What Are the Five Signs of BPPV?
Dr. Carly Clevenger••6 min read
Learn the five common signs of BPPV — short, position-triggered spinning, nausea, morning onset, and lingering unsteadiness — so you can seek accurate diagnosis and effective repositioning treatment.
Have you ever rolled over in bed and suddenly felt like the entire room was spinning out of control? Or maybe you bent down to tie your shoe and stood up to a wave of dizziness that made you grab the nearest wall?
If this sounds familiar, you're not alone.
BPPV (benign paroxysmal positional vertigo) is the most common cause of peripheral vertigo, affecting about 2.4% of people at some point in their lives [1]. And here's the thing: it often shows up in the most ordinary moments of your day.
But here's the truth: recognizing the signs early can help you get the right treatment faster and get back to living without fear of the next dizzy spell.
The Five Telltale Signs of BPPV
BPPV has a pretty distinct pattern. Once you know what to look for, the pieces often fall into place.
1. Sudden Spinning Sensation With Head Movement
This is the hallmark of BPPV. You move your head in a certain way and boom — the world starts spinning.
It's not a vague lightheadedness. It's a rotational vertigo that feels like you or the room is moving when nothing actually is.
Common triggers include:
• Rolling over in bed (especially first thing in the morning)
• Looking up at a high shelf or the ceiling
• Bending forward and then standing back up
• Tipping your head back at the salon or dentist
If your dizziness is tied to specific head positions, that's a major clue.
2. Brief Episodes (Usually Less Than a Minute)
BPPV episodes are short. Most last anywhere from a few seconds to under a minute [2].
That doesn't mean they're not terrifying. But the brevity is actually one of the key distinguishing features.
If your vertigo lasts for hours or days without stopping, it's likely something else. BPPV comes in waves, triggered by movement, and then settles down when you hold still.
3. It Happens When You Get Up From Bed
This is one of the most common complaints we hear: 'I wake up fine, but the second I sit up or roll over, everything spins.'
Research shows that rolling over in bed is one of the most reliable predictors of BPPV [2]. It's often the first movement of the day that sets it off because your inner ear has been still all night.
And that morning spin? It can set the tone for your entire day, making you anxious about every head turn.
4. Nausea (But Not Always Vomiting)
The spinning sensation often brings a wave of nausea with it. Your brain is getting mixed signals from your inner ear and your eyes, and your stomach doesn't like it.
Some people feel mildly queasy. Others feel like they might throw up. It varies from person to person and episode to episode.
But here's what's important: the nausea usually fades as the vertigo does.
5. Feeling Unsteady or 'Off' Between Episodes
Even when you're not actively spinning, you might feel a lingering sense of imbalance or unsteadiness.
You're more cautious when you walk. You avoid certain movements. You feel like you're not quite yourself.
This is especially common in older adults, who may experience more prolonged unsteadiness rather than brief vertigo spells [3].
It's frustrating because you're not 'dizzy' in the classic sense, but you don't feel safe or confident in your body either.
Why These Signs Matter
BPPV is caused by tiny calcium crystals in your inner ear that have moved into the wrong place. When you move your head, these crystals shift and send false signals to your brain about motion.
The good news? BPPV is highly treatable.
But only if it's correctly diagnosed.
Too often, people are told their dizziness is just anxiety, dehydration, or something they have to live with. And that's simply not true.
When you recognize these five signs, you can advocate for yourself and seek out a provider who understands vestibular disorders.
What BPPV Is Not
Let's clear up some confusion.
BPPV is not:
• Constant dizziness that never goes away
• Vertigo that happens without any head movement
• Associated with hearing loss or ringing in the ears (that's more typical of Meniere's disease)
• Accompanied by neurological symptoms like slurred speech, vision changes, or weakness (those require immediate medical attention)
If your symptoms don't fit the BPPV pattern, that doesn't mean they're not real. It just means we need to dig deeper to find the true cause.
When Should You Get Help?
If you're experiencing any combination of these five signs, don't wait.
BPPV doesn't usually go away on its own. In fact, about 56% of people experience recurrent episodes [1]. The longer you live with it, the more it impacts your quality of life.
You start avoiding activities. You feel anxious about driving or being alone. You lose confidence in your body.
And you don't have to.
We specialize in diagnosing and treating vestibular disorders like BPPV. Through specific positional testing, we can identify exactly which ear and which canal is affected. And then we use targeted repositioning maneuvers to move those crystals back where they belong.
Most people feel significantly better after just one or two sessions.
You're Not Imagining This
If you've been told your dizziness is 'all in your head' or that you just need to relax, let us be clear: your symptoms are real.
BPPV is a mechanical problem with a mechanical solution. It's not about anxiety or stress, even though those things can certainly make it worse.
You deserve answers. You deserve to feel steady and confident again.
And we're here to help you get there.
If you're experiencing the signs of BPPV, don't wait for it to get worse or hope it goes away on its own. Give us a call, and let's figure out exactly what's going on. You deserve to live without the fear of the next spin.
We do more than treat symptoms — we listen, dig deep, and help you understand what's really going on. Through expert care, honest guidance, and a whole lot of support, we help you move from feeling overwhelmed to steady, confident, and back in control.
References
[1] von Brevern M, et al. Epidemiology of benign paroxysmal positional vertigo: a population based study. Journal of Neurology, Neurosurgery & Psychiatry. 2007. https://pmc.ncbi.nlm.nih.gov/articles/PMC2117684/
[2] Luryi AL, et al. Two Symptoms Strongly Suggest Benign Paroxysmal Positional Vertigo. Frontiers in Neurology. 2021. https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2020.625776/full
[3] Oghalai JS, et al. Best practice assessment and management of benign paroxysmal positional vertigo. Age and Ageing. 2025. https://academic.oup.com/ageing/article/54/8/afaf225/8236556
