Feeling dizzy, especially when lying down, can be both uncomfortable and frustrating. If you find yourself being surprised by sudden bouts of dizziness, you may be dealing with a condition called benign paroxysmal positional vertigo (BPPV). This common inner ear disorder is characterized by a sudden feeling that the room is spinning and is the main cause of vertigo. BPPV often occurs when your head changes position and is especially noticeable when lying down, rolling over in bed, or tilting your head. While BPPV is usually not serious, it can significantly impact daily activities and increase the risk of falls, especially in older adults.
Understanding BPPV in Older Adults
Benign paroxysmal positional vertigo occurs when small calcium crystals, called otoconia, become dislodged from their normal location in the inner ear and move into the semicircular canals. The inner ear plays an important role in maintaining balance by sending signals to the brain about the position and movement of the head. When these crystals move into the canals, they block the flow of fluid that helps sense head movement, resulting in a feeling of dizziness or lightheadedness. Vertigo episodes like those of BPPV are usually brief, although they can range from mild to severe.
While BPPV itself is not life-threatening, the symptoms can cause significant discomfort and increase the risk of falls in older adults.
What causes BPPV?
The exact cause of BPPV is not always clear, but certain factors may increase your chances of developing the condition. Some common causes and risk factors include:
- Age: BPPV is more common in people over 50 because the structures of the inner ear can degenerate with age.
- Gender: BPPV is two to three times more common in women than in men.
- Head injury: Any injury to the head or neck can dislodge calcium crystals in the inner ear, which can cause vertigo.
- Ear infection: Some ear infections can cause inflammation in the inner ear, which can disrupt your normal balance.
- Prolonged bed rest: Being in bed for long periods of time or being inactive, such as when you are recovering from surgery or an illness, can increase your risk of BPPV.
Although BPPV can sometimes occur without a clear or obvious cause, these risk factors make you more likely to experience the condition. If you frequently feel dizzy when lying down or changing positions, you should consult your doctor to determine if BPPV is an underlying problem.
What causes BPPV when lying down?
BPPV episodes almost always occur when you change your head position. These movements cause the dislodged crystals in your inner ear to move, disrupting the balance signals sent to your brain.
Along with dizziness when lying down, some other common movements that can cause dizziness include:
- Standing up from a lying or sitting position
- Bending over or tilting your head back
- Turning your head too quickly
Symptoms of BPPV
The most obvious symptom of BPPV is sudden dizziness, especially caused by certain head movements. However, there are other symptoms you may experience along with this feeling of dizziness, including:
- Dizziness: Vertigo is the feeling that you or your surroundings are moving or spinning, even when you are standing still. In BPPV, this often happens when you change the position of your head.
- Nausea and vomiting: The spinning sensation can sometimes make you feel nauseous or vomit, especially after a severe episode of dizziness.
- Loss of balance: People with BPPV often feel off-balance when walking, as if they are about to fall, especially when standing up too quickly.
- Feeling unsteady: You may feel off-balance or unsteady when doing everyday activities like walking or standing, which can increase your risk of falling.
- Nystagmus: This is an abnormal eye movement that occurs along with dizziness. It can look like the eyes are moving rapidly back and forth or in a jerky motion, which is characteristic of BPPV.
Best Management Solution for BPPV
BPPV is relatively easy to treat. The Epley maneuver is considered an effective solution for how to get rid of vertigo when lying down.
The manipulation of the crystals is called the Epley maneuver. It is a successful, non-invasive, drug-free procedure that can be performed with the help of a physical therapist.
It works by positioning the head in a specific sequence that helps the crystals float out of the semicircular canal. You may need to try several different positions during the same exam for this maneuver to be successful.
The steps to perform the Epley maneuver are as follows:
- Turn your head 45 degrees in the direction of the ear that is causing the vertigo.
- Lie on your stomach with your head facing away from the edge of the exam table for at least 30 seconds.
- Turn your body to the opposite side while keeping your head still.
- Turn your body and head at the same time.
- Sit up carefully.
- Repeat up to six times until the dizziness subsides.
You should always seek the help of a medical professional to ensure that the movement is performed correctly and to monitor for any other serious factors.
