It is not uncommon for divers to experience vertigo while scuba diving. Vertigo is the feeling of tilting, swaying, whirling or spinning when your surrounds are in fact not moving.
When does vertigo occur? Alternobaric vertigo can occur when descending or ascending and sometimes as soon as you surface from a dive.
Why does it happen? It is a direct result of unequal pressure in each ear. It can also be a result of an inner ear infection or more chronic issues such as Meniere’s disease.
If it strikes while diving then it can be quite dangerous. Vertigo can cause the diver to become very disorientated and confused. They may not be able to tell which way is to the surface and begin to panic. We all know panicking while diving can be quite disastrous and shooting back to the surface will have serious health implications. In serious cases the diver could vomit which can lead to choking and drowning.
If the diver is on the surface, land or back on a boat when they experience vertigo, at least they are able to sit, stand or lay down.
Causes and Types of Vertigo
There are many causes of vertigo, however from diving it is most often a result of inner-ear barotrauma.
Vertigo can also be a result of uneven equalizing (known as alternobaric vertigo) or if cold water is in one ear but not the other (known as caloric vertigo).
From diving physics we understand that the greatest pressure changes occur closer to the surface. As a diver descends it is imperative to equalize the pressure in the middle ear. For many divers they will continue to descend even if they haven’t equalized properly which can cause problems. Generally the ears equalize on their own while ascending but you may need to do so as well.
The good thing about alternobaric or caloric vertigo is that as soon as the diver equalizes properly or the water flows out of the ear the vertigo will disappear which no lasting effects. As this type is manageable then the disorientation, nausea and potentially vomiting will be reduced as will diving accidents as a result.
However, vertigo is also a symptom of vestibular or inner ear injury which can lead to chronic symptoms. These include, disorientation, disturbed vision, imbalance, hearing issues, involuntary eye movement (nystagmus) as well as many other symptoms.
It is important to note the vertigo is not the same as being dizzy, lightheaded or slightly unsteady on your feet.
With vertigo, if you are sitting, standing or laying and feel like the whole world is spinning when in actual fact it’s not then you have vertigo.
As we have mentioned alternobaric and caloric vertigo will disappear as soon as the ears are equalized evenly or water is removed. For the other type of vertigo, it can differentiate between inner-ear barotrauma and inner-ear decompression sickness.
General Guidance if you Have Suffered from Vertigo
If you have experienced vertigo during or after a dive I recommend have your eustachian tubes (middle ear) evaluated before diving again. It is always best to ensure that it was a one off or manageable symptom to prevent diving accidents in the future.
Continuous vertigo is a symptom of potentially very serious conditions. Do not continue to dive until you have had a thorough evaluation from a specialist. The Divers Alert Network (DAN) can provide you with a referral.
If you do damage your inner ear or middle ear it can be permanent. For a one off case of injury the vertigo may take 2-6 weeks to disappear, this is because the brain has already learnt to compensate for that ear. This means that although the vertigo has gone the ear canal may not be healed properly.
If left untreated then it can also make other activities in your day to day life difficult, including driving a car or anything that requires spatial awareness.
Before returning to diving after vertigo you should have a thorough medical evaluation to determine if there is permanent damage or not.
Ways to Prevent Vertigo
The only real way to prevent vertigo is to be vigilant and continually equalize your ears evenly throughout the dive. Generally tend to feel when you need to equalize so be sure to stop and equalize properly before continuing. Something this simple can be all one needs.
In addition to this if you have experienced vertigo, please do get your ears checked before continuing to dive. If left untreated it can cause serious damage to your ears which may result in the end of your diving adventures.
Divers Alert Network
DAN have many great resources for diving safety. This is a very informative video ears about barotrauma.
While it is not uncommon for divers to experience vertigo while scuba diving it can turn your scuba diving experience into a bad one. Vertigo is the feeling of tilting, swaying, whirling or spinning when your surrounds are in fact not moving. While there can be many causes, it is important to take the care and have your ear canals checked if you have been affected. I hope you found the information useful for how to prevent vertigo while scuba diving.