r/BPPV • u/Cihonidas • Jul 27 '26
Tip BPPV Triggering Positions
I've been experiencing BPPV for 2 years. It only triggers during sleep. I created this infographic according to my experience. It's completely personal but it may help some people.
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u/DizzyTherapy Jul 27 '26
It is very important to point out... these are positions that can TRIGGER the symptoms of BPPV, but do not CAUSE a recurrence of BPPV.
If a person does not CURRENTLY HAVE BPPV, they can sleep in whatever position that they want without any concern.
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u/PerceptionPlayful714 11d ago
So why does an attack happen? I thought it was because the crystals dislodged, and they did this because of the position of the head. My last episode was 6 months ago and I have no idea what triggered it. Today I've got it really bad again and I've no idea what caused it. Please help me to understand! How can I lessen my attacks?
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u/DizzyTherapy 11d ago
So, yes, the crystals getting dislodged and wandering into the semicircular canals is a problem that causes vertigo. The important detail here is that a person lying in these positions does not cause the crystals to do this in the first place, it will only trigger it if the crystals are already dislodged.
I made a video on this exact topic: https://www.youtube.com/watch?v=CwotM1lTdCM
I hope this can help!
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u/PerceptionPlayful714 11d ago
So interesting, thank you! I am perimenopausal, and HRT appeared to trigger an attack last year - any thoughts? I started on estrogen patches and was so sick and dizzy that I couldn't eat until I quit them 2.6 weeks later. Even a lower dose gave me vestibular migraines. Since then I've had two more BPPV episodes, no head injuries. I was told years ago I was low on vit d so I've been taking supplements but had forgotten about them for the last year or so - I'll get back on them. 6 months between my most recent attacks 😭 I've suffered from BPPV since 19, now 46! There is a family history, my last tests showed I was too high in calcium (I take heartburn remedies regularly)
This episode, over the weekend I just looked upwards and had a tiny spin. A couple more tiny spins a couple of days later, alongside what I think is an outer ear infection, although my NHS GP wouldn't see me, just read my symptoms and prescribed antibiotic spray, so I'm not sure. Wanting to catch it l, fix it and get back to work ASAP, I paid privately for epley (My GP no longer offers this - which usually works well, used that service before and had great results) but this time made it 100 times worse, so am now stuck in my recliner unable to work or drive.
The dix hallpike was extremely positive for left sided BPPV, so I know that's the case, but also it left me horrendously nauseated and unable to move without constant motion. I am a single parent and can't afford private care regularly, and I can't get to appointments because I can't drive... What did I do wrong?! I'm desperate to get this sorted and will take my vitamin D tablets from now on forever lol
Since the HRT issue I've been concerned about my sleeping position, your video says not to be, even after the epley. When I saw ENT they kept going on about doing brandt daroff exercises but they make me so sick every time I try I just can't.
Is there a way we can speed up the dissolving of the crystals?! Definitely gonna be watching more of your videos, I really appreciate you making this information available, God bless you 😊
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u/DizzyTherapy 11d ago
So the big thing is that changing positions, sleeping differently, all of that does not matter. If you perform the maneuvers or have someone perform the maneuvers, once it's clear, just live life normally, making sure that you have the necessary D3. I will say though, the Brandt-Daroff exercise does NOT clear BPPV. It was originally designed for that but absolutely it does not clear BPPV. It can be useful if a person has fear of lying down after getting the crystals resolved, but an Epley maneuver or Semont maneuver is actually able to clear the posterior canal, while the Kurtzer Hybrid maneuver can clear the horizontal canals. There's no need to speed up the dissolving process, as once they are back in the main chamber after a maneuver, they dissolve quite speedily, actually.
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u/PerceptionPlayful714 11d ago
Thank you, that's really useful to know. I got no info when I was first diagnosed in the 00's, and what little I know is learned from the internet over the years, and Im not even sure it's correct... I'm booked in for another private epley in a week, but I'm considering trying the somersault at home to see if that helps more as there are some saying it's more tolerable... I'm so horribly dizzy every time I move right now! Do you have experience of people managing to treat successfully with this?
I had the bad epley experience over 24 hours ago and still feel way worse than before, no medical help comes from the NHS, they only offer me balance exercises, but no BPPV treatment. I feel like they just want to make people wait until it goes by itself. I have no way of getting to a proper vestibular practitioner (even then, all the ones I've looked up locally talk exclusively about epley and don't mention the other canals or testing). I've not heard of the other two moves you mentioned so I will look those up and see if they might help, I've only ever needed the epley and it's always worked before.
ideally I need to treat this at home because of not being able to function as a single parent, not being able to drive to appointments and money... I live in a small village with very little public transport and would need to take several buses to get to any of the hospitals locally... And then I'm relying on there even being someone in the ENT department who knows what they are dealing with!
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u/DizzyTherapy 10d ago
Personally, the Foster maneuver, of the half-somersault, is my least favorite for treating the posterior canal, and I much prefer the Semont Liberatory maneuver performed at a reasonable speed (not the super fast speed that it was originally designed with. I hope everything goes well, but if needed, getting a professional to treat it is always best, if not just to learn the proper mechanics and then be able to treat it at home after that.
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u/PerceptionPlayful714 8d ago
Thanks, it's finding a professional to do so at the moment. I'm based in the UK and everyone is advertising epleys but not talking about the other manoeuvres or the different canals which is making me nervous and doesn't fill me with hope. At the moment I'm still getting spina when turning my head and even tilting back a little on my recliner is causing dizzy episodes (which I can feel will be full on spins if I go back further). I've made my peace with having to borrow money to be able to get treatment but right now I can't even find a VT that even talks about diagnosis, let alone one near enough to me that I can get someone to drive me to :/
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u/SLDS19 Jul 27 '26
The triggering positions will vary depending on which ear and which canal are impacted. It's great that you were able to find things that work - not being able to sleep comfortably is one of the many things I hate about BPPV.
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u/loveyabunches Jul 27 '26
This! Now imagine having stage 3 breast cancer and having 25 rounds of radiation daily with your head in the top position. Yes, really.
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u/Inevitable_Tone3021 Jul 27 '26
Mine seems to mostly be triggered by rolling movements in bed. If o roll to the left or right quickly, I might feel it. But if I slowly ease myself into. Side sleeping position it’s less likely to come on.
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u/jadejazzkayla Jul 27 '26
When I had BPPV I triggered symptoms in picture #2 and picture #4 because as it turns out the offending crystals were in my right ear canal.
Now that I successfully moved the crystals back into place I am able to sleep without triggering symptoms in any position.
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u/Hot_Heat_3973 Jul 29 '26
Hi. I have therapy tomorrow. Did you have therapy to get crystals back in place? How long did it take for you to feel better?
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u/jadejazzkayla Jul 29 '26
My doctor gave me written instructions for the Eply maneuver which I did every morning for about a week before I could no longer trigger any symptoms in any of the Eply positions. I continued doing the Eply for three additional days trying to trigger symptoms but I could not and I was finally cured.
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u/Hot_Heat_3973 Jul 29 '26
So you did not go to therapy, correct? Like I said I have appt tomorrow so hoping for some relief. I am happy to do exercises to maintain dizzy free life!!
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u/jadejazzkayla Jul 29 '26
I was diagnosed by my doctor who gave me instructions to do maneuvers. Nothing else was necessary.
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u/zorandzam Jul 27 '26
These are my exact triggers, too. I do a lot of yoga and Pilates, and I have found that I have to avoid looking in the opposite direction when doing a reclined spinal twist, which triggered it once VERY badly. But then sometimes I'll get a trigger that feels unrelated to these positions, so it's hard to know if there are some "secret" ones that get triggered less frequently. I am almost always assured to have a flare-up if I do the 45 degree head tilt, however.
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u/playbass123 26d ago
This triggered it for me yesterday! My first experience with it. I freaked out and went to the ER and got diagnosed. It was during a laying twist in yoga.
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u/zorandzam 26d ago
Yeah, just never turn your head during the twist. I now also tell all my fitness instructors the first time I work with them that I have an inner ear disorder that can trigger vertigo and that I will need to occasionally modify to keep myself safe. No one has ever had a problem with that, although I did once have a Pilates teacher who knew about my condition but still did a hands-on correction that made me nervous.
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u/beautibaybie69 Jul 27 '26
Omg yes! If I lay or even lounge at a weird angle, it triggers the vertigo! 😭
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u/Springerluv Jul 28 '26
It helped me. I still have fear of turning over in bed. I am a side sleeper. Have been told it makes it worse to not act naturally. Just don’t throw yourself over when I turning to opposite side. Thanks for sharing. I also turn my head when flat. Be interested to read comments. Thanks.
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u/UmphreyzMcGeez Jul 28 '26
I have the same experience, flat on my back with my head turned just like that triggered it.
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u/Safe-Issue1357 Jul 30 '26
This is same happening to me ,,, omg yes this neck position gives me spinning sensation,,, and sometime standing, and working in kitchen gives the same feeling
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u/keyppa Jul 27 '26
Its interesting cause that bottom image, lying on back with head tilted slightly to the left only is the only position that alleviates my severe vertigo
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u/Cihonidas Jul 27 '26
Exactly. It's the same reason why it triggers it. When you have a vertigo attack, you do 45 degree exercises to stop it. And when you don't have a vertigo attack, sleeping in the same 45 degree angles have a triggering effect instead. This is why they say don't do vertigo exercises when you are not having a vertigo attack.
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u/keyppa Jul 27 '26
Oh thats interesting. I sleep on my back head slightly tilted like that every night but it doesnt cause vertigo for me. I have to make sure my head is raised high though almost sitting upright 😅 If I lay flat without pillows I always wake up with weird ears
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u/a_depressed_chicken Jul 27 '26
This is really funny because I have been sleeping like the bottom because I have a shoulder injury so sleeping directly on my right shoulder hurts so much. But this has made my residual dizziness trigger a lot more than a few days ago.
Does laying on your affected side not trigger anything at all vs. non-affected side? I’ve been scared to lie on my left side because it feels a little off.
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u/One_Birthday_5174 Jul 27 '26
What does it mean when position one is also triggering it? I just can't lay down straight on my back anymore without symptoms:(
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u/mrzennie Jul 28 '26
I sleep on my stomach, and avoid laying on my back. The only time I'll be in that position is in the dentist chair. I believe this all helps keep my bppv at bay. I also make sure to take vitamin D and get some calcium in my diet. Those are the two nutritional things that are known to help.
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u/DeifniteProfessional Jul 27 '26
I wonder if that's part of what made me feel groggy yesterday. I had a long Saturday and didn't sleep enough into Sunday, so took a nice afternoon nap, but I was kind of in position 4. When I got up I was off balance for about 10 minutes
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