Causes of Vertigo. Vertigo is often caused by an inner ear problem. Some of the most common causes include: BPPV. These initials stand for benign paroxysmal positional vertigo. BPPV occurs when tiny calcium particles (canaliths) clump up in canals of the inner ear.
I think the pain is worse at night because of the activity during the day. I do experience pain at night (and throughout the day off & on). It makes it hard to go to sleep at night plus in the middle of the night the pain wakes me up.
Change in focus. One reason a toothache may be worse at night is our focus shifts from our daytime activities. This quiet time allows us to pay more attention to our pain/discomfort. I suppose one can imagine it as a leaky faucet.