Vertigo Exercises You Can Do at Home — Epley Manoeuvre & More

If you feel the room spinning when you roll over in bed, look up, or bend forward — especially if it lasts only seconds to minutes — you almost certainly have BPPV (Benign Paroxysmal Positional Vertigo). The good news: it is extremely common, completely benign, and often fixable with a specific head manoeuvre.

What Is BPPV?

BPPV is caused by tiny calcium crystals (otoliths) in the inner ear becoming dislodged and floating into the semicircular canals, where they trigger false signals of movement. The result is a sudden, intense spinning sensation triggered by head position changes. The vertigo typically lasts 10–60 seconds per episode.

The Epley Manoeuvre — Step by Step

The Epley Manoeuvre repositions the displaced crystals out of the sensitive canal. It works for the most common type of BPPV (posterior canal BPPV affecting the right ear is shown below). Your neurologist will confirm which side is affected before guiding you.

1. Sit on your bed and turn your head 45° to the right (toward the affected ear).
2. Lie back quickly with your head still turned 45° right, so your head hangs slightly off the edge of the bed. Wait 30 seconds (until the vertigo stops).
3. Turn your head 90° to the left (now facing 45° to the left). Wait 30 seconds.
4. Roll your entire body onto your left side (head now facing the floor). Wait 30 seconds.
5. Sit up slowly on the left side of the bed. Wait 1 minute before standing.

Repeat twice more (3 repetitions per session). You may feel significant vertigo during the manoeuvre — this is expected and means it is working. Do the manoeuvre 3 times per day until you have had no symptoms for 24 hours.

Brandt-Daroff Exercises

If the Epley Manoeuvre does not fully resolve your vertigo, Brandt-Daroff exercises are a useful addition. They habituate the brain to the triggering position:

1. Sit upright on the edge of the bed.
2. Quickly lie down on your right side, head tilted 45° upward. Hold for 30 seconds.
3. Sit upright again. Hold for 30 seconds.
4. Quickly lie down on your left side, head tilted 45° upward. Hold for 30 seconds.
5. Sit upright. That is one cycle. Repeat 5 times, twice daily.

When NOT to Self-Treat

These exercises are safe for BPPV but should not be attempted without a diagnosis if you also have:

• Vertigo with sudden severe headache, double vision, or weakness — this could be a stroke. Seek emergency care immediately.
• Vertigo with hearing loss or ringing in the ear — could be Meniere's disease, which requires different treatment.
• Vertigo lasting hours or days continuously — not BPPV.
• Vertigo after a head injury — needs assessment first.

When Will I Feel Better?

Most patients with BPPV see improvement within 1–3 sessions of the Epley Manoeuvre. About 80% of cases resolve completely within one week of consistent treatment. BPPV can recur — particularly after sleeping on the same side, or after viral illness — but responds to the same treatment.

If your vertigo does not improve after 1 week of daily Epley exercises, please see a neurologist for assessment. Other causes of vertigo (vestibular neuritis, Meniere's, central vertigo) require different treatments.

Dr. Anand Karnam at Sri Anand CNC performs an in-clinic Dix-Hallpike test to confirm BPPV and guides the manoeuvre personally. Call +91 90633 66983.