What is BPPV?
Benign paroxysmal positional vertigo (BPPV) occurs when calcium carbonate crystals called otoconia break loose in the inner ear's balance organ and drift into a semicircular canal. When you move your head, they disturb the fluid and trigger vertigo. One population study estimated lifetime prevalence at about 2.4% (von Brevern et al., 2007).
This article is general health information and is not a substitute for diagnosis or treatment. If symptoms persist, see a doctor.
How do you know if dizziness is BPPV?
- The room spins when you lie down, sit up, roll over in bed or tilt your head back.
- Episodes are short, usually under a minute.
- Nausea is common, but hearing usually isn't affected.
| BPPV | Orthostatic hypotension | |
|---|---|---|
| Feeling | Spinning | Lightheaded, vision dims |
| Trigger | Head position changes, including lying down | Standing up |
| Duration | Seconds | Seconds to minutes |
Lightheadedness when you stand up may point to orthostatic hypotension instead.
Diagnosis and treatment
Doctors use the Dix-Hallpike test to look for characteristic eye movements (nystagmus) in certain positions. The main treatment is a canalith repositioning procedure that guides the crystals back where they belong. The best-known version, the Epley maneuver (Epley, 1992), is recommended by U.S. guidelines (Bhattacharyya et al., 2017), which advise against routine use of vertigo medications. BPPV often comes back, and recurrences are treated the same way.
FAQ
- Is BPPV dangerous?
- It's "benign," but it raises fall risk. Slurred speech, weakness on one side or a severe headache with dizziness can signal a stroke—call emergency services right away.
- Can I do the Epley maneuver at home?
- It's safest after a diagnosis and with instructions from a clinician, since the right maneuver depends on which ear and canal are involved.
Sources reviewed: 2026-10-25
See also: Tinnitus
References
- Bhattacharyya, N., Gubbels, S. P., Schwartz, S. R., et al. (2017). Clinical practice guideline: Benign paroxysmal positional vertigo (update). Otolaryngology–Head and Neck Surgery, 156(3 Suppl), S1–S47.
- von Brevern, M., Radtke, A., Lezius, F., et al. (2007). Epidemiology of benign paroxysmal positional vertigo: A population based study. Journal of Neurology, Neurosurgery & Psychiatry, 78(7), 710–715.
- Epley, J. M. (1992). The canalith repositioning procedure: For treatment of benign paroxysmal positional vertigo. Otolaryngology–Head and Neck Surgery, 107(3), 399–404.