Sudden vertigo in the brain while sleeping may be otolithiasis, which is caused by an otolith detaching from the semicircular canal and can occur at any age. Symptoms can appear suddenly when the patient’s head position is rotated. There may also be spinning when looking at things, nausea, vomiting, and in severe cases, deafness and tinnitus. Symptoms last anywhere from a few seconds or 1-2 minutes and are treated primarily with repositioning and in severe cases should be seen by an ENT. Blood pressure should be tested to rule out blood pressure abnormalities, such as both elevated and lowered blood pressure may occur. In addition, cranial CT or cranial MRI should be examined to exclude cerebrovascular disease. For example, most patients with cerebral infarction develop in a quiet state or during sleep, and the sudden onset of symptoms is mainly seen in cerebellar and brainstem lesions. Peripheral vertigo can also be seen in patients with Meniere’s syndrome, for example. It can also be seen in cervical spondylosis, if necessary, check the cervical spine nuclear magnetic to clarify.