19 Possible Causes of Random Dizzy Spells Throughout the Day—and When to Worry

Rachel Nall MSN CRNA Korin Miller Erica Sloan 3 weeks ago

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19 Possible Causes of Random Dizzy Spells Throughout the Day—and When to Worry

Feeling as if the room is spinning is fine when you’re on the teacups ride (if you enjoy that type of thing). But experiencing random dizzy spells throughout the day is nothing short of unnerving. The potential causes can range from something as innocuous as slacking on your hydration to an ear condition or even a serious emergency, like a stroke. Dizzy spells can also severely interfere with your life, making you afraid to engage in certain activities or worried that something is seriously wrong with you.

It can be tough to define dizziness, but the general consensus is that you feel a disturbance in your balance or sense of place. Doctors tend to distinguish among a few different types. There’s vertigo, which feels like “the world’s moving around you, or you’re moving,” and often entails a spinning sensation, Erin G. Piker, PhD, AuD, associate professor and program director of audiology at James Madison University, tells SELF. And that’s typically caused by a disconnect between your ears and your brain. There’s also what doctors call presyncope, which feels more like lightheadedness or as if you’re about to faint, and generally springs from a cardiovascular issue. The final two categories are disequilibrium, which is an unsteady or off-balance feeling, and general dizziness, “a vague category for patients who really can’t tell you what it feels like,” Dr. Piker says. And it can be tough to pinpoint the root cause of each kind, given that different people can perceive dizziness in various ways, she adds.

Sometimes dizzy spells occur all by themselves. Other times, they can coincide with symptoms like a headache, nausea, or anxiety. After all, there’s a close link between the vestibular system (in your inner ear), which helps you maintain your balance, and the autonomic nervous system, which controls basic body functions like your breathing and heart rate, Dr. Piker says. “So whatever is making you perceive dizziness could also trigger fight-or-flight mode,” she explains, leaving you pale, clammy, and nauseated.

Identifying potential causes of random dizzy spells throughout the day can help you separate between what’s no big deal and what’s something you need to head straight to the emergency room over. One place to start is by considering whether your dizziness leans more toward the spinning or the woozy type—while it can be tricky to suss this out, it’s likely going to be among the first questions your doctor asks to help determine the core body system causing the problem. Read on to find the typical triggers for dizziness of both sorts, as well as when to seek out medical care, what to do the next time you’re caught in a spell, and how to prevent injuries from dizziness-related falls.

What are common causes of random dizzy spells that feel like spinning?

Drinking one too many alcoholic beverages

If you’ve ever felt wobbly after downing, say, a third margarita, you already know alcohol can trigger some disequilibrium due to its effects on your central nervous system. But booze can also mess with your inner ear in a way that makes it feel like you’re spinning. That’s because of something called positional alcohol nystagmus, Dr. Piker explains: Within your inner ear, the alcohol gets absorbed at different rates by the fluid and the membrane, which means the two no longer share the same specific gravity. That disconnect sends a signal to your brain that you’re “turning over and over” each time you move your head, she says. It’s the reason lying down after drinking can be so damn dizzying.

The good news is, it’s temporary, Dr. Piker says. It’ll fade as alcohol gets eliminated from your system. The bad news is, you can have an after-effect (if it’s flushed at different rates from your inner ear fluid and membrane), which can pile onto a hangover, she adds.

Motion sickness

Motion sickness occurs when your eyes, ears, body, and brain can’t agree on what the hell is going on. More scientifically, when your brain receives conflicting signals from the motion-sensing parts of your body—like your eyes and ears—it gets confused about whether you’re moving or sitting still. The result: dizziness, possibly alongside nausea, sweating, and vomiting.

The miracles of modern technology mean motion sickness doesn’t just occur when you’re traveling by planes, trains, and automobiles. What your eyes perceive while partaking in a virtual reality experience can also trigger the same kind of dizziness.

Benign paroxysmal positional vertigo (BPPV)

BPPV is the most common peripheral vestibular system disorder, which just means that fluid and other delicate parts of your inner ear are out of whack. While it most often affects people assigned female at birth and those in the 50-to-70 age group, folks of any sex can experience this condition at any age. It may sound very New Age, but people get BPPV when the calcium carbonate crystals in the inner ear move to an area where they shouldn’t be, Dr. Piker says.

“The typical story is that somebody is lying down in bed, and they experience a real spinning sensation like they’re on a carousel,” Clifford Hume, MD, associate professor of head and neck surgery at the University of Washington, tells SELF. “The sensation usually lasts for about a minute, then goes away.”

In some cases, it can stick around for a few days or weeks, and it could require treatment such as canalith repositioning, which is a series of slow head movements, to move those tiny crystals back into an area of the ear that doesn’t cause vertigo. If that doesn’t work, surgery to plug a certain part of your inner ear may also be an option.

Infection or inflammation of your inner ear

A variety of conditions impacting your inner ear—and in turn, your vestibular system—can leave you feeling seriously off-kilter, Dr. Piker says. For instance, a viral or bacterial infection like a cold or the flu could trigger inflammation of a part of your inner ear called the labyrinth (a.k.a. labyrinthitis) or your vestibular nerve (vestibular neuritis). And because both structures are key to balance, when either is affected, you could wind up with vertigo as well as nausea, vomiting, and in the case of labyrinthitis, potentially some hearing loss.

Meniere’s disease

The inner ear strikes again in this chronic disorder, which typically brings a sudden loss of hearing in one ear, tinnitus (ringing in the ears), and vertigo, Dr. Hume says. Since dizziness and vertigo can go from zero to 60 within a few minutes, it can be really alarming, but thankfully episodes typically only last for 20 minutes to a few hours.

Doctors don’t really know what causes it, but extra fluid in the inner ear is thought to be related or at least trigger symptom flare-ups. There’s also a close relationship between Meniere’s disease and another dreaded M-word, migraine. An estimated 51% of people with the inner ear condition also experience migraine, compared to 12% of the population without Meniere’s disease.

Vestibular migraine

There’s a “special” kind of migraine called a vestibular migraine that’s known to cause dizziness of the spinning sort. Though Dr. Piker points out that while experiencing a vertigo sensation is typical, some people may perceive it as unsteadiness. According to the American Migraine Foundation, it affects up to five times more women than men, particularly those with a personal or family history of migraine or motion sickness. (A similar gender disparity exists for migraine in general.)

Not all vestibular migraine attacks occur with headaches, but they can and often do. Other potential symptoms beyond the vertigo and head pain include nausea, vomiting, pressure in the ears, and sensitivity to light and sound.

What are common causes of dizziness that feels like lightheadedness?

Dehydration

We could all probably put down the latte and pick up our water bottle a little more often. After all, the body is between 55% and 78% water, so it’s important to keep replenishing fluids. The reason skimping on water intake could leave you feeling woozy is because it reduces the volume of your blood, lowering your blood pressure and preventing enough blood—and the essential oxygen it carries—from getting to your brain. Alongside dizziness, the trickle-down effects of dehydration could prompt a headache, fatigue, muscle weakness and problems focusing. It’s good to hydrate regularly throughout the day, but be extra diligent when exercising or enjoying the outdoors in the steamy summer months (when you’re likely to lose more fluids via sweat).

Overdoing it during workouts

Exercising without staying hydrated or having consumed enough calories for energy is a surefire way to feel faint or as if you’re on the verge of passing out. As is jumping into a super-intense workout when your body isn’t ready to take on that level of intensity or doing vigorous physical activity in a very hot climate. It’s important to fuel your body well, regularly replenish your fluids, and gradually level up your workouts to avoid feeling off-balance mid-sweat—after all, getting dizzy at the gym or while out on a run could cause you to fall and seriously injure yourself.

Though not as common, it is possible to exercise so intensely that you’re gasping for air, which leads to hyperventilation—rapid breathing that causes carbon dioxide levels in the blood to drop, resulting in lightheadedness. If that sounds like you, know that it’s okay to take a break during your HIIT class (it really isn’t a competition!).

Anxiety

Dizziness and anxiety tend to go hand-in-hand for a few different reasons. As noted, any sensation of vertigo could prompt some anxiety as a result of the connections between your vestibular system and your nervous system. But at the same time, the physical manifestations of anxiety symptoms like a racing heart and shortness of breath could certainly leave you feeling lightheaded (which might just exacerbate your anxiety, kicking off a vicious cycle). And research suggests being emotionally unsteady could also trigger a “subjective sensation of dizziness”—which could fall into either category on this list.

Hypoglycemia

Also known as low blood sugar, hypoglycemia is most common in people with diabetes who use insulin, and it can cause a lightheaded sensation, similar to standing up too fast. You might also experience sweating and anxiety. If you do have diabetes and take insulin, it’s important to always carry a fast-acting source of carbohydrates with you—such as glucose tabs—to quickly bring your blood sugar back up to a healthy level in a pinch.

Nutritional deficiencies

Eating a colorful array of fruits and vegetables as well as fortified foods, fish, and nuts is a good way to hit the recommended values for key vitamins and minerals—but it’s always possible to come up short. An iron deficiency, in particular, can lead to symptoms of dizziness, as it can cause iron-deficiency anemia (another cause on this list), which involves not having enough healthy red blood cells. Other vitamin deficiencies could also be to blame, though, including a lack of folate, vitamin B12, and vitamin D.

Anemia

Anemia is when you have lower blood counts than normal. It can be due to a number of things, including iron and vitamin deficiencies, as we talked about above. The problem is, when you don’t have enough blood, it can’t carry enough oxygen to your tissues. This can cause shortness of breath and lightheadedness or dizziness. If you are very anemic, you may even experience this symptom when lying down.

Pregnancy

Pregnancy is to blame for a lot of weird sensations and symptoms, and feeling dizzy is just one of many on the list. Hormonal changes are responsible for triggering things like nausea and dizziness, including that pesky morning sickness, particularly in the first trimester.

Morning sickness often goes away by 14 weeks of pregnancy, but for some poor souls, it can last for months or even the entire pregnancy. The good news is, once you have the baby, you likely won’t feel dizzy anymore (but you probably won’t get much sleep for a while, either).

Medications

There are a lot of meds that could be the culprit here, typically because they suppress your central nervous system or lower your blood pressure, Dr. Piker says. To name a few: Anti-seizure drugs, antidepressants, and sedatives are all known to cause dizziness as a side effect. Blood-pressure-lowering medications can also make you feel especially faint if they work a little too well and your blood pressure drops excessively low.

Another thing to note: Quickly losing a significant amount of weight on a GLP-1 drug could also prompt some dizziness by dropping your blood pressure, Joyce Oen-Hsiao, MD, associate professor of cardiovascular medicine at Yale School of Medicine, tells SELF. That’s especially common in folks who were taking meds for high blood pressure before losing the weight, and then stay on them along with the GLP-1s, she points out.

In any case, it’s worth reviewing your medication list with your doctor if you suspect one of the drugs you’re on might be triggering your lightheadedness (and don’t forget to include any supplements you take, too). Even if you think a particular medication is the culprit, don’t stop taking it without your doctor’s advice.

Postural orthostatic tachycardia syndrome (POTS)

This condition is a form of autonomic dysfunction, which is basically what happens when your autonomic nervous system (again, the one in charge of key involuntary body functions) and your cardiovascular system don’t communicate properly, Dr. Oen-Hsiao says. In particular, when you go from sitting to standing (that’s the postural orthostatic part), your nervous system fails to tell your circulatory system to ramp up your heart rate and get your blood pumping upward toward your brain; instead, gravity takes over, the blood pools in your lower half, and suddenly you feel super woozy. Sensing the problem, your heart jumps into overdrive, overcompensating by beating way too fast (which is what tachycardia means). The big swings in heart rate and blood pressure can ultimately leave you whirling and also trigger fatigue, brain fog, difficulties with sleep, and anxiety, among other POTS symptoms.

Though doctors aren’t sure what causes it, POTS is particularly common in young women and often crops up in the aftermath of a big injury, surgery, and viral illness. In fact, researchers have noted an uptick in diagnoses since the COVID-19 pandemic. “The thinking is, there’s such an inflammatory response from the COVID illness that it just winds up affecting the nervous system as well,” Dr. Oen-Hsiao says.

Orthostatic hypotension

Closely related to POTS is this other form of autonomic wonkiness, which refers more generally to any kind of big blood-pressure drop that occurs when you go from sitting to standing (though not necessarily as part of a chronic condition or linked to a subsequent spike in heart rate). In addition to feeling dizzy, you may have symptoms that include feeling weak, nauseated, and as if you have a headache. Some people even report problems thinking straight as well as neck pain.

Orthostatic hypotension causes can be temporary—like being a bit dehydrated after an epic cycling class. Less fluid in your system means lower blood volume, which can make it tougher for your body to compensate for position changes and get blood flowing upward to your brain. Dr. Oen-Hsiao points out that orthostatic hypotension also commonly coincides with diabetes, particularly if it’s not well-controlled. It’s thought that, over time, high blood sugar levels can fry some of the nerves responsible for blood-pressure regulation. Certain medications and heart or neurological disorders can also trigger orthostatic hypotension, so it’s important to see your doctor if symptoms persist.

Heart arrhythmia

If your heart isn’t beating at a typical cadence, you could wind up woozy at random times throughout the day. The main categories of arrhythmia include bradyarrhythmia (a slow heartbeat) and tachyarrhythmia (a high one). The first is more common in older adults and typically occurs as a result of heart damage or age-related changes in the heart’s electrical system, though it could also be a symptom of hypothyroidism; the second can also spring from electrical- or valve-related heart problems, as well as hyperthyroidism, irregular blood pressure, alcohol and drug use, and smoking.

Either way, an irregular heartbeat could prevent your blood from being able to circulate efficiently to your brain, Dr. Oen-Hsiao notes, leaving you lightheaded, especially when you’re physically exerting yourself—and the demand on your heart is higher. In both cases, you might also experience shortness of breath and chest pain, and tachyarrhythmia can bring on the feeling of a racing or pounding heart, too.

In rare cases, random dizzy spells can also signal a medical emergency.

It isn’t likely, but bigger issues could also be sending you spinning or making you feel as if you’re about to pass out…or both. Read on to learn about these potential dizziness causes and other common signs that one of these might be unfolding.

An important note: If you suspect any of the below is to blame, go straight to the ER, so you can get quick care and improve your chances of preventing future damage.

Stroke

This is a biggie. Strokes occur when blood flow is blocked to your brain. An estimated 0.7% to 3.2% of people who go to the emergency department with dizziness are having a stroke. While you may associate strokes with older people, they can certainly occur in young people—in fact, strokes have gone up by about 15% in young adults from 2011 to 2022, according to data from the CDC.

Beyond dizziness, you want to look out for the sudden onset of “the worst headache of your life and any loss of limb function,” Dr. Hume says. Other common stroke symptoms include numbness on one side of your body, drooping of one side of your face, and difficulty speaking or walking, Dr. Piker notes.

Concussion

Okay, so it’s more than likely that you’d know if you recently had a bonk to the head. What you might not know is that a concussion or head trauma can cause dizziness, even when lying down. It’s a type of traumatic brain injury where you get a bump, hit, or other type of trauma to the head, and it makes your brain move inside your skull. In fact, about half of all people with a concussion experience dizziness at some point during their recovery.

You might also feel nauseated, unusually tired, and like you can’t remember things well, and you could have blurry vision. A few warning signs that you’re dealing with a concussion and not something else include:

losing consciousness after a head injury
having one pupil that’s larger than the other
experiencing seizures, slurred speech, or agitation

When should you worry about random dizzy spells throughout the day?

As noted, it’s important to head to the ER if your dizziness coincides with a recent hit to the head or with any of the symptoms above that could indicate a brain or heart condition. To recap, look out for things like numbness on one side of your body, severe headache, and problems walking or speaking as potential indicators of stroke. And be aware of symptoms like chest pain, a racing heart, and shortness of breath as signs of a heart issue. Dr. Piker adds that if you’re feeling like you’re about to pass out (and especially if you lose consciousness), that warrants a trip to the ER, as well.

Both Dr. Piker and Dr. Oen-Hsiao also note that if you’re experiencing progressive dizziness—meaning, worse or more consistent bouts of dizziness—that’s worth seeing your regular doctor about. Don’t be surprised if they order tests or have you see an expert; underlying causes of dizziness can be difficult to diagnose.

“Currently, the vestibular system is one of the least understood sensory systems relative to things like vision and hearing,” says Dr. Piker. “Having access to more sensitive tests is important because many women with balance or vestibular disorders go a long time without a diagnosis.”

What are dizziness treatment options?

This likely won’t surprise you, but the treatments for dizziness can vary based on what is causing your dizzy spells in the first place. It’s possible that you won’t need treatment at all, and your body will naturally adjust to whatever caused the dizziness. Or you may be able to resolve your symptoms with lifestyle changes, such as hydrating more often, fueling your body with nutrient-rich foods, avoiding overexertion during workouts, drinking less alcohol, and managing your blood sugar (if you have diabetes). Working with your doctor to tweak your medication regimen could also help, if you suspect a particular drug is the culprit.

If it’s vertigo, especially BPPV, physical therapy is one of the best and most effective treatments, Dr. Hume says. Depending on your condition’s severity, sometimes as little as one physical therapy visit can help reduce symptoms, he says. Other times, it isn’t that easy, and you may need five or more appointments.

Dizziness treatments related to migraine begin with improving three major factors, Dr. Hume says: diet, sleep, and stress. Then you can address environmental triggers, he says, such as “busy visual scenes, strong odors, or even extended amounts of screen time.”

As for heart-related dizziness, such as orthostatic hypotension and POTS, solutions might look like increasing salt and water intake (to bump up your blood volume) and taking certain medications to help regulate your heart rate and blood pressure.

How to deal with a dizzy spell in the moment

Whenever you get hit with a wave of dizziness, it’s important to take a few steps to avoid injury (from bumping into something or falling), and if you’re woozy, to keep from passing out. Lying down is a good start if you’re at home, Dr. Piker says. If you’re dealing with any nausea or headache, turn off the lights and if possible, lower the temperature in the room. If you’re out and about, try to sit or even squat down and wrap your arms around your legs—this way you’re less likely to faint, Dr. Oen-Hsiao says, because the position will help push more blood to your brain. And if you still feel woozy, it may help to lie all the way down on the ground and elevate your legs, she adds.

It’s also important to rehydrate and refuel if you suspect that overexertion or being depleted of either water or food might be the cause of your lightheadedness.

How to prevent injuries from dizziness at home

This may seem like common sense, but if you can identify the underlying dizziness triggers, don’t do those activities. “If you know you get dizzy on a ladder, don’t be up on a ladder or even looking up at a shelf,” Dr. Hume advises. Take that as an excuse to finally hire someone else to clean out your gutters or hang those holiday lights. And if you know that certain visual disturbances or bright lights can spark a vestibular migraine, do your best to steer clear, Dr. Piker suggests.

In plenty of other scenarios, however, it’s not so easy to get ahead of dizziness—which is why it’s important to take steps that can at least lower your risk of falling in the midst of a dizzy spell. (After all, taking a tumble could cause you to break a bone, have a concussion, or otherwise get injured.) According to Dr. Piker, that includes engaging in some regular balance-boosting movement—for instance, tai chi, walking, running, and resistance-training exercises. It’s also good practice to avoid sudden movements when possible (particularly when you go from sitting to standing) and to sit, squat, or lie down as soon as you start to feel the least bit unsteady.

And if you can feel yourself tipping over? Keep in mind some advice for falling that can help you avoid really hurting yourself: Angle toward a softer surface if possible, stick out your butt, relax your body to lower your center of gravity, and tuck your chin to protect your head.