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Writer's pictureThomas Patullo AP, OTR

The “Vestibular Yawn” — Why Balance Disorders Cause Fatigue

Updated: Nov 20, 2018

Sometimes, people with dizziness, vertigo or balance disorders complain about a surprising symptom: exhaustion.



In fact, chronic fatigue is so prevalent with vestibular conditions, people often start to wonder, “Is there something else could be wrong?”


It’s true, fatigue is associated with a lot of other medical issues: thyroid problems, diabetes, cardiac problems, digestive issues, kidney disorders, liver problems, weak immune systems, infections or blood disorders and even concerns about other types of neurological problems… just to name a few.


Mystery = Misery


If you’re worried, go ahead and pursue the necessary tests that your doctor recommends in order to identify any other conditions that might affect your vestibular rehabilitation training. We want as much information as possible when we’re working to regain our balance!


However, if all those tests come back negative?


“It’s All In Your Head”


Ok, technically, it is in your head. But you’re not nuts. Fatigue is the logical effect of your brain’s struggle to understand what your eyes and ears aren’t accurately communicating. So is anxiety, depression and confusion.

Vestibular disorders are inherently worrying, depressing, confusing — and most definitely exhausting! That’s where the “vestibular yawn” comes into play.


Fatigue, in my experience, is one of the most common secondary symptoms of a vestibular disorder. What is happening? I would describe this type of fatigue as a result of your brain having to work overtime to manage your physical world when your inner ear or the processing of vestibular signals is impaired.


Error… Recalculating…


It’s often described as your brain is having to deal with frequent or chronic “error signals” when your ability to process your balance, head movements or change of position is not accurate.


These systems are and should be automatic — just like breathing, we typically do not have to pay attention to the sensory processing that the inner ear is doing. But nothing about vestibular disorders is typical!


Let me give an example: Let’s say you have never driven a manual shift or “stick shift” car, and someone gives you the keys and says no problem, here is what you do: push the clutch down with your left foot, put the car in first gear, then give it some gas; the car will drive, then shift between gears based on the speed.


What do you think will happen? They could give you the best instructions, but you are only used to driving cars with an automatic transmission. You will experience significant stress, the car will typically stall or lunge. Let’s say you manage to do it — how do you think you will feel?


I can remember my first experience and it was exhausting!


The same fatigue principle applies to vestibular disorders. Your brain is trying to navigate this new way of driving. So, as you’re learning, keep in mind:

  • Using the pacing techniques described in the WUZI modules, along with the instructions on how to improve recovery times with the most challenging exercises for you

  • As you progress through the modules, the fatigue symptoms will fade to be less frequent and less intense

  • In time, you’ll gain more energy and strength, but give yourself time to rest and recover — retraining requires recharging!

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