Planting SEEDS for your vestibular health

Written By Elizabeth Crawford

The SEEDS are five healthy behaviours to help support your recovery and complement your vestibular rehabilitation, whether you are dealing with symptoms of concussion, vestibular migraine, PPPD, or another vestibular disorder.

Sleep
Eating
Exercise
Drinking water
Stress management & social connection

Why vestibular rehabilitation is enhanced by healthy habits

Vestibular symptoms have physical and psychological impacts. Working alongside your medical treatment and vestibular rehabilitation, these factors can be key to achieving sustained improvement in how you feel and what you can do.

It can be overwhelming to think about healthy habits, especially when your symptoms are easily triggered, interfere with your daily function, and make it hard to stick to a routine. Pick one small change to work on - choose something important to you that is realistic and achievable. 

Read on to learn more about how SEEDS can improve your physical and mental health, support your brain function, and enhance your wellbeing. 

Sleep

Both the amount and quality of your sleep is important for physical and mental health. 

Poor sleep can contribute to cognitive symptoms and fatigue. Sleep disturbance is common with vestibular disorders and concussion.

It can help to stick to a regular bedtime and wake time, keep a relaxing routine around bedtime, and use other sleep hygiene strategies:

  • Getting exposure to bright light when you wake up

  • Getting exercise during the day

  • Avoid napping, or take short naps only before 3pm

  • Avoid caffeine, particularly after 1pm

  • Avoid nicotine

  • Limit or avoid alcohol

  • Avoid bright lights or screen use before bedtime

  • Keep your bedroom quiet, dark, and at a comfortable temperature

Eating

You need fuel for activity and recovery, and maintaining adequate nutrition and a balanced diet is important for your overall health. In some vestibular disorders, symptom exacerbations may be associated with dietary factors like too much salt, too much caffeine, food triggers, or skipping meals. 

Some people with Meniere’s disease or secondary endolymphatic hydrops find a low sodium diet decreases dizziness, as salt is a factor that can affect fluid balance in the inner ear.

Some people with vestibular migraine find their symptoms improve if they limit caffeinated beverages, alcohol, and food triggers. Low blood sugar (hypoglycemia) or fluctuations in blood sugar levels can also be a migraine trigger for some people. Migraine dietary triggers can be highly individual - some people find they are sensitive to foods high in histamine (e.g. alcohol, eggplant, shellfish, chocolate) or tyramine (e.g. cured meats, soy products, aged cheeses).

Some evidence-based guidelines for healthy eating:

Exercise

We have good evidence that exercise has benefits for general health. 

  • Regular physical activity can decrease your risk of heart disease and stroke, reduce your risk of type II diabetes, and can reduce your risk of at least eight types of cancer. 

  • If you have type 2 diabetes, exercise can help control blood sugar levels, lower your risk of heart disease, and decrease your risk of nerve damage.

  • If you have arthritis, exercise can help decrease pain and improve your physical function. 

  • Taking more steps each day can help lower your risk of premature death from all causes.

  • Exercise can help decrease anxiety, improve mood, and reduce stress.

  • Exercise can improve cognitive performance and decrease your risk of dementia.

  • Exercise can improve sleep. It can help decrease the time it takes to fall asleep, improve your sleep quality, and increase your deep sleep. 

  • Exercise can help decrease your risk of falling, and can decrease your risk of injury if you do fall since it helps keep your muscles and bones strong. 

Exercise helps to boost brain derived neurotrophic factor (BDNF). BDNF is a protein found in your brain that is associated with improvement in mental abilities and decreased anxiety and depression. BDNF levels increase with aerobic and resistance exercise. BDNF is important for neuroplasticity. Neuroplasticity means developing new connections and pathways in our brain, and the ability of our nervous system to adapt and change over time and with experience. We need neuroplastic changes in order to compensate for vestibular loss, decrease our sensitivity to movement and other symptom triggers, and improve our balance abilities, all of which are key components of vestibular rehab.

Research-based guidelines recommend 150 minutes of moderate intensity aerobic physical activity per week (e.g. brisk walking for 30 minutes per day, 5 days per week) and strengthening activity for your major muscle groups on 2 days per week. 

This can feel like a lot if you have symptoms that are worsened with head and body movements or with exertion. Any amount of physical activity is better than none! Start with what feels manageable, choose activities that you enjoy, and get into a routine. A vestibular rehabilitation physical therapist can help create an exercise plan that works for you.

Drinking water

Hydration is important for many body functions. Dehydration can affect memory, concentration, reaction time, fatigue, and mood. Dehydration can trigger headaches and migraines. Dehydration can also contribute to orthostatic hypotension - feeling dizzy, lightheaded, or faint when you get up from sitting or get up from lying down due to a drop in blood pressure. It can help maintain hydration if you drink water at regular intervals during the day, before you feel thirsty. 

Stress management & social connection

Anxiety, depression, and social isolation are common consequences of vestibular disorders.

Fear, anxiety, and panic are common emotional responses to symptoms of dizziness, vertigo, imbalance, and falls. This is particularly the case when symptoms are unpredictable, and finding the right diagnosis and treatment can be a stressful and frustrating process. Vestibular problems can be invisible, which can be isolating since it can feel like others don’t understand what you are going through or like they think your symptoms are “all in your head”. It is very common to worry about making your symptoms worse or be afraid of losing your balance or falling. This worry and fear can lead you to try to eliminate potential triggers, avoid certain environments, and withdraw from activities that you enjoy.

Depression and low mood are also common emotional responses, particularly with persistent vestibular conditions. Many people experience sadness and a sense of loss, and some people experience feelings of guilt when they are not able to take care of their usual roles and responsibilities.

Social connections are important for mental well being. It can help to connect with people who make you feel supported and understood, and to hear success stories from people who have experienced similar challenges. 

There are many ways to support your mental health and mind-body connection:

  • Cognitive Behavioural Therapy (CBT), Acceptance and Commitment Therapy (ACT), and psychotherapy

  • Mindfulness based meditation

  • Mindful movement like yoga or tai chi

  • Breathing and relaxation exercises like progressive muscle relaxation, diaphragmatic breathing, or visualization/guided imagery

  • Identifying and challenging unhelpful thoughts

  • Planning small achievable goals

  • Reengaging in meaningful and enjoyable activities, even if this is in a gradual or modified way at first

Need more support? Our team can help you set goals to take small steps towards big changes. Book an appointment. 

Elizabeth Crawford
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