause Dizziness?

There are many reasons why you might feel dizzy other than sleep apnea. In order to successfully treat dizziness, it’s essential to identify the root cause.

Talk to your healthcare provider about your dizziness. They can help determine the cause or refer you to a specialist if needed.

Other medical conditions that can cause dizziness include:

• Infections of the inner ear
• Vestibular disorders (inner ear disorders)
• Benign ear tumors
• Heart and blood vessel conditions, such as low blood pressure and abnormal heartbeat rhythms
• Neurological conditions, such as migraine, Parkinson’s disease, and multiple sclerosis
• Head injuries like concussions
• Anemia (low red blood cell count)
• Carbon monoxide poisoning

You may also feel dizzy because you’re anxious, stressed out, or taking blood pressure medications. Having blood sugar levels that are too low, not drinking enough water, and motion sickness are also common causes of dizziness.

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