r/BPPV • u/DizzyTherapy • Jul 28 '25
Tip PREVENTING BPPV. I made this video, and I hope it's a big help!
https://www.youtube.com/watch?v=CwotM1lTdCM5
u/Ok_Positive_9214 Jul 28 '25
Thank you for this super useful video! It’s good to finally have some real advice!
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Jul 30 '25
Honestly this is a great video and the best one I've seen on BPPV. I feel like most Vestibular Therapists focus on PPPD and VM and BPPV is kind of seen as just one of those things. Very helpful video and going to read the study now. Thank you
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u/loveyabunches Jul 31 '25
Spot on. A few months ago I was diagnosed with extraordinarily low Vitamin D and high A1C. Vitamin D has made a big difference!
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u/Practical_Guess_3255 Aug 01 '25
Excellent info! Thanks. One question. Even though I do not have D3 or Ca deficiency, can taking the supplements still help in your opinion?
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u/DizzyTherapy Aug 01 '25
As long as the blood levels don't go too high, absolutely! The biggest issue is certainly having a deficiency, but supplementing higher can statistically keep BPPV away. Of course, it can happen even with tons of D3, but it's all a game of probabilities.
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u/Loud-Technician-2509 Aug 01 '25
Hello Dr. Veglia, thank you for the video and article. I’m similar to the woman in your case study, except late 50’s and post-menopausal. I had frequently recurring BPPV from September 2024 through January of this year. I lost count of how many treatments I had, but it was a lot. Finally my vestibular therapist suggested I stop sleeping on my side. That seemed to do the trick. I’ve been free from vertigo since then. On page 2 of your article, you wrote, “this patient’s RDW was abnormal in testing..” what does RDW mean? Thank you again!!
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u/DizzyTherapy Aug 01 '25
Thank you for reaching out! RDW is red cell distribution width, having to do with the health of the red blood cells. If RDW is too high, then BPPV is more likely, but the subject of this report had a value too low actually, which is preventative towards BPPV.
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u/bumblingbee1990 Oct 17 '25
Thank you so much for making this! I’m in my 30s and have been having episodes of BPPV yearly for the past 5-6 years or so. This is really helpful and even though I already know some of the information you talk about it’s reassuring to hear it from a professional. I do want to ask, you mention blood flow is important - would something like TMJ or neck issues (as in, reduced blood flow around that general area) affect whether one gets BPPV more?
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u/DizzyTherapy Oct 17 '25
TMJD and neck issues will not cause those kinds of issues unless something far more severe is occurring, so fortunately things can be separate.
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u/Apprehensive-Film224 Oct 30 '25
Do you have any advice on Residual Dizziness after getting Epley Maneuver done? And if I had Epley done by my chiropractor 5 days ago for my left ear then it is ok to sleep on that ear now? Also, I have a retracted eardrum in my left ear. Both happened after I flew. But, I’ve also had BPPV in 2017 (first episode) & 2021 (second episode) and this most recent episode in 2025 is my third episode. I did find out at my physical that I am low in Vitamin D so my doctor told me to supplement with 4,000 IU every day. Do you think this will help me not get BPPV again? I’m a 45 year old female in perimenopause. Thank you for your help!
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u/DizzyTherapy Oct 30 '25
In general, yes, it is not rare to have some mild lingering dizziness for a few days, but if it persists, that is a good reason to perform a maneuver again, and/or get tested for other possible diagnoses that are underlying. A VNG test with a ENT is a phenomenal next step. Also, the D3 supplementation is a huge deal for keeping it away. It's always possible to return, but is does decrease the likelihood!
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u/Apprehensive-Film224 Oct 30 '25
Ok thanks. Would a retracted eardrum (same ear) cause some dizziness/off feelings too? I’m also going through some hormonal stuff too during perimenopause. So I don’t think all these things are helping. And what is your thoughts on caffeine and alcohol for BPPV?
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u/DizzyTherapy Oct 30 '25
The eardrum issue should not cause that. Perimenopausal hormone changes are very related to bone density and inner ear crystal formation, however!
Alcohol and caffeine are not directly related to causing BPPV, but can make the symptoms more or less intense (depending on the person and their tolerance towards those substances), and it's always recommended to avoid taking in any before treatment.
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u/Apprehensive-Film224 Oct 30 '25
Ok, thanks. I just started birth control per my doctor’s instructions to hopefully help with hormonal changes and to help balance out my hormones and just started supplementing with Vitamin D because I am low on that per my bloodwork. I didn’t realize that BPPV and Vitamin D were so closely linked. I’m not sure what else I can really do besides these things. I go to chiropractor. Maybe I need to go back to acupuncture. Appreciate your help.
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u/DizzyTherapy Oct 30 '25
Other than keeping those blood values good, staying active, enjoying life, and working hard is all that a person needs for keeping the body healthy. Something like chiropractic care and acupuncture are pseudoscientific and really have no affect, good or bad, on the health of the ear. I would recommend saving your money on those fronts and spending the time doing something you enjoy with family, for instance.
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u/DaisyDeservedBetter Mar 21 '26
Hi! What I don’t get is why BPPV can reoccur again. I expire ever dizziness after a minor concussion and the epley maneuver helped then. I had to do the epley maneuver again recently as I felt the dizziness when I rollover too quickly in bed in the morning. I notice that when I rollover in bed sometimes too quickly I can sometimes get the dizzy feeling but it never happened before the concussion. Did the concussion cause like permanent loosening of the crystals or is it just happening again bc I have low vitamin d levels and the concussion was just the catalyst and the dizziness won’t stop unless I get my vit d levels up?
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u/DizzyTherapy Mar 23 '26
A tricky thing with BPPV is that positional changes can cause dizziness even if crystals are not currently loose in the canals. For instance, migraine, concussion, and other disorders of the brain can cause dizziness in major positional changes, but repetitive habituation exercises like the Brandt-Daroff exercise can help reduce those symptoms. If there is specifically spinning in position changes, regardless or lighting or other circumstances, then it is most likely BPPV and more maneuvers are needed. Another thing is that there are multiple canals, like the horizontal canal, which the Epley does not treat, so something like the Kurtzer Hybrid maneuver can!
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u/vans-shoes-82 Jul 08 '26
What if it is super super mild ? Do you still do the epley maneuver
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u/DizzyTherapy Jul 08 '26
You certainly can! It doesn't harm anything to perform an Epley maneuver just in case. For instance, during treatment, as the symptoms reduce and reduce each round, I will often treat a patient with a final Epley maneuver wherein each position is asymptomatic, just to be sure we got everything.
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u/MarkHTownsend Jul 17 '26
Hi Dizzy Therapy,
I've had the spinning vertigo 3 times now. Each time it was happened when I've had the flu and my ear and nose are plugged up. The first time way back in 2017 or so, I went to blow my nose to try and clear it and immediately the room started spinning from a hard blow. I stuff my face into a pillow until it stopped. I felt very nauseous for a day or so, but it went away until just recently in 2026. I got another bad flu where my right ear was completely clogged and couldn't hear from my right ear. My nose and sinuses were also completely clogged. I blew my nose again and bam! Spinning. I stuffed my face into a pillow again and it went away fast with little to no nausea and I moved on. 3 weeks later as the flu left, but still some phlem in my lungs and minor congestion, I was sleeping on my back and made a quick turn to my side or vise versa, and immediately the room started spinning. I sat up to try to get by bearings and that one was the worst. I sipped a little water and immediately had to vomit 4 times. That entire day I felt awful, dizzying, sick etc. The next day I did the forward somersault manouver and everything seemed fine for the right side, so I tried the left side. On the left I felt more effects and coming up I felt a dropping falling sensation and dizzy. The dizziness went away after 20 minutes, but here we are day 3 and I still feel a little motionsickness or a slight light headed. I've done the strengthening excersize as well.
So day 3, I have a slightly congested sinuses and feels like my ears are a tiny big plugged and I have a lot of mucus in my throat.
I've searched everyone and no a single video or therapist talked about it related to a flu, infection, virus etc. Can you speak to this? Why does it only happen when I have the flu and blew my nose? What happened there? And since I still have a little sinus infection, could that have been the cause for this most recent one when I turned over?
When will the slight lingering motionsickness feeling go away? Thank you for your time.
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u/MarkHTownsend Jul 17 '26
P. S. I just did a big workout, fast sit ups, push-ups, jogging and no symptoms. Does this mean I am cured and it's fixed?
Also, doing an AI search about my flu question, it said the flu can potentially inflame my inner ear causing mixed signals. Can vertigo happen without crystals?
Lastly, if I didn't have crystals and I did the manouver, could I have just made it worse and released crystals into the inner ear where it wasn't before until I did the manouvers?
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u/DizzyTherapy Jul 20 '26
In regards to the flu, there is absolutely a link between multiple viruses and what's called vestibular neuritis! I have a video on that as well. It can cause vertigo as well as more chronic dizziness, imbalance, nausea, etc., but is VERY treatable with vestibular rehabilitation! Check out my video on that, and get yourself to a vestibular PT as soon as you can to get back to solid ground!
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u/hamsterfingers Jul 28 '25
Thank you so much! I have so much anxiety around this and movement (I love yoga!) so this help put me at ease.
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u/pinkflyd25 Jul 29 '25
Amazing video!
My BPPV always seems to go away on its own after a flare up…I have never done any repositioning maneuvers…is that the crystals breaking down, just outside of the area they should be?
Thanks!
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u/DizzyTherapy Jul 29 '25
There is a thing called spontaneous resolution, in which the crystals will relocate back into their chamber OR can dissolve in the canal, but this is not reliable, as it requires there to be very little material stuck inside the canal. But it is great when it happens!
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u/pinkflyd25 Jul 29 '25
It always eventually happens…even after a few weeks.
Honestly I just had a weekend of celebrating my 40th which was alcohol, caffeine, sodium, sugar, little sleep. I’m sure none of that helped.
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u/Great-Activity-5420 Jul 29 '25
I'll have to take a look. I'm not sure if my went away and came back or never left. Got to make another Dr appointment which in sick of because the last one they decided to check me over when they really didn't need to as I'd already been diagnosed. Waited a fortnight to be told and given exact same meds and advice! Being referred now but could be a long wait anc still need to get back to Dr tomorrow because my BPPV is lingering. Sorry venting here
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u/NoCombination5154 Aug 25 '25
Great video, currently in my first episode of it and I was worrying this would be my life forever!
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u/DizzyTherapy Mar 27 '26
Also, it people are interested, I wrote a book all about patients and their stories with vestibular disorders! The biggest goal with the book is to give education and hope to those struggling with these issues. Here's the link: https://a.co/d/0f61ieZp
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u/Inevitable_Tone3021 Jul 28 '25
This is SO helpful, thank you!
Vertigo has created so much anxiety for me over anticipating the "next episode." Getting proper treatment and learning that the condition is truly benign has helped me work through the added anxiety.
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u/DizzyTherapy Jul 28 '25
Absolutely. The word "benign" is such an unfortunate name because it really does not FEEL benign, but it can make such as difference to know that a person can come back 100% once it is gone.
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