Imagine you have just rolled over in bed and suddenly feel the room spinning uncontrollably. For a lot of us, this may feel physically uncomfortable and very unsettling. Even though this may feel very intense, this type of dizziness follows a very clear and distinctive pattern. In a lot of cases, this is commonly caused by benign paroxysmal positional vertigo, or BPPV.
BPPV is a mechanical condition of the inner ear. Within the inner ear, we all have small calcium crystals in a structure known as the utricle, which helps detect gravity and linear motion. This important structure helps the body know whether you are going up or down in an elevator or forwards and backwards in a car. Other important structures of the inner ear are the three semicircular canals, which detect rotational movement. They are like the spirit levels for your body, as the fluid-filled canals work together to sense motion in all directions, like turning, nodding, or tilting in relation to gravity.
Why am I dizzy when rolling in bed?
BPPV occurs when the crystals become dislodged and enter one of the semicircular canals, where they may float freely or become stuck. This is why symptoms are triggered by specific head and body positions. Most commonly, rolling in bed, lying down, bending to pick something up, looking and reaching for something overhead, or even sitting up changes your head position relative to gravity. This movement then causes the crystals to move within the canal, triggering vertigo.
The resulting intense sensation is usually brief. People often describe this as the room spinning or moving. This intense feeling may, for some, bring nausea and feelings of imbalance and dizziness, especially when they try to stand up.
As BPPV is a physical issue within the inner ear, it is very treatable.
BPPV treatment involves crystal repositioning/realignment techniques which are designed to guide the crystals back to their original location. Different techniques are used depending on which canals the crystals are present in. The Epley manoeuvre is one such technique. When done correctly, it can help completely resolve the symptoms quickly and effectively.
Accurate positional vertigo assessment is very important, as it helps in identifying which ear and which canal is involved. This allows for the right treatment techniques to be used to resolve your BPPV.
How long does BPPV last?
For most people, these symptoms are short-lived once treated, but some can experience ongoing balance problems and residual dizziness for some time.
This happens as your body and brain try to compensate for the symptoms felt. For example, your eyes may overwork to help make sense of the world; your neck and upper back may become stiffer, or you may avoid certain movements altogether.
This is where vestibular rehabilitation can become important after BPPV, especially if symptoms are ongoing. Whilst vestibular rehabilitation cannot change things overnight, it can often shorten recovery time, improve your balance and confidence and reduce the risk of dizziness becoming chronic. It is easier to guide the body’s balance systems back to normal if the ongoing symptoms are addressed early on.
