What causes vertigo (dizziness) during flight?

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Last updated: February 18, 2025View editorial policy

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From the Guidelines

Vertigo, or dizziness, during flight is primarily caused by moderate hypoxia due to the low cabin pressure, which can lead to a decrease in oxygen saturation, resulting in symptoms such as dizziness, nausea, and headache 1.

Key Factors Contributing to Vertigo

  • Cabin pressure: The cabin pressure in most modern aircraft corresponds to an altitude of 2400 m (8000 ft), leading to a reduction in atmospheric pressure and a fall in oxygen saturation up to 90-93% 1.
  • Hypoxia: The decrease in oxygen saturation can cause changes in brain metabolism, particularly in individuals with pre-existing cognitive impairment or respiratory comorbidities, exacerbating symptoms such as disorientation, agitation, and confusion 1.
  • Dehydration: Low cabin humidity can lead to fluid loss, further contributing to the risk of vertigo and other symptoms 1.

Managing Vertigo During Flight

To alleviate symptoms, it is recommended to:

  • Stay hydrated by drinking plenty of water
  • Avoid heavy meals and choose a seat over the wing for less turbulence
  • Consider taking an antihistamine such as dimenhydrinate (Dramamine) 50mg or meclizine (Bonine) 25mg about an hour before flying, under the guidance of a healthcare professional 1.

From the FDA Drug Label

Meclizine hydrochloride tablets are indicated for the treatment of vertigo associated with diseases affecting the vestibular system in adults.

The cause of vertigo (dizziness) during flight is not directly stated in the drug label. Key points:

  • The label mentions vertigo associated with diseases affecting the vestibular system.
  • It does not specifically address the cause of vertigo during flight. 2

From the Research

Causes of Vertigo (Dizziness) During Flight

  • The decrease in partial oxygen pressure during flight can cause hypoxia, which may lead to dizziness or vertigo 3.
  • Expansion of trapped air volume and low cabin humidity may also contribute to discomfort and dizziness during flight 3.
  • Hypoxia-related symptoms, such as difficulty breathing and elevated heart rate, can produce aversive somatic sensations, including dizziness 4.
  • Anxiety sensitivity, or the tendency to interpret bodily sensations as threatening or harmful, can moderate the relationship between hypoxia-related symptoms and fear of flying, potentially exacerbating dizziness or vertigo 4.

Related Factors

  • Immobility during flight and recirculation of air may also contribute to the development of dizziness or vertigo 3.
  • Underlying medical conditions, such as respiratory or neurological diseases, can increase the risk of experiencing dizziness or vertigo during flight 3.
  • The relationship between somatic sensations and in-flight anxiety is stronger for people with high anxiety sensitivity than for those with low anxiety sensitivity, which may contribute to the development of dizziness or vertigo 4.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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