BPPV was the first answer I got.
After weeks of feeling off-balance and not knowing why, I went to a physiotherapist who ran some tests — including a binocular assessment where he could actually see the crystals in my inner ear shifting. He performed the Epley maneuver, and the diagnosis was clear: Benign Paroxysmal Positional Vertigo.
I felt relieved. Finally, a name for what was happening. A diagnosis. A treatment.
I went home, did the Epley maneuver three times a day for two weeks. The spinning gradually stopped.
But the dizziness didn’t.
If you’ve been diagnosed with BPPV but still don’t feel right, this post might connect some dots for you.
What is BPPV, exactly?
BPPV stands for Benign Paroxysmal Positional Vertigo. In plain language: Benign — not dangerous. Paroxysmal — sudden, brief episodes. Positional — triggered by head movements. Vertigo — a spinning sensation.
It happens when tiny calcium crystals called otoconia become dislodged inside your inner ear and float into one of the semicircular canals. These canals help your brain understand which way your head is moving. When loose crystals end up where they shouldn’t be, they send false movement signals to your brain — and the result is a sudden, intense spinning sensation.
The classic triggers are specific head movements: rolling over in bed, looking up at a shelf, tilting your head back, bending down to pick something up. The spinning is intense but short, usually lasting less than a minute.
BPPV is one of the most common causes of vertigo — and also one of the most treatable.
What BPPV actually feels like
BPPV is not subtle. When it hits, you know it.
The room suddenly spins. You feel a total loss of control for a few seconds. A strong wave of vertigo hits, tied directly to a movement you just made. And the key thing — you can almost always pinpoint the exact movement that triggered it.
Between episodes, you might feel okay or slightly off, but the main event is always that sudden spin. It comes fast, hits hard, and settles within a minute.
This is what makes BPPV distinct from other vestibular conditions — the trigger is always a head movement, and the episode is always brief.
How BPPV is treated
The primary treatment is the Epley maneuver — a sequence of specific head movements that guide the loose crystals back where they belong. A physiotherapist can perform it, or teach you to do it at home.
I did the Epley three times a day for about two weeks. The spinning gradually reduced and eventually stopped. Some people get relief after just one or two sessions. Others need more time.
BPPV can come back — the crystals can dislodge again over time. That’s why it’s worth learning the Epley so you can manage a recurrence at home.
When it works, it works well. BPPV is one of the most treatable vestibular conditions out there.
When BPPV doesn’t explain everything
This is the part I wish someone had told me earlier.
After two weeks of Epley, my spinning stopped. The positional vertigo was gone. But I was still off-balance, still foggy, still sensitive to light and noise.
At the time, I assumed it was just BPPV taking longer to fully resolve. So I kept waiting. But the dizziness that remained didn’t behave like BPPV at all.
It didn’t come in brief spinning episodes tied to head movements. It was constant and fluctuating. It got worse in bright, noisy environments. And one evening, after eating a Subway sandwich on my break, the dizziness spiked so hard I couldn’t get up from my chair — even though I hadn’t moved my head at all.
BPPV doesn’t react to food. BPPV doesn’t care about fluorescent lights or noise. BPPV is about head position.
What I was experiencing on top of BPPV was vestibular migraine — a separate condition with its own triggers, running in the background the whole time.
BPPV vs vestibular migraine — the key differences
Once I understood I had both conditions, I learned to tell them apart. They feel quite different once you know what to look for.
BPPV is triggered by head movements. The spinning is sudden, intense, and brief — seconds to a minute. Between episodes, you may feel mostly okay. The Epley maneuver treats it effectively.
Vestibular migraine is triggered by sensory input, food, stress, and sleep disruption. The dizziness is a constant rocking, swaying, or brain fog that builds over time and lingers for hours or days. It doesn’t respond to the Epley because it’s not a crystal problem — it’s a neurological one.
When you have both, symptoms overlap and things get confusing. Some days the spinning hits from BPPV. Other days the constant fog comes from VM. Sometimes both show up together.
The distinction that helped me most: if your dizziness is triggered by turning your head — likely BPPV. If it gets worse after a meal, a stressful day, or time under bright lights — likely VM.
I cover vestibular migraine in detail in my post What is Vestibular Migraine? What Your Doctor Didn’t Have Time to Explain.
What I wish I’d known earlier
I spent weeks assuming BPPV explained everything. The spinning stopped, but the dizziness stayed, and I kept waiting for it to resolve on its own.
What I actually needed was to understand that a second condition was involved — one with completely different triggers and a different management approach.
If you’re in that position right now — BPPV treated, spinning gone, but still not feeling right — here’s what I’d tell you:
Don’t dismiss what you’re still feeling. The remaining symptoms aren’t “just anxiety” or “just taking time.” They could be pointing to something real.
Start paying attention to what makes things worse. If food, light, sound, or stress seem to affect your dizziness — that’s not BPPV. That’s worth bringing up with your doctor.
And know that having more than one vestibular condition is common. VM and BPPV overlap frequently. Understanding which one is active — based on what triggered it — is the first step toward actually managing both.
My BPPV diagnosis was the first piece of the puzzle. But it wasn’t the whole picture. If your experience sounds anything like mine, yours might not be either.
I’m putting together a free Vestibular Trigger Checklist covering the most common triggers across VM, BPPV, and PPPD — food, light, sound, sleep, stress, and more. Drop your email and I’ll send it to you when it’s ready.
[Email signup form coming soon]