How long does BPPV last? Why does it go and come back?

We were recently asked, “Why does BPPV go away and come back?”.  To understand the treatment and natural history of BPPV it helps to understand how it happens in the first place.  
Lets imagine that the inner ear is akin to a tiny snow globe inside the head.  In a healthy person the snow inside this globe is actually stuck down but with age the snow comes loose and begins to fly around when disturbed.  Now lets imagine there is a house inside the snow globe.  Inside the house are the very sensitive balance organs of the inner ear.  There are, of course, windows in the house and sometimes flying snow comes in through those windows.  When that happens you get BPPV. 
Every time the snow globe is disturbed, by rolling over or looking up, the snow inside the house causes the balance organs to be confused and the sensation of vertigo results.   The snow can fall out of the windows of the house as well but this only happens sometimes when you are in just the right position.   The treatment maneuver for BPPV carefully guides these particles out.  You can have your doctor do the maneuver or do it yourself with a BPPV treatment device.
Without treatment BPPV often lasts 2 weeks until the particles inside the house (which is actually called the posterior semi-circular canal) fall out or somehow breakup.  However, more snow can come in and usually does in about 60% of people. 

35 Responses

  1. Clearwater Clinical

    This sounds like an unusual and complicated case. There are many possibilities we could discuss – but perhaps in this case it is best to jump right to seeking another ENT opinion. Make sure the doctor you are seeing is a neuro-otologist not a regular ENT. Furthermore, if you have not yet had “caloric” vestibular testing or “rotatory chair” or a “VNG” it might good to get these to confirm the diagnosis. You might not have BPPV. There are a few positional vertigo diseases which are not BPPV – which I will leave to your doctor to discuss. Hope you find your answer.

  2. Candace

    I have had BBV for two months now. It started with a severe case which last about 2-3 weeks. I have had BBV and possibly Migraine Vertigo occasionally for over 30 years. My last case of BBV was 15 years ago. I know how to do the Epley on my own so when I got it this time I did the maneuver and it helped a little. I have an ENT who specializes in vertigo and he has also done the maneuver in the office. However, my problem now is that I can not lay flat without getting dizzy (spinning sensation). I can use a large pillow to sleep or I sleep in a recliner and that is works. I’ve never had residual effects like this in the past. Most of the time it has come and gone quickly. I’ve had hearing tests and a MRI in the past and nothing has shown any problems. After I perform the Epley I feel less dizzy but it takes a couple hours for me to feel better. The symptoms will stay away but the second I lay flat they come back. I’m frustrated with feeling completely fine only to try and sleep normal or do yoga again and have the symptoms return. How long can this keep happening? I’m concerned that there is something else like an infection (although the ENT says my ears look normal) or possibly something else that just hasn’t been diagnosed. Do I just keep trying to lay flat occasionally and hope that it will go away one day? Is this something that may never go away?

  3. Clearwater Clinical

    Thanks for sharing your story. I agree – get a proper diagnosis first. If you have BPPV there are quick and easy treatments. What you describe now sounds like “post maneuver disequilibrium” which is an off balance sensation that you get following BPPV. It usually lasts a couple of weeks and goes away so long as you do keep active. If BPPV comes back you can treat it at home with DizzyFIX which takes you through the Epley maneuver.

  4. Clearwater Clinical

    That sounds terrible. It isn’t really clear what you have had without more details and perhaps a diagnosis. There often aren’t any ways to prevent future episodes of dizziness unless the diagnosis is clear. Best of luck.

  5. Clearwater Clinical

    Hmmm, really you need a diagnosis first before any treatment can be recommended. Have you spoken with your own doctor? Based on what you describe it is possible that you have BPPV but there are many other conditions. It sounds like you might benefit from a hearing test too. I would suggest you seek an ENT doctor out who specializes in dizziness. Best of luck

  6. Clearwater Clinical

    If you as still dizzy I would return to your doctor and get a diagnosis. You may need to see and ENT, neurologist or physio and may need further investigation. I would ask more questions of your own doctor first. Best of luck.

  7. Clearwater Clinical

    If you find a “vestibular physiotherapist” they might have a “tilting bed” that can do the maneuver without having to move your neck around. You can do the maneuver with a stiff neck – it is harder – but you just have to roll your body more and be on a bed that is inclined down (head down) 30 degrees or so. Don’t try this alone as you can slip off the bed, but you might find an ENT or a physio willing to do it. There is also a chair called the Epley Omniax that can take you through the maneuver. They are a little difficult to find but depending on where you are you might find an ENT with one – I don’t think the company that makes them is in business anymore – so again, might be hard to find.

    Finally, there is another maneuver (still need to turn your head, but at least you don’t need to extend your neck) called the Semont Maneuver. It is basically as effective as the Epley. see:

  8. beth Marcus

    I just developed vertigo, ( dizziness & spinning ). Went to the neurologist, but he could not manuver my head because I have a metal plate in the back of my neck from cervical surgery. Any suggestions for relief ?

  9. karen Beckingham

    I have had vertigo twice the doctor put me on prochlopera zine this episode had lasted 2 weeks and I get dizziness and loose my balance what should I do

  10. karen

    I have had vitigon twice and when I lay in bed is worse , if I put my head to the left the room spin if I get upto quick the room spin also get ringing in both ears I have had this episode for two weeks now and tablets don’t seem to be working .what can I do

  11. NZ

    i had this problem of bppv and severe spinning and vomitting .i was admitted in hospital and treated. two three days after coming home i again had same problem and was admitted again. how could i ensure that this will not be severe ao much in future

  12. Renee Graham

    I was diagnosed with BBPV on a Sunday Morning. I woke up spinning. I felt like I was on a merry-go-round. Spinning out of control. Went to the medac center, but couldn’t get out the wheelchair to the examing table. The MD called the EMS to come pick me up. Once at the ER, i was given a cat scan. Thank the Lord there wasn’t any stroke noticed. Anyway after being prescribed Valium and Metlizim was sent home, still spinning. For 4 1/2 days I took the medicine, slept, took the medicine, slept and still continued to spin the entire time . I never got nauseated but couldn’t walk straight for nothing. Had to hold on to the walls, and anything else just to make it to where I needed to go. My best friend suggested I call my primary Dr. To get a referral to another specialist. So, on the 4th day I was referred to an ENT, upon arriving at the office, he checked my eyes. Confirmation affirmed. He placed me in the dark, OMG! Dizzy city, when he flicked the lights back on. Next step he placed me on a table and did several excercises, which tested my nerves. He tossed me, turned me, did all but flipped me upside down. Yes, I was dizzy as ever. But when he finished I could instantly feel the relief. It’s taking me a minute to get over this hangover feeling, but it’s better than the ‘drunk’ feeling. I’ve only had one more slight episode since, the maneuver,but it only lasted like 2minutes. My struggle is i cannot bend my head down to pick anything up off the floor and no sudden head movements. Also, I have to rise very slowly when getting off the bed, also. But best believe I’m way better than I was. Have faith it will get better. I’m on my 6th day. Not completely back to normal, but feel the progress. Find a certified ENT (ear,nose, and throat doctor)

  13. Shilpa soni

    I am suffering of bppv from last two months last month I was filling like spinning when I gone to bed this process was continue next two three days after that the whole month l was filling dizziness now I am in depration it will be cure or not. I have taken treatment from ent.

  14. Lina

    Hi, there I want to tell you look up Vertigo exercise do it at least twice a week only don’t over do it. what I did was lay down on right side lay down half way looking ceiling for like count to 30 and get up slowly and then go left repeat again than sit like 10 minutes close eyes and then sit up straight than, look to left than right 10 times each side not to fast. than look 10 times angle up down both left than right than stop close eyes like for a min. do this twice a week see what your feeling and if it helps you it helped me . I hope this helps thank u god bless I am in the same situation.

  15. Lina

    I went o doctor told me an ,Inner middle ear infection . told me take antibiotics ok I notice blurry vision a lot .and also dizziness looking up. and what I learn don’t look up and look up the vertigo exercise . and do it helps a lot you get back on tract sleep at least 8 hours a day. drink lots of water and get up slowly and don’t bent down unless feel up to it I been doing this but my daughter said make sure not diagnose Meniere’s disease .You can get hearing loss other problems. also sleep bad ear rotate on ears get up slowly sit bed get up. Do the same couch and you get better,\. may god help you and this I put I learn thank u.

  16. Clearwater Clinical

    That’s a tough one that should probably be best answered by your own physician. Many people prefer not to drive while having BPPV, certainly it is impossible to drive when you have active vertigo like with Meniere’s disease.

  17. Don Styles

    Recently diagnosed with BPPV, Is it prudent to drive?

  18. khalid

    I hv tinitis from 2006 but now I am also suffering Vertigofrom last 3 months I had 3 severe attack of head spinning 2 times fall down.Now spinning has stope but always feel dizziness &my main problem is that I hv severe pain in my legs even can’t walk.please suggest something for my Legs

  19. Rkn

    So if you went for a month with positional vertigo didn’t know what going on first thought the problem was diabetic due to blurry. Vision double vision went doctor sugar was high never had this before so u til other day thought dizzy would go away after regulate the sugar problem so how long this vertigo might last so stop being dizzy it not spinning dizzy more off balance

  20. Clearwater Clinical

    Sadly the feeling you get after an episode of BPPV just has to wear off. I find that the faster you treat BPPV (the fewer episodes you have during any one period) the shorter the duration of recovery. So I mean that if you get up in bed and have BPPV then do the Epley maneuver right then, then go back to bed for a few hours. Wake up again and usually I find that things are much better. However, taking meds and staying in bed is not a good compensatory strategy once you have recovered from the initial episode. Moving around and moving your head, will help you brain get back to normal. Good luck.

  21. Suzy

    I had my 1st episode of ‘bv’ about 5 yrs ago. I had just gone to bed when suddenly my head felt like it was spinning, then dizziness & nausea joined in. I went into a cold sweat, vomiting, the dizziness lasted for 7 hrs. I ended up lying on the floor fearing I was going to fall off the bed. I clutched my fingers into the floor because it felt like I was going to spin off & fly away. This episode took a few days to settle. The other day it happened again while I was out in my front garden. I felt a dizzy spell come on & felt light headed. I had to sit & lean against the wall for support. I couldn’t stand up or walk & the only way I could get back inside was to crawl back & drag myself in. After vomiting & rest it seems to have settled. It’s been 3 days now & the dizziness has stopped but I still feel unsettled, what can I do to control this?

  22. Clearwater Clinical

    Thanks for the comment.

    The risk of ‘moving from 1 chamber to another’ is low, and even in the even of this happening it is usually brief (although intense).

    Most people prefer to have the Epley and get rid of BPPV (for years if not completely), rather than live with it. If you do nothing it will persist for weeks to months to years. If you do the Epley it will mostly likely go away quickly. You can do it at home if you like with DizzyFIX of with your ENT physician or vestibular physiotherapist.

    In most cases you should not have to “live with it”

    Make sure to discuss any plans with your own physician.

    Good luck.

  23. Alex Smith

    Had this for around year. Went away by about 75%. But always in the background. Had the manoeuvre done. But risk moving from one camber to the other. You just live with it now.

  24. Clearwater Clinical

    Thanks for the comments. BPPV is easy to treat in most cases. I would seek someone who has experience like an ENT or a neurologist who specializes in vertigo. If you have BPPV then discuss an Epley maneuver or home treatment with DizzyFIX with your physician.

  25. Mishka

    I was just diagnosed with bppv, I had a very scary attack last Saturday late at night, dizzy and nauseated. Finally after 3 er visits and someone to listen got told what it was, now just hopping it goes away soon,

  26. sandy

    Hello fellow dizzies , I have been dealing with this for 3 years! I am constantly looking for answers , I have bppv but also am dizzy 24 hours a day , then go into attacks , anyone else have this ? I have seen many drs no answers other than possible meniers or possible MAV and also BPPV

  27. Clearwater Clinical

    Quick answer – yes and no.

    Long answer – No BPPV and tinnitus are not causally related. However, BPPV can often ride along with other forms of vertigo like meniere’s disease, which is associated with tinnitus and hearing loss. So yes you can have tinnitus and BPPV and they often occur together but they are not related from a disease standpoint.


  28. judi

    Is tinnitus connected to BPPV?

  29. judi

    I have been diagnosed with BPPV but also suffer from tinnitus. Are the two connected?

  30. Clearwater Clinical

    Dizziness looking down is not BPPV. However, BPPV can be very recurrent. If you have recurrent BPPV in the posterior canal then the DizzyFIX might be a nice way to treat it at home. Usually horizontal (lateral) canal BPPV is short lived but quite intense.

  31. JS


    I’ve been treated for BPPV twice in the past two months using the barbecue roll (or something to that effect), but the keeps returning. How often does this recur typically? Is there anything else I should/could be doing? Also, the ENT said my rocks (my word. Forgot what they called it) were in one area–apparently a less than typical area–lateral canal, maybe? Is it possible to have issues in other canals and that maybe that is why I continue to have issues? And if so, how would I deal with these? Also, I had nystagmus on the down gaze and notice I tend to feel dizzy when I look down (head in same position but eyes shifted downward, like when reading). Is there a way to solve this?


  32. Clearwater Clinical

    Thanks for your comments. Can you clarify what you mean by “dizzy”, do you mean spinning dizziness or just off balance? It is common to have an “off balance” feeling after a correct BPPV treatment maneuver which lasts weeks. However, if you still get dizzy with turning when laying down then you may not have complete resolution and could benefit from a second manevuer. You may also have a different diagnosis. It may be worth clarifying with you own doctor. Depending on what you do for you work don’t put yourself at risk if you feel dizzy (ie no ladders etc)

  33. devona

    Bart, thanks for the info. Did u go to work w/these symptoms? I’ve been going though this for 2 wks & 3 days I feel better at times when I’m just sitting Watchn tv then I get up & there if goes my doctor did the movements it help a little bit but I’m still dizzy. Help…

  34. admin

    That’s a very interesting situation and not all that uncommon. The answer is yes it is possible to have both. Unfortunately BPPV is a side effect of any injury to the ear. That injury may be as simple as ongoing age, but also can be due to head trauma, infections or other ear diseases like Meniere’s. Vertigo and dizziness that lasts longer than a minute or so is not BPPV. Other possibilities include a “Fistula” which causes hearing loss and vertigo intermittently. There are treatments for all of these which in some cases include surgery or injections of medication into the ear. Vertigo can be a difficult problem so it is important to seek local diagnosis and treatment. If your local ENT can’t help then find a “neurotologist” – who is a specialized ENT dealing with the inner ear. Regards.

  35. Bart Wiley

    Can bppv last for a year, I’m tryn to figure out if I have meniers it bppv it seems like I have some symptoms of both , I feel pressure in my head, but on other hand my eyes twitch or bounce when ever I put my head in a onward position it’s weird I have attacks that come about every 5 days I’ll be dizzy for about 3 days straight both some realy bad attacks in those three days then it will leave an come right back again , it’s been doing this for about a year now , if u have any suggestion about my diagnosis I would be greatfull my ENT can’t seem to help me out

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