Can you Prevent the Return of BPPV?

Benign Paroxysmal Positional Vertigo (BPPV) is one of the most common causes of dizziness. Although it’s not dangerous, it can be extremely unsettling and disruptive to daily life. The good news is that treatments such as the Epley manoeuvre often provide rapid relief — sometimes within minutes.

However, for some people, BPPV can return. While recurrences aren’t always avoidable, a few simple habits and strategies may help reduce the chances of experiencing another episode. Here are some practical, physiotherapist-approved tips to support long-term vestibular health.

Move Your Head Slowly and Deliberately

Sudden movements are one of the most common triggers for BPPV symptoms. Being mindful of how you move your head can make a real difference.

Try to:

  • Avoid quick, jerky head turns

  • Move gently when leaning forward

  • Take your time when rolling over in bed or sitting up

Even small changes in the way you transition between positions can help decrease dizziness and reduce irritation to your vestibular system.

Adjust Your Sleeping Habits

How you sleep can influence BPPV symptoms. Many people benefit from:

  • Sleeping on their back with their head slightly elevated

  • Using an extra pillow or two for gentle support

  • Avoiding the side where BPPV symptoms typically occur

  • Choosing a pillow that keeps the neck supported without excessive bending

These adjustments can minimise the chances of crystal displacement during the night.

Incorporate Balance Exercises

Strengthening your balance system can make your body more adaptable to positional changes. You don’t need anything complicated — simple exercises work well:

  • Standing on one leg (with support close by)

  • Heel-to-toe walking

  • Gentle yoga or tai chi

  • Slow, controlled head-turning movements (when not in an acute BPPV episode)

These activities help your brain and muscles coordinate more effectively, giving you greater stability and confidence throughout the day.

Limit Prolonged Upward Head Positions

Keeping your head tilted back for long periods — like when reaching on high shelves, painting ceilings, or doing overhead tasks — can sometimes aggravate BPPV.

If you need to work above head height, try breaking up the task:

  • Take regular pauses

  • Bring your head back to a neutral position

  • Let your vestibular system “reset” before continuing

Manage Everyday Stress

While stress doesn’t cause BPPV, it can make symptoms feel more intense or harder to control. Supporting your general wellbeing can help your body stay more stable.

Useful stress-management tools include:

  • Deep breathing

  • Stretching

  • Mindfulness or meditation

  • Relaxed walking

  • Light physical activity

A calmer nervous system often means a steadier balance system.

Stay Moderately Active

Regular movement keeps your vestibular system healthy and responsive. Aim for gentle, consistent activity such as:

  • Walking

  • Low-impact exercise

  • Mobility routines

  • Gentle stretching

Too little movement can reduce your balance resilience, while overexertion may aggravate symptoms. A middle-ground approach works best.

Stay Connected With Your Vestibular Physiotherapist

If you’ve experienced BPPV before, maintaining occasional contact with your vestibular physiotherapist can be incredibly valuable. They can:

  • Reassess your symptoms if anything feels different

  • Provide a tailored prevention strategy

  • Perform repositioning manoeuvres if needed

  • Guide you through vestibular strengthening exercises

Early intervention often means quicker relief and fewer disruptions to daily life.

Final Thoughts

Managing BPPV isn’t just about treating dizziness when it occurs — it’s also about adopting small lifestyle habits that support your vestibular system and reduce the chances of recurrence. With mindful movement, better sleep positioning, gentle exercise, and ongoing support from your physiotherapist, you can feel more steady, confident, and in control.

If you suspect BPPV, don’t wait: early evaluation and treatment often make all the difference. At Head2Toe, our expert physiotherapists are here to help you get back to optimal function.

Our Physiotherapists have a variety of post graduate specialisations. If you or anyone you know, would like to have a physiotherapy assessment with the team at Dorking , Leatherhead or Crawley , book online here or contact us here.

Blog post guest written by James Johnson, Physiotherapist, Dorking Clinic.

h2t-Team-James Johnson