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Driving with a Vestibular Disorder

Having a vestibular disorder can make driving more difficult than for those without a vestibular disorder (1). As a clinician, driving is a common activity patients report having increased difficulty performing or are unable to do; severely impacting their independence and everyday activities. This is why driving is a big goal for my vestibular patients to get back to and such a big win when they do. Below is information about why driving is so challenging with a vestibular disorder along with a few tips to help manage being in a car and return to driving.  

Why is Driving So Hard with a Vestibular Disorder? 

Driving is difficult for those with a vestibular disorder because of a sensory mismatch between our vestibular, proprioceptive, and visual systems (you can learn more about how each of these systems relates to our balance and spatial awareness here). After an initial vestibular episode, our body is underutilizing vestibular information or receiving inaccurate vestibular information. When the information from our vestibular system doesn’t match up with the information from our other senses,  symptoms occur (fogginess, lightheadedness, dizziness, rocking/swaying or feeling “off”). 

With decreased input from the vestibular system, our bodies begin to rely more on our visual system to give us information. This makes driving challenging because of the increased use of our eyes. This makes busy environments challenging and overstimulating. If you’ve ever driven in the snow at night and you’ve accidentally turned on your brights; you’re suddenly overwhelmed with tiny snowflakes taking up your view and it’s very hard to see the road. That’s what it can feel like when you’re driving with a vestibular disorder. 

When we rely on our eyes for a lot of our information, sometimes the way our brain processes our visual information changes too. What can happen is we focus too much on our central vision and ignore the information in the periphery. This can create more sensory mismatch and make it hard to determine where our body is in space. Think of a time you’re in a car while stopped (in a parking space or at an intersection) and you suddenly slam on your brake because you think you’re moving but it was actually the car next to you moving. This is what happens when we ignore our peripheral vision and use too much of our central vision. 

Head turns is also a movement that can be difficult due to vestibular involvement. This is because our brain uses the information from our inner ear to help direct the direction and speed of our eyes. This is called the vestibular ocular reflex and can be affected by a vestibular disorder. This can make rapid and repetitive head movements needed for driving quite challenging. Luckily there are ways to help all of the reasons mentioned above to get you back to driving! 

How to Make Driving with a Vestibular Disorder Easier

  1.       Be the driver if able and safe. Talk to your medical provider if you have questions or concerns about driving.
  1.       Look at the horizon (as a passenger). Looking further away from where the background is moving slower can help reduce symptoms.
  1.       Block out the busy noise. Use window covers to block bright light if you are light-sensitive and/or to block out busier environments. Make sure this does not block the view of the driver to drive safely
  1.       Be prepared for any symptoms that might flare-up. Read more about motion sickness relief options here.
  1.     Work your way back to driving slowly in Vestibular Group Fit or Vestibular Rehabilitation Therapy

If you would like to return to driving and other functional activities, Vestibular Group Fit can help! Click here to find out how: 

Disclaimer:

Remember: this post is for informational purposes only and may not be the best fit for you and your personal situation. It shall not be construed as medical advice. The information and education provided here is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis. Always check with your own physician or medical professional before trying or implementing any information read here.  

Resources:

  1. Wei, E. X., & Agrawal, Y. (2017). Vestibular Dysfunction and Difficulty with Driving: Data from the 2001–2004 National Health and Nutrition Examination Surveys. Frontiers in Neurology, 8. https://doi.org/10.3389/fneur.2017.00557

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