Health

The method (for the left side) is performed as shown in the figure below. One stays in each of the supine (lying down) positions for 30 seconds, and in the sitting upright position (top picture) for 1 minute. Thus, one cycle takes 2.5 minutes. Typically three cycles are performed just prior to going to sleep. It is best to do them at night rather than in the morning or midday, so that if one becomes dizzy following the exercises, then it can resolve while sleeping. The mirror image of this procedure is used for the right ear. 

There are several problems with the “do it yourself” method. If the diagnosis of BPPV has not been confirmed, one may be attempting to treat another condition (such as a brain tumor or stroke) with positional exercises. This is unlikely to be successful and may delay proper treatment. A second problem is that the home-Epley requires knowledge of the “bad” side. Sometimes this can be tricky to establish. Although complications, such as having the crystals drift into another canal, are rare with the Epley, they can occur. These complications are better handled in a doctor's office than at home.

Finally, occasionally during the Epley maneuver neurological symptoms are provoked due to compression of the vertebral arteries. In our opinion, it is safer to have the first Epley performed in a doctor’s office where appropriate action can be taken and the diagnosis can be confirmed.