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Feeling Dizzy When You Roll Over or Lie Down? Positional Vertigo (BPPV) Explained

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Most of the dizziness Dr Phil Mifsud sees is positional vertigo, where the balance system in the inner ear sends the wrong signals. He explains what is happening, the neck tightness that often goes with it, and the home manoeuvre that helps reset it.

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Written by Dr Phillip Mifsud, Chiropractor & Exercise Physiologist and founder of Bodyline Health, Lower Plenty. Based on Dr Phil’s own video and clinical experience.

Quick answer: Positional vertigo is a brief spinning dizziness set off by a change in head position. Positional vertigo (benign paroxysmal positional vertigo, BPPV) causes brief spinning dizziness when you move your head, roll over in bed or lie down. The fluid-filled balance canals in the inner ear send the wrong signals to the brain. It is usually managed with treatment for any neck tightness plus a simple repositioning manoeuvre done at home, after more serious causes of dizziness have been ruled out.

Watch the video

Feeling Dizzy?

Dr Phil explains this in under two minutes.

First: get dizziness checked

Dizziness can be frightening, and it can occasionally signal something more serious. Always get it assessed so the more sinister causes are ruled out. That said, in the majority of cases Dr Phil sees each week, it turns out to be positional vertigo. He has had it himself, so he knows how unsettling it is.

What is positional vertigo?

Inside each ear is a set of small, fluid-filled canals that act as your balance centre, a bit like a spirit level. In positional vertigo, the canals start sending the wrong signals to your brain when you move your head. The result is a short burst of spinning, often when rolling over in bed, lying down, getting up or looking up.

Why does neck tightness matter?

Many people with positional vertigo also have tightness at the base of the neck. Whether the tightness is contributing to the dizziness or the dizziness is causing the tightness, it needs to be addressed, so treatment usually includes work on the upper neck.

The home manoeuvre to reset your balance system

Once other causes have been ruled out, Dr Phil sends patients home with a manoeuvre to help reset the balance system:

  1. Sit on the edge of your bed, somewhere safe.
  2. Focus your eyes on one spot on the ceiling.
  3. Lie down onto one side and tilt your head.
  4. Then sit back up briskly. This will bring on the spinning; that is expected.
  5. Repeat on the other side.

Repeat over a couple of days. Do it on your bed, have someone nearby the first few times, and do not drive straight afterwards. Ask us to show you the correct technique for your situation before trying it.

Who at Bodyline Health can help with positional vertigo?

Because Bodyline Health has several disciplines under one roof at 17 Main Road, Lower Plenty, your care can be shared between practitioners who talk to each other.

  • Dr Phillip Mifsud (Chiropractor): assessment, upper neck treatment and teaching the home manoeuvre.
  • Keryn Arrowsmith (Myotherapist): releasing tightness at the base of the skull and neck.
  • Catherine Farchione (Chinese Medicine and acupuncture): a complementary option some patients use for dizziness.

When to seek urgent medical help

Call 000 immediately if dizziness comes with sudden severe headache, double vision, slurred speech, facial drooping, weakness or numbness in an arm or leg, difficulty walking, or chest pain. These can be signs of a stroke or heart problem. See your GP if dizziness is constant, comes with hearing loss or ringing in one ear, or follows a head injury.

Further reading on positional vertigo: Vertigo (Healthdirect Australia).

Common questions

What is positional vertigo?

Benign paroxysmal positional vertigo (BPPV) causes brief spinning when you move your head, roll over or lie down, because the inner ear balance canals send the wrong signals to the brain.

Why do I get dizzy when I roll over in bed?

Rolling over changes your head position, which triggers the faulty signals from the inner ear in positional vertigo.

Can a chiropractor help with dizziness?

Yes, for positional vertigo once other causes are ruled out: by treating neck tightness and teaching a home repositioning manoeuvre.

How long does positional vertigo last?

Many people improve within days of doing the repositioning manoeuvre, although it can recur.

When is dizziness an emergency?

When it comes with a severe headache, double vision, slurred speech, facial drooping, weakness, numbness or chest pain. Call 000.

This article is general information, not a diagnosis or a substitute for individual medical advice. If you are unsure, see your GP or book an assessment.

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17 Main Road, Lower Plenty,
(03) 9017 4784

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