Dizzy when you roll over in bed?
If the room spins for under a minute when you roll over, lie down or look up, there is a specific and very treatable cause worth ruling in or out.
The pattern that matters
The distinctive thing about BPPV — benign paroxysmal positional vertigo — is that it is triggered by a change in head position, and it is brief.
Rolling over in bed, lying down, sitting up, tipping the head back to hang washing or look in a high cupboard. The spinning is intense, and it typically settles within a minute if you keep still.
Dizziness that is constant, or that comes with hearing loss, severe headache, double vision, weakness, numbness or difficulty speaking is a different matter entirely and should be seen by a doctor promptly.
Why it happens
The inner ear contains tiny crystals that normally sit in one chamber and help sense gravity. In BPPV, some of them move into one of the semicircular canals, where they do not belong.
When you move your head, they shift and send the brain a strong but wrong signal about movement. The eyes respond to that false signal, and the room appears to spin.
How it is assessed
Assessment involves moving your head into the position that provokes it, while watching your eyes. The characteristic eye movement that follows tells the clinician which ear and which canal is involved.
It is uncomfortable for a few seconds, and it is the reason a diagnosis can usually be made in the room rather than needing a scan.
How it is treated
Treatment is a sequence of specific head and body position changes designed to move the crystals back where they belong. It is done in the clinic and takes a few minutes.
It does not work for every type of dizziness, which is exactly why the assessment comes first. Where balance has been affected for a while, some retraining work usually follows.
General information only, and not a substitute for individual advice. If something is worrying you, see your GP or book an assessment.