The sensation commonly known as “the spins” is technically a form of rotational vertigo, which is the false perception that you or your surroundings are moving. The duration of this unsettling feeling varies widely, ranging from a few seconds to several days, depending on the underlying cause. Understanding the science behind this dizziness, whether triggered by intoxication or a medical condition, reveals the factors governing how long the spinning sensation lasts.
The Biological Mechanism of Rotational Vertigo
The body’s sense of balance is maintained largely by the vestibular system, a complex sensory organ located within the inner ear. This system contains three fluid-filled loops, the semicircular canals, which detect movement across three different planes. These canals contain a fluid called endolymph and a small, gelatinous sensory receptor known as the cupula.
When the head rotates, the endolymph fluid initially lags behind due to inertia, causing it to push against and deflect the cupula. This deflection bends hair-like cells, converting mechanical movement into electrical signals sent to the brain about the speed and direction of rotation. When the head stops moving, the fluid continues to swirl momentarily, bending the cupula in the opposite direction. This conflicting signal is the physiological basis for the temporary dizziness experienced after spinning.
Rotational vertigo occurs when this delicate system sends a false signal of movement to the brain. This can happen through mechanical disruption or changes in the fluid chemistry, as is the case with alcohol. The brain receives distorted information from the inner ear that conflicts with visual and body position cues, resulting in the disorienting feeling that the world is spinning uncontrollably.
How Alcohol Metabolism Determines Duration
Alcohol intoxication is the most common non-medical cause of “the spins,” and its effect is directly related to the rate at which the body processes the substance. Alcohol enters the bloodstream and rapidly diffuses into the inner ear structures, but it affects the density of the cupula and the surrounding endolymph fluid at different speeds. Alcohol is less dense than water, and its presence quickly makes the cupula lighter than the fluid it rests in, causing it to float.
This difference in density causes the cupula to float or sink, incorrectly signaling movement to the brain, even when the person is lying still. The initial phase of spins often peaks shortly after drinking, as the alcohol concentration in the cupula is higher than in the endolymph. The duration of this phase is determined by the time it takes for the alcohol concentration to equalize between the cupula and the fluid, a process that can take a few hours.
The second phase of alcohol-related spins occurs later, as the body begins to eliminate the alcohol from the bloodstream and inner ear. Alcohol leaves the cupula relatively quickly, but it lingers slightly longer in the endolymph fluid. This temporary imbalance causes the cupula to become relatively heavier than the surrounding fluid, making it sink and triggering a second, sometimes reversed, spinning sensation. The overall duration of the alcohol-induced spins is tied to the liver’s metabolism rate, which reduces the blood alcohol concentration by approximately 0.015% per hour. The spinning will continue until the body has processed enough alcohol to restore the density equilibrium in the inner ear.
Duration of Medically-Related Spins
When vertigo is caused by a medical issue, the duration is determined by the specific pathology affecting the inner ear. Benign Paroxysmal Positional Vertigo (BPPV) is the most frequent cause of inner ear-related vertigo, and its episodes are characteristically short. The spinning sensation in BPPV is triggered by specific head movements, such as rolling over in bed, and typically lasts less than a minute before resolving. This condition results from tiny calcium crystals becoming dislodged and moving into one of the semicircular canals, briefly disrupting the fluid dynamics when the head changes position.
Conditions involving inflammation or infection of the inner ear structures, such as vestibular neuritis or labyrinthitis, result in a much longer duration of vertigo. The acute phase of severe, constant spinning, often accompanied by intense nausea, can last for one to three days. While the most severe symptoms typically resolve within a few days, residual dizziness, imbalance, and motion sensitivity can linger for several weeks or months as the brain works to compensate for the damaged inner ear input.
Meniere’s disease, a condition affecting the fluid balance within the inner ear, causes recurrent episodes of spontaneous vertigo. These attacks are typically longer than BPPV episodes but are not constant. An episode of Meniere’s disease usually lasts for a minimum of 20 minutes and can persist for several hours, but it rarely continues for longer than 24 hours.
Immediate Strategies for Managing Acute Dizziness
When a sudden episode of rotational vertigo occurs, the immediate goal is to reduce sensory conflict and prevent injury. A person should sit or lie down immediately to avoid falling, which is a significant risk during a spinning attack. Focusing the eyes on a single, stationary object can help the brain reconcile the visual input with the false motion signal coming from the inner ear.
Movement should be slow and deliberate, especially when changing position, as sudden head movements can exacerbate the spinning sensation. Staying adequately hydrated is also important, as dehydration can contribute to general dizziness and lightheadedness.
There are certain signs that indicate the dizziness is a medical emergency requiring immediate attention, rather than a benign inner ear issue. These “red flags” include vertigo accompanied by a sudden, severe headache, double vision, slurred speech, or weakness or numbness in the arms or legs. These symptoms suggest a problem in the central nervous system, such as a stroke, and should prompt an urgent call for professional medical assistance.