Benign paroxysmal positional vertigo (BPPV) is a medical mouthful but an important condition to know about—especially because it’s often challenging to get a proper diagnosis for this common type of dizziness.  

When you break down the medical terms of BPPV, each one describes a key element of the condition—benign means it’s not life-threatening…paroxysmal means it starts and stops suddenly…positional means symptoms are triggered by position changes…and vertigo, which is the main symptom, refers to the unpleasant sensation of feeling like you or the room is spinning.

Because dizziness, a general term used to describe vertigo, light-headedness and/or impaired balance, is estimated to affect three of out every 10 people age 70 and older, it’s crucial to correctly diagnose the problem so it can be treated appropriately. With BPPV, X-rays and other diagnostic tests don’t identify the condition. Instead, a special type of physical exam that many health care providers may not be familiar with must be used for a proper diagnosis. The good news is that once BPPV is diagnosed, it’s fairly easy to treat (see below), and you don’t need to take medication.

To help physicians home in on BPPV and the dangers of its related fall risk in older adults, researchers at the University of Gothenburg asked 149 older adults being treated for dizziness to answer a 15-question survey about their symptoms in addition to receiving a physical exam.

The key question:“Do you get dizzy when you lie down or roll over in bed?” was most often associated with the correct diagnosis of BPPV. Patients who answered “yes” to this question were about 60% more likely to be diagnosed with BPPV than those who answered “no.”

Patients who said they had “continuous dizziness” were less likely to be diagnosed with BPPV than those who had dizziness “lasting seconds,” according to the research, which was published in Journal of Vestibular Research. Short periods of dizziness are linked to BPPV.

Effective treatment for BPPV: While the exact cause of BPPV has not yet been determined, doctors know that the condition occurs when calcium crystals, known as otoconia, break loose from sensory hair cells inside the inner ear. Until the crystals settle back into position, sudden movement causes them to float in the inner-ear fluid, triggering vertigo. BPPV usually goes away on its own within a few weeks, but you can eliminate it sooner by doing simple exercises called the Epley maneuver.

This treatment involves positioning your head and body in ways that help the otoconia settle inside the inner ear. The maneuvers can be done by a health-care provider (such as an ear, nose and throat doctor, or otololaryngologist, or an audiologist). They take only a few minutes to complete, and they usually relieve BPPV after a few sessions. Click here to see how the maneuver is performed.

Important:If you have sudden episodes of spinning vertigo triggered by movement, especially while lying down or turning over, you may have BPPV and should consult your health care provider for a diagnosis. Other causes of vertigo include Meniere’s disease, which is believed to result from a buildup of fluid in the inner ear and may lead to hearing loss, and labyrinthitis, which often results from an infection in the inner ear. Treatment depends on the cause.

To get a diagnosis and appropriate treatment for vertigo, start with your primary care provider. He/she may refer you to an otolaryngologist, who specializes in these conditions. To find an otolaryngologist near you, consult the American Academy of Otolaryngology-Head and Neck Surgery at and click on “Find an ENT.”

Source: Study titled “Asking About Dizziness When Turning in Bed Predicts Examination Findings for Benign Paroxysmal Positional Vertigo,” by researchers at University of Gothenburg, Sweden, published in Journal of Vestibular Research.

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