• Vertigo frequently begins in the morning while the patient is in bed (matutinal vertigo). One hundred consecutive patients with vestibular disease were studied to assess the frequency and clinical characteristics of this temporal pattern. Forty-eight percent of the patients reported matutinal vertigo. The pattern can occur with central as well as peripheral disorders and is therefore not a localizing marker. It is most frequent with disorders in which positional features (vertigo and nystagmus) are prominent, and sleeping position appears to play a role in its production. It may be possible to prevent recurrent attacks by altering the patient's sleeping position.
Berkowitz BW. Matutinal VertigoClinical Characteristics and Possible Management. Arch Neurol. 1985;42(9):874–877. doi:10.1001/archneur.1985.04060080056016