Understanding BPPV: A Common Cause of Dizziness

Dizziness can be quite the nuisance, especially when it strikes unexpectedly. While we’ve all felt that off-balance sensation after a thrilling rollercoaster ride or a playful spin with the grandkids, persistent dizziness may point to a condition known as benign paroxysmal positional vertigo, or BPPV for short.

BPPV is surprisingly common, affecting around 20% of people who visit their doctors for dizziness. Although anyone can develop BPPV, it’s most frequently seen in older adults. According to a clinical audiologist at Rush University Medical Center, BPPV has distinct features that set it apart from other dizziness causes. It usually hits when certain head movements occur, such as tilting your head or sitting up from lying down.

Inside our ears, we have organs that help us hear and maintain balance. The inner ear contains three semicircular canals that play a crucial role in sensing direction—up and down, side to side, and rotational movements. These canals are lined with tiny nerve endings covered by calcium carbonate crystals. When we move, gravity pulls these crystals down, helping our brain track our body’s position.

But sometimes, those tiny crystals can get dislodged and start floating around in the ears. This disruption can trick the brain into feeling like you’re spinning, even when you’re not. So, when experiencing unexplained dizziness, it’s important to talk to your doctor, as several health conditions like migraines, diabetes, or head injuries can also be culprits.

If you’re trying to figure out which ear is causing the trouble, there are a couple of straightforward tests. Many patients report that their dizziness flares up when they roll over in bed. This is linked to the ear that senses rotational movement—if you’re dizzy when rolling to the left, it’s likely your left ear at play.

You can also try standing with your eyes closed and marching in place for about 30 seconds. Your body will tend to rotate toward the affected ear. If these self-tests don’t pinpoint the issue, it’s wise to see a specialist such as an ear, nose, and throat doctor or a vestibular-trained audiologist.

When it comes to treating BPPV, one popular method is the Epley Maneuver, which involves specific head movements to encourage those pesky crystals to settle back into their rightful place. While it’s best to have a health professional guide you through the maneuver, you can attempt it at home, provided you first learn it correctly.

To perform the Epley Maneuver, start by sitting on your bed and turning your head 45 degrees towards the ear that’s acting up. Then, lie back quickly, letting your head hang slightly off the edge, which might make you feel more dizzy—but that’s okay. After a moment, turn your head 90 degrees to the other side, align your body with your head, stay on your side for a few minutes, and when you’re ready, sit back up.

Remember, be careful when doing this at home. If done incorrectly, it could potentially worsen your vertigo by moving the crystals into a different canal. For safety, always consider consulting a professional, such as an audiologist or a vestibular physical therapist, who can demonstrate the maneuver properly.