How do I perform the Epley maneuver at home?

From the Guidelines

To perform the Epley maneuver at home, start by sitting on your bed with a pillow behind you, turn your head 45 degrees toward the affected ear, and quickly lie back with your shoulders on the pillow, holding this position for 30 seconds or until dizziness subsides, as recommended by the most recent guidelines 1. The Epley maneuver is a series of movements that can be done at home to treat benign paroxysmal positional vertigo (BPPV), which causes brief episodes of dizziness when you move your head.

• Begin by sitting on your bed with a pillow behind you that will be under your shoulders when you lie down.
• Turn your head 45 degrees toward the affected ear (the side that causes dizziness).
• Quickly lie back with your shoulders on the pillow, head reclined, and still turned 45 degrees.
• Hold this position for 30 seconds or until dizziness subsides.
• Next, without raising your head, turn it 90 degrees to the opposite side and hold for another 30 seconds.
• Then, roll your body to that same side while keeping your head in position, so you're looking at the floor, and hold for 30 seconds.
• Finally, slowly return to a sitting position and remain still for a few minutes. This maneuver works by moving displaced calcium carbonate crystals from the semicircular canals back to the utricle in your inner ear where they belong, resolving the cause of vertigo, as supported by the updated clinical practice guideline 1. It is essential to note that patients with physical limitations, such as cervical stenosis, Down syndrome, severe rheumatoid arthritis, cervical radiculopathies, Paget’s disease, morbid obesity, ankylosing spondylitis, low back dysfunction, retinal detachment, and spinal cord injuries, may not be candidates for this maneuver or may need specialized examination tables for performance of the maneuver, as stated in the clinical practice guideline 1. You may need to repeat this daily until symptoms resolve, but stop if vomiting or severe symptoms occur and consult a healthcare provider, as self-administered CRP (Epley) has been shown to be effective in treating BPPV, with a 95% resolution of positional nystagmus 1 week after treatment 1.

From the Research

Epley Maneuver Home Instructions

To perform the Epley maneuver at home, follow these steps:

• Start by sitting on a bed with your legs extended in front of you 2
• Turn your head to the right at a 45-degree angle 3
• Lie down on your back with your head still turned to the right, and hold this position for 30 seconds 2
• Without turning your head, roll onto your left side and hold for 30 seconds 2
• Sit up and turn your head to the left at a 45-degree angle, then lie down on your back again with your head still turned to the left 3
• Repeat the process on the other side if necessary 2

Important Considerations

• It is essential to have adequate instruction to obtain a good result when performing the self-Epley maneuver at home 4
• Video-sharing media, such as YouTube, can be a useful resource for learning the Epley maneuver, with many accurate video demonstrations available 5
• However, it is crucial to ensure that the video instructions are accurate and reliable 5

Effectiveness and Safety

• The Epley maneuver has been shown to be a safe and effective treatment for posterior canal benign paroxysmal positional vertigo (BPPV) 6, 2
• Studies have reported a high success rate for the Epley maneuver, with up to 90% of patients experiencing complete resolution of vertigo symptoms 6, 4
• Adverse effects are infrequently reported, with no serious adverse effects of treatment noted in the studies reviewed 6