Vertigo Is More Than Just Dizziness: New Research Reveals the Hidden Link Between Balance, Sleep, and Mental Wellbeing

Written by Dr Julian Simpson — Chiropractor with 15+ years of experience, Board Member of the Chiropractic Australia Research Foundation, and author/reviewer of 800+ health articles.

Vertigo Is More Than Just Dizziness: New Research Reveals the Hidden Link Between Balance, Sleep and Mental Wellbeing

Why Do Some People Struggle Long After Their Vertigo Settles?

If you've ever experienced vertigo, you'll know it's far more than simply feeling a little dizzy.

Many people across Sunbury, Melton and Melbourne's north-west describe feeling exhausted, anxious, foggy-headed and emotionally drained long after the spinning sensations have improved.

Whether you're commuting down the Calder Freeway, working long shifts on your feet, caring for young children, or trying to stay active around local sporting clubs, ongoing dizziness can have a major impact on everyday life.

New research is helping us understand why.

A large 2025 study involving more than 600 participants found that Benign Paroxysmal Positional Vertigo (BPPV) may affect far more than the inner ear. Researchers discovered strong links between vertigo, anxiety, depression, sleep quality and changes in important brain neurotransmitters that help regulate mood, balance and recovery.

The findings highlight why a comprehensive approach to vertigo management may be just as important as treating the inner ear itself.

What Is BPPV?

Benign Paroxysmal Positional Vertigo (BPPV) is the most common cause of vertigo worldwide.

It occurs when tiny calcium crystals inside the inner ear become displaced and move into one of the balance canals.

When this happens, normal head movements can trigger:

• Sudden spinning sensations

• Dizziness when rolling over in bed

• Balance problems

• Nausea

• Motion sensitivity

• Difficulty walking confidently

• Fear of movement

Research estimates that approximately 2.4% of people will experience BPPV during their lifetime, with recurrence rates of 15–20% each year.

Importantly, BPPV accounts for a significant proportion of all vestibular disorders seen in clinical practice.

The Surprising Link Between Vertigo and Mental Health

Most people assume vertigo is purely a physical condition.

However, this new research found that people with BPPV experienced dramatically higher levels of anxiety and depression compared to healthy individuals.

Researchers assessed 310 patients with BPPV and compared them with 300 healthy controls.

The results were striking:

Anxiety Scores Were Three Times Higher

Patients with BPPV recorded average anxiety scores of:

• 15.09 compared to 5.00 in healthy controls

This represents a substantial increase in anxiety symptoms.

Depression Scores Were Nearly Three Times Higher

Average depression scores were:

• 16.18 in the BPPV group

• 5.55 in healthy controls

Researchers noted a strong relationship between dizziness severity and emotional wellbeing.

Simply put:

The worse the dizziness, the worse people tended to feel emotionally.

Vertigo Can Seriously Impact Sleep

One of the most overlooked aspects of vertigo is its effect on sleep quality.

Many people with BPPV report:

• Difficulty getting comfortable in bed

• Fear of rolling onto the "wrong side"

• Frequent waking

• Poor quality sleep

• Daytime fatigue

The study found BPPV sufferers had sleep quality scores almost four times worse than healthy participants.

Average sleep scores were:

• 12.0 in BPPV patients

• 3.36 in healthy controls

Researchers believe this creates a vicious cycle:

Vertigo disrupts sleep, poor sleep affects recovery, and reduced recovery may increase dizziness and emotional distress.

What Are Neurotransmitters and Why Do They Matter?

One of the most fascinating aspects of the research involved measuring neurotransmitters.

Neurotransmitters are chemical messengers that help your brain and nervous system communicate.

They influence:

• Mood

• Balance

• Sleep

• Stress responses

• Movement control

• Learning and adaptation

Researchers discovered that patients with BPPV had significantly lower levels of:

Dopamine

Often called the "motivation" neurotransmitter.

Dopamine helps regulate:

• Movement

• Reward pathways

• Focus

• Learning

• Nervous system adaptation

Norepinephrine

Important for:

• Alertness

• Balance regulation

• Stress responses

• Vestibular compensation

Epinephrine

Plays a key role in:

• Physical resilience

• Nervous system regulation

• Adaptation to stress

Patients with lower neurotransmitter levels generally reported:

• Greater dizziness

• More physical limitations

• Poorer emotional wellbeing

• Higher levels of depression

Why Some People Continue Feeling "Off" After Treatment

One of the most important findings is that successful treatment of the inner ear does not always mean immediate recovery.

Many patients continue experiencing:

• Residual dizziness

• Motion sensitivity

• Anxiety

• Fatigue

• Poor sleep

• Reduced confidence

Researchers believe this may occur because the brain needs time to recalibrate after vestibular dysfunction.

The inner ear may recover quickly.

The nervous system often takes longer.

Why a Holistic Approach Works BestModern research increasingly shows that vertigo is rarely just an "ear problem."The most successful recovery plans often combine:Accurate diagnosisCanalith repositioning procedures when appropriateVestibular rehabilitation exercisesNeck and postural assessmentPhysical activity and movement strategiesSleep optimisationStress managementPatient educationAddressing all contributing factors often produces better long-term outcomes than focusing on a single aspect of care alone.

Evidence-Based Recommendations for Managing Vertigo

Current evidence suggests several strategies may help support recovery.

1. Obtain an Accurate Diagnosis

BPPV should be properly assessed using recognised vestibular testing procedures such as:

• Dix-Hallpike testing

• Supine roll testing

• Vestibular assessment

Not all dizziness is caused by BPPV.

2. Consider Repositioning Procedures

When BPPV is confirmed, repositioning manoeuvres such as:

• Epley Manoeuvre

• Barbecue Roll

• Yacovino Manoeuvre

remain the gold-standard treatment.

Research shows these procedures successfully resolve symptoms in the majority of cases.

3. Address Neck Function

Many people with dizziness also experience:

• Neck stiffness

• Reduced mobility

• Headaches

• Postural strain

The neck provides important sensory information to the brain regarding balance and body position.

4. Prioritise Sleep

The research demonstrated a strong relationship between vertigo severity and poor sleep quality.

Practical sleep strategies include:

• Maintaining consistent bedtimes

• Reducing screen exposure before bed

• Limiting caffeine later in the day

• Creating a comfortable sleep environment

5. Keep Moving

Gentle activity may help encourage vestibular adaptation.

This might include:

• Walking

• Structured exercise

• Vestibular rehabilitation programmes

• Balance exercises

Avoiding movement completely may delay recovery.

6. Manage Stress and Anxiety

Because anxiety and vertigo influence one another, addressing emotional wellbeing may support overall recovery.

Strategies may include:

• Mindfulness

• Relaxation techniques

• Counselling

• Exercise

• Professional support where appropriate

Can Chiropractic Care Help?

At Health Wise Chiropractic, we regularly assess patients experiencing:

• Dizziness

• Vertigo

• Neck pain

• Headaches

• Postural dysfunction

• Balance concerns

Many patients presenting with vertigo also report:

• Neck stiffness

• Reduced cervical mobility

• Tension headaches

• Poor posture

• Ongoing feelings of instability

A comprehensive assessment can help identify musculoskeletal factors that may be contributing to symptoms while ensuring appropriate referral for vestibular or medical assessment where required.

Our approach focuses on helping patients improve function, mobility and confidence while supporting their broader recovery journey.

Looking for Help With Vertigo in Sunbury or Melton?

If you're experiencing vertigo, dizziness, balance problems, headaches or neck stiffness, you don't have to simply "put up with it."

At Health Wise Chiropractic, our Sunbury and Melton teams provide evidence-informed assessments designed to identify potential contributing factors and help guide you towards the most appropriate management pathway.

Whether your symptoms are new, recurring, or lingering after previous treatment, we're here to help you better understand what's happening and what steps may support your recovery.

References

Based on 2025 research investigating psychological health, sleep quality and neurotransmitter changes in 310 patients with Benign Paroxysmal Positional Vertigo (BPPV), alongside current evidence relating to vestibular rehabilitation, balance disorders and recovery from dizziness.

How Chiropractic Care May Help

At Health Wise Chiropractic, we take a comprehensive approach to posture-related care.

Treatment may include:

• Chiropractic adjustments

• Postural assessment

• Soft tissue therapy

• Corrective exercises

• Ergonomic advice

• Laser therapy

• Shockwave therapy

• Spinal decompression therapy

We focus on addressing both the symptoms and the underlying biomechanical stress contributing to neck dysfunction.

About the Author

Dr Julian Simpson is an Australian chiropractor with over 15 years of experience in musculoskeletal healthcare and rehabilitation.

He is a Board Member of the Chiropractic Australia Research Foundation and has reviewed and written more than 800 evidence-based health articles focused on spinal health, rehabilitation, sports injuries and conservative care approaches.

His treatment focus includes:

• Chiropractic adjustments

• Sports chiropractic

• Massage therapy

• Shockwave therapy

• Laser therapy

• Non-surgical spinal decompression

Dr Simpson provides patient care through Healthwise Chiropractic, serving communities including Sunbury, Melton, Diggers Rest and surrounding regions.

Reference

Zhang Q, She R, Zhou H, Guo J, Hu Z. Serum neurotransmitter imbalances in benign paroxysmal positional vertigo: correlations with anxiety, depression, and sleep quality. Front Neurol. 2026 Apr 10;17:1798705. doi: 10.3389/fneur.2026.1798705. PMID: 42037689; PMCID: PMC13106000.