I woke up and I feel really dizzy – could it be BPPV?

I woke up and I feel really dizzy - could it be BPPV?

You just got up and the room is spinning. You may even feel like throwing up.

I woke up and I feel really dizzy - could it be BPPV?

Benign Paroxysmal Peripheral Vertigo (BPPV) is a common cause for feeling intense and debilitating vertigo. It is characterised by a feeling of the room spinning or “vertigo” (not “wobbly, woozy or faint”) with symptoms worsening on head movement and usually lasting for less than 2 minutes each time with sudden onset (paroxysmal). BPPV must be differentiated from other inner ear conditions like vestibular neuritis, labyrinthitis, or Meniere’s disease or even changes within the brain. BPPV can be managed effectively with the help of a physiotherapist.

Our inner ear (see the diagram of the semicircular canals above) has a crucial role in regulating our balance or sense of position in space. Each ear has a set of 3 semicircular canals (one at each plane much like a spirit level in three planes at the left and right ears) which contain floating crystal-like calcium carbonate material known as otoconia. These crystals move within the ear in response to gravity inside the semicircular canals much the same as a bubble within a spirit level or an ice cube when you tilt a glass of water. This movement of the floating bio-crystals happens each time we move our heads and activates tiny hair cells to give our brains a sense of movement. Combined with receptors in the neck and generally within the body these sensors assist us to remain upright (with the skeleton and a few muscles).

Physiotherapists use the Dix-Hallpike test to determine if someone may have BPPV.  If this is confirmed the Epley manoeuvre may be performed (full informed consent first…) as a tool to move the fluid within the semicircular canals in a fairly dramatic fashion. The Epley manoeuvre often results in an almost immediate improvement (after some vertigo…) but the procedure may need to be performed by the person at home, or with a physio, over time until symptoms fully settle. Neck treatments and exercises, relaxation, posture management (especially at the neck but obvs further down the kinetic chain, neck bone connected to the tailbone via a few other bones..) and lifestyle approaches are usually combined to give ideal results.

BPPV is usually very responsive to treatment but it is very important to have an assessment with a Physiotherapist or Doctor to ensure that the dizziness you are experiencing is not another condition requiring different interventions.

The lifestyle changes alluded to often relate to balance but in the “lifestyle” sense rather than the “keep you from falling” sense. More rest, less stress, good exercise, diet.