BPPV is the most common inner ear cause of vertigo, but remains a mystery to most people including healthcare providers. So I created this list to help you understand it better.
BPPV is an acronym for the most common vestibular disorder: Benign Paroxysmal Positional Vertigo.
What is BPPV?
Benign Paroxysmal Positional Vertigo causes a false feeling of spinning, tilting or translating while lying down or rolling in bed. Other head positions and motions can trigger vertigo symptoms, like looking up, looking down, and shaking the head fast up/down or side/side for people with BPPV.
It is most commonly found in people in their 50’s and 60’s, with a 7:1 ratio of women to men who suffer in middle age. BPPV is part of normal aging and is commonly found in both male and female adults over 65 years old, remaining high through end of life.
Those who have BPPV may not experience symptoms of vertigo unless they move their head into a “provoking position or triggering motion,” but they will likely experience imbalance, unstable walking, repeated falls and bumping into walls without another explanation.
Trauma to the head and neck often causes it in younger people, such as after car accidents, sports concussions, boxing matches, blast injuries from roadside bombs in war veterans, and other jarring impacts associated with sports and active lifestyles.
In pubescent adolescents, the ratio is 3:1 of girls to boys who suffer with it. Pregnant women and Peri-menopausal women also have higher rates of
BPPV, suggesting a hormonal influence in many non-trauma related cases of BPPV.
Other common triggers for it include low Vitamin D levels, seasonal allergies, sinus infections, stress, dehydration, vestibular hypo-function from viral or bacterial inner ear infections, dental work and poor blood flow in smaller blood vessels due to medical conditions like diabetes, high blood pressure and high cholesterol.
Older adults with BPPV who fall are more likely to sustain a fracture, or broken bone.
It often causes difficulty with short term memory, concentration, decision-making and reading. It can be mistaken for mild cognitive impairment in older adults.
BPPV Treatment
The most common medication prescribed to reduce the symptoms of BPPV is called Meclizine and it can cause dizziness, drowsiness and blurry vision in the short term, often contributing to more falls. With chronic, long-term use, that same medication can cause irreversible cognitive impairment due to its anticholinergic effect on the nervous system.
Meclizine is on the BEERS criteria list of medications that should be avoided in older adults regardless of their condition because of safety concerns.
Other medications commonly prescribed for treatment are Benzodiazepines like Diazepam (Valium), which are highly addictive. Common side effects include unsteady walking, loss of muscle control and reduced coordination.
Benzodiazepines are associated with a 50% increased risk of hip fracture in older adults and should be used with caution.
If properly evaluated and treated by a Healthcare Provider who specializes in dizziness and vertigo, or a Vestibular Expert, it can be completely resolved in 1-2 treatment sessions about 85-90% of the time.
Disclaimer
This blog is provided for informational purposes only. The content and any comments by Dr. Kim Bell, DPT are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. The details of any case mentioned in this post represent a typical patient that Dr. Bell might see and do not describe the circumstances of a specific individual.
I’m 52 and recently noticed the earth will take a slight roll when walking down stairs or bending over to ajust my chair. Allergies have also been really bad. I found out, my sinuses actually swell and touch my molar roots. Yea me! Took unbearable tooth pain and an X-ray to tell me I needed a little ole diphenhydramine. I had thought my dizziness problem was a combination of age, weight gain and allergies, now I’m pretty sure that is correct. Thank you for the article on vertigo and dentistry.
Hi Kimberly,
Thank you for sharing your story!
I suggest for you to also check out these blogs for more free helpful information:
BPPV Symptoms
Home Remedies
How to Find a Vertigo Doctor in Your Area
Vestibular Problems: Why Didn’t my Doctor Realize Them?
All my best,
Kim Bell, DPT
Hi Dr Bell,
4 mornings ago while waking I started to turn over to my right side in bed and suddenly the room started to spin wildly. From memory I think it was in an anticlockwise direction. I grabbed my mattress with both hands initially thinking it was an earthquake and yelled EARTHQUAKE !! Then I was afraid to move. Feel nauseous afterwards Happening every morning now. I move very slowly and carefully. Will this go away.Would appreciate your input.
I am a 70 yr old male. Have had slight imbalance in past when putting things on clothes line but nothing as crazy as this
Hi Brian,
I feel for you!
This can go away with proper medical care.
Here are some helpful blog articles I have published that I think you may want to check out:
Was that an Earthquake?
Vertigo Lying down and Rolling over
BPPV Symptoms: What to Know
How to Find a Vertigo Doctor in Your Area
Vestibular Problems: Why Didn’t my Doctor Realize Them?
Home Remedies that Help
BPPV causes Dizziness and Imbalance
Vestibular Rehabilitation: A Specialty
I highly recommend for you to watch my new video lecture. I just created this for a local senior center in my area and I have a specific learning objective about how to manage dizziness lying down and rolling over. Check it out here.
I hope that is helpful information.
Best wishes,
Kim Bell, DPT
Hi there,
I have undiagnosed BPPV, happened for the first time about 4 years ago when I was 25 (male). Did my research as I couldn’t sleep and was nauseous all the time due to being in triggered positions. Found out about the Epley maneuver and gave it a shot. Cleared it up on the third attempt. Has reoccurred twice in the past 4 years, each time resolved with the Epley maneuver at home. A pain in the rear to be sure but resolved relatively easily.
I had a brief bout of vertigo over the weekend, lasting about 3 days, but now my short term memory is gone. I do not remember what I did last week at all, will my memory come back?
Hi Crissie,
If you have not already, I suggest you see your primary care provider and you may also need to see a neurologist for medical evaluation and individual advice for your case.
You can also go to the emergency room anytime for immediate care.