Should You Drive with a Vestibular Disorder?

Many people who have been diagnosed with a vestibular disorder or experience episodic or chronic vertigo, dizziness, or imbalance have questions about driving. Some are concerned about safety should an episode occur while they are driving. Others are worried that people – especially law enforcement – may think they are under the influence because they are unstable when they walk. One of the worst fears is that their driver’s license will be revoked.

Driving when you have vestibular dysfunction poses unique challenges that individuals must navigate with heightened awareness and adaptability. The vestibular system is responsible for maintaining balance and spatial orientation. When the vestibular system is impaired, it may result in symptoms like dizziness, vertigo, and poor coordination, which can significantly impact one’s ability to drive safely.

Negotiating the complexities of the road demands a delicate interplay between sensory inputs, motor skills, and cognitive functions. When the vestibular system is compromised, individuals may find themselves grappling with an array of unsettling sensations that can make driving a daunting task. Consequently, drivers with vestibular disorders often need to employ coping strategies, lifestyle adjustments, and precautionary measures to ensure road safety for themselves and others.

Below is testimony from this author about her experience with driving as a vestibular patient. 

Ashley’s Story

“My name is Ashley and I have Vestibular Migraine and Persistent Postural Perceptual Dizziness (PPPD). After my diagnosis, there was a time when I thought I would never drive again. All the stimuli from driving overwhelmed my system, and I did not feel safe on the road for the sake of myself and others. I brought these concerns to my physical therapist and she recommended that I see an Occupational Therapist (OT) for driving rehabilitation.

Driving rehabilitation is usually for people who have had a stroke, concussion or other event that has left them unable to drive. With my symptoms, I fell into the TBI/ concussion protocol, and completed 8 weeks of outpatient driving rehabilitation. Without the help of my OT, I would not have regained my ability to drive. She helped me get some of my independence back, which I am so grateful for.”

Here are some tips and tricks to make driving with a vestibular disorder safer and more manageable.

• Four Corners on a windshield:  Looking at the four corners of the windshield can open the visual field and allow for safer driving. Please only do so at a red light or in a stopped, parked vehicle. 
• Listen to your body. If you feel an oncoming dizzy episode, don’t drive. Stay put or find someone else to drive you where you need to go.
• Avoid rush hour: Drive during less busy times, such as 10am-3pm on weekdays and early morning on weekends.
• Take the long way home: Some people prefer to avoid freeways and instead drive on neighborhood streets they are familiar with.
• Inclement weather: Avoid driving in rain, snow, or when road conditions are less favorable.
• One errand at a time: Limit the number of stops you make. The more stores you visit, the higher the chance you will become overstimulated.
• Light conditions: Drive during early morning or late afternoon when the sun is not as bright.
• Visor: Pull down your vehicle’s sunshield or visor to help minimize glare. This can also help reduce overstimulation.
• Driving Go-Pack: Keep sunglasses, a hat, and gum in your vehicle. Sunglasses and hats will help reduce the impact of bright light. Gum or mints can give more sensory input on winding roads or hills and can be useful in high traffic.
• Stomp around: Pull over to a safe place, get out, and walk around. Make sure to stomp around with your feet, and possibly hit your legs with your hands. This will help to increase the sensory input to your body, so you feel more grounded and centered. 
• Clothing: For longer drives, try wearing tight clothes like leggings, a sports bra, or a compression shirt, to give you more sensory input, as well as good fitting shoes.
• Turn off the radio: Limit music when starting out or feeling unwell, as this can be distracting. 
• Use your GPS: Having a GPS guide helps to lighten the burden of finding your way when driving. You only have to make decisions about driving and not about how to get to your destination.

Regulations

There are different regulations about driving with certain health conditions based on where you live. For example, South Carolina and Utah, USA do not have any stipulations about driving with a vestibular condition. However, US federal law requires that you stop driving until any vertigo attacks are controlled and well regulated. In the United Kingdom, Meniere’s Disease patients are required to stop driving after a diagnosis is reached but can be allowed to drive again if symptoms are well controlled, per the Driver and Vehicle Licensing Agency (DVLA).

According to Genoveva Hurtado, an audiologist at Rocky Mountain Hearing and Balance in Utah and visiting researcher at the Medical University of South Carolina (MUSC), “There are no real clear guidelines about what patients or clinicians should do regarding driving and vestibular disorders.” This is why MUSC is applying to start a study looking into subjective and objective measures to better understand what patients are more likely to be concerned about when driving and what avenues can assist them to be as independent and active as they can safely be.

Many people avoid bringing up concerns about driving with their healthcare provider because they don’t want to have a red flag on their medical record that could cause them to lose their driver’s license. However, it is better to be safe than sorry. If you’re uncertain whether your health condition could restrict your driving permissions, check with your department of motor vehicles. And please consult your vestibular healthcare specialist before you start to drive after being diagnosed with any vestibular condition.

These tips provide helpful guidance but are not a replacement for medical advice.

Authors: Ashley Chin, VeDA Ambassador and Vestibular Patient, Genoveva “Veva” Hurtado, Audiologist