I get flare-ups of this a few times a year. Once it was triggered by being in a yoga class and, doing a twist lying down, we were instructed to turn our head to look at the opposite hand. I felt the world unzip itself and everything went swimmy. It resolved in just a few seconds, but because of that I never turn my head in that position anymore.
I've had a full workup by an ENT on what causes it, and he was fully convinced it's just BPPV and my crystals being prone to dislocation. Epley maneuvers for a day or two almost always fix it right up. It's now been a while since it's happened, but having that reassurance and knowing exactly what it is has comforted me that if I have another flare-up, it's not something to be duly concerned about.
Sometimes I'll feel it sort of threatening to come on, and I do one set of Epleys on each side and it kind of staves it off.
Other than being mindful of my head position when lying down, I still work out and even do yoga and inversions, but just very carefully. At this point, I've almost completely pinpointed the specific positions that bring it on. I will say that I theorize that doing a FULL range of movement and exercise kind of acts as pre-emptive Epleys in a way, so unless you feel like your vertigo stays spinning longer than a few seconds or impairs walking and driving, you can probably safely do almost anything you want, just carefully.
In my case, I think several falls over time (one in very early childhood, one in elementary school, one in my early 30s, and one about two years ago) cumulatively worked to dislodge my crystals. While I was not seriously injured in any of these falls, they all involved some head trauma that wasn't bad enough to even cause a concussion but were significant enough that I still remember all four of them (nothing wacky happened; the first I tripped at day care, the second a friend and I were horsing around on a playground and I fell; the third I accidentally banged my forehead on a fireplace mantel that proved to be extremely hard; and the most recent one I tripped over a laundry basket in the middle of the night and faceplanted on my carpeted bedroom floor). Again, didn't even have a concussion from any of them, but I think that is plenty to have damaged these delicate dumb little rocks in my head.
Some things to remember about BPPV when it flares up:
1) It WILL resolve itself so long as you take the time to do Epleys carefully and correctly. Do them on the affected side three times a day for at least three days, and you should experience relief by the time the last day comes.
2) Try to slightly elevate your head when you sleep. If your pillow is very flat, get a fluffier one or double up.
3) Be careful when you roll over in bed. Try to prop yourself up a little and go slowly and carefully so you don't trigger an attack.
4) Go up and down stairs very slowly and carefully.
5) Be careful about turning your head too quickly, even when standing up.
If Epleys alone don't resolve it, your situation might be a little bit more serious. If you haven't already gotten a consult from an ENT, do so. Mine was great. I got a CAT scan, too, to make sure that it wasn't something worse, which was very reassuring.
Sometimes BPPV is accompanied by other ear issues, such as tinnitus and hearing loss. Mindfulness has been shown to be helpful with both. Get into a meditation practice to reduce stress.
Finally, make sure it's really BPPV and not Meniere's Disease, as the symptoms can be similar. Meniere's is not necessarily anything to be too concerned about, but Epleys many not be as effective in reducing the vertigo.
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