What to Do for Vertigo at Home: Exercises and Tips

The single most effective thing you can do for vertigo at home depends on what type of vertigo you have, but for the most common kind, a self-administered repositioning maneuver performed on your bed can resolve symptoms within days. Benign paroxysmal positional vertigo, or BPPV, accounts for a large share of vertigo cases and responds remarkably well to specific head-and-body movements you can learn and repeat at home. For other causes of vertigo, different exercises and lifestyle adjustments can meaningfully reduce how often episodes strike and how disabling they feel.

Why BPPV Responds to Home Exercises

BPPV happens when tiny calcium carbonate crystals called otoconia break loose inside your inner ear and drift into one of the semicircular canals, where they do not belong. When you move your head, these stray crystals shift with gravity and send false signals to your brain about your body’s position, producing that characteristic spinning sensation. The brief delay before the room starts spinning, typically a second or two after you change position, is explained by the time it takes for the crystals to move through a wider chamber and enter the narrower canal duct, where they actually disturb fluid flow.¹ The good news is that if the crystals got in, they can be guided back out. That is exactly what repositioning maneuvers do: a precise sequence of head positions uses gravity to march the crystals out of the canal and back into the chamber where they are harmless.

The Self-Epley Maneuver

The Epley maneuver is the most studied and widely recommended repositioning technique for posterior canal BPPV, which is the most common form. A clinician typically performs it in the office, but you can do a self-administered version at home with comparable results. In a randomized controlled trial comparing the clinician-performed Epley to a twice-daily self-Epley done at home, about 91% of the self-Epley group and 88% of the clinician-Epley group were cured after one week, with no meaningful difference between the two.²

Here is roughly how the self-Epley works for the right ear (reverse all directions for the left ear):

Starting position: Sit on the edge of your bed with a pillow placed so it will land under your shoulders when you lie back. Turn your head 45 degrees to the right.
Lie back quickly: Drop back so your shoulders hit the pillow and your head hangs slightly over the edge of the bed, still turned 45 degrees right. Wait 30 seconds or until any dizziness stops.
Turn your head left: Without lifting it, rotate your head 90 degrees so you are now looking 45 degrees to the left. Wait another 30 seconds.
Roll onto your side: Turn your head another 90 degrees to the left and roll your body to match, so you are lying on your left side with your head facing somewhat downward. Wait 30 seconds.
Sit up slowly: Push yourself up from the side-lying position and remain seated for a minute.

The maneuver often needs to be repeated. In one trial of the traditional Epley, about 61% of patients were symptom-free after the first attempt, and nearly all were clear after two or three rounds.³ Doing the self-Epley twice a day, as in the trial above, gives the crystals multiple chances to clear the canal. If your vertigo does not improve after a week of home attempts, see a clinician, because you may need a supervised version or a different maneuver altogether.

The Half Somersault as a Gentler Alternative

If the Epley feels too intense, too nauseating, or too difficult because of neck or back problems, the half somersault maneuver offers an alternative that some people find easier to tolerate at home. Instead of lying flat and hanging your head backward, you start on your hands and knees, tip your head forward toward the floor (like a partial somersault), then rotate your head toward the affected ear and raise it to back level before sitting upright.

The half somersault has a slower initial success rate than the Epley. In one head-to-head comparison, about 35% of half-somersault patients resolved on the first attempt compared to 61% for the Epley, and more patients in the half-somersault group required three or four repetitions.³ However, the picture gets more interesting over time. A separate study found that while the Epley worked faster initially, the half somersault group experienced fewer treatment failures over a six-month follow-up period, and patients reported significantly less dizziness during the maneuver itself.⁴ The practical takeaway: if you can handle the Epley and want the fastest relief, start there. If it makes you too dizzy or you have trouble lying flat, the half somersault is a reasonable trade-off that may work especially well over the longer term.

What About Brandt-Daroff Exercises?

Brandt-Daroff exercises are the home exercise that gets prescribed most broadly. They involve sitting on the edge of a bed, then quickly lying to one side with your head tilted up at a 45-degree angle, holding for 30 seconds, returning to sitting, and repeating on the opposite side. You do five repetitions on each side, typically two or three times a day. They are simple and do not require you to know which ear is affected, which is their main advantage.

Their main disadvantage is that the evidence for posterior canal BPPV, the most common type, is not very convincing. A systematic review of randomized controlled trials found that Brandt-Daroff exercises do not significantly reduce symptoms or speed recovery compared to repositioning maneuvers like the Epley or Semont.⁵ This does not mean they are useless. They may help with habituation, gradually reducing the brain’s sensitivity to the abnormal signals, and they could serve as a reasonable fallback if you cannot perform the Epley or half somersault. But if you have a choice, a targeted repositioning maneuver is the stronger bet.

One area where modified Brandt-Daroff exercises may earn their keep is horizontal canal BPPV, a less common variant where the crystals enter a different canal. Standard Brandt-Daroff movements were never designed for horizontal canal involvement, but researchers have shown that a lateral modification, where you perform the side-to-side movements while keeping your head turned in specific directions, can effectively treat this variant.⁶ This is worth knowing because horizontal canal BPPV can sometimes appear as a complication of treating the posterior canal form.

Gaze Stabilization for Other Types of Vertigo

Not all vertigo comes from loose crystals. If your vertigo stems from vestibular neuritis, labyrinthitis, or another condition that has damaged vestibular function on one side, repositioning maneuvers will not help because there is nothing to reposition. For these situations, vestibular rehabilitation exercises, especially gaze stabilization, form the backbone of home treatment.

Gaze stabilization exercises train your brain to keep your vision steady during head movement, compensating for the weakened vestibular signal. The basic version is straightforward: hold a business card or your thumb at arm’s length, focus on a letter or word, and turn your head side to side (or up and down) while keeping the target in focus. You start slowly and gradually increase speed over days and weeks. These exercises are a mainstay of vestibular rehabilitation programs and are prescribed to improve the vestibulo-ocular reflex, reduce dizziness during movement, and sharpen visual clarity when the head is not still.⁷

Consistency matters more than intensity here. Most protocols call for a few minutes several times a day rather than one long session. The exercises should provoke mild dizziness; if they do not, you are not challenging your vestibular system enough. If they make you severely nauseated or unsteady, you are pushing too hard. It typically takes weeks of daily practice before you notice a clear improvement.

How You Sleep Can Make a Difference

Sleep position is one of those details people rarely think about, but for BPPV it turns out to be surprisingly relevant. In a study tracking recurrence after a successful repositioning maneuver, patients who slept on the affected side had a recurrence rate of about 31%, meaningfully higher than those who slept in other positions.⁸ Sleeping with the treated ear facing up, or on your back, appears to reduce the chance that crystals migrate back into the canal.

For people with stubborn, recurrent BPPV that keeps coming back despite successful treatments, sleeping with the head elevated may offer additional protection. A six-month randomized trial compared patients who slept with their heads elevated to those who slept flat. By the six-month mark, nystagmus (the involuntary eye movement that signals active BPPV) had disappeared in about 86% of the head-up group compared to 50% of the flat-sleeping group.⁹ You can achieve this with a wedge pillow or by raising the head of your bed slightly. It is a low-effort change that may meaningfully reduce how often BPPV returns.

Diet and Lifestyle Tips for Ménière’s-Related Vertigo

If your vertigo comes from Ménière’s disease rather than BPPV, the home strategies shift. Ménière’s involves abnormal fluid pressure in the inner ear, and dietary adjustments are typically the first intervention recommended. A low-salt diet is the most common recommendation, along with reducing alcohol and caffeine intake.¹⁰ The rationale is that sodium promotes fluid retention, which can worsen the pressure imbalance in the inner ear.

The evidence for dietary restriction is not as strong as many patients assume. There is no firm consensus on how well it works, and the studies that exist are a mixed bag. That said, a recent study found that combining a low-sodium diet with adequate water intake led to better improvements in hearing, balance, and handicap scores compared to treatment without the dietary component.¹¹ The water piece is worth highlighting: some people hear “low salt” and reduce both salt and fluids, but adequate hydration appears to be part of what makes the strategy work. As a practical guideline, most recommendations suggest keeping sodium under 1,500 to 2,000 milligrams per day, which is substantially less than what most people eat.

Preventing Falls While Managing Vertigo at Home

Vertigo-related falls are a real and underappreciated risk, especially if you are doing exercises that intentionally provoke dizziness. A large study of over 500 dizzy patients found that fall rates varied dramatically by the underlying condition. Patients with central balance disorders had the highest fall rates, with over half being recurrent fallers. Among those with bilateral vestibular failure or peripheral nerve problems, about 30% were recurrent fallers.¹²

When performing repositioning maneuvers at home, do them on your bed rather than on the floor. Have someone nearby the first time you try. Clear the area around the bed of hard-edged furniture. If you get up at night, take a moment sitting on the edge of the bed before standing, and use a nightlight so you are not navigating in total darkness, which forces your already-compromised vestibular system to work harder.

When Home Exercises Are Not Enough

Home management works well for straightforward BPPV, but certain signs mean you should stop the home exercises and see a doctor. Vertigo that comes with new hearing loss, double vision, slurred speech, difficulty swallowing, or limb weakness could signal something more serious, including stroke. Emergency guidelines emphasize that distinguishing a peripheral cause like BPPV from a central cause like a brainstem stroke often requires clinical examination techniques that are difficult to perform on yourself.¹³ Certain patterns of involuntary eye movement, such as purely vertical or torsional nystagmus, strongly suggest a central cause and warrant urgent evaluation.¹⁴

A more benign but confusing complication is canal switching, where a repositioning maneuver successfully clears crystals from one canal but inadvertently pushes them into another. This happens in a small percentage of Epley maneuvers, roughly 1% to 8% depending on the study.¹⁵ The telltale sign is that your vertigo changes character after a maneuver: the spinning is triggered by different head movements than before, or the direction feels different. Canal switching is not dangerous, but it means you now need a different maneuver to clear the new canal, and identifying which canal is involved generally requires a clinician.

The Anxiety-Vertigo Feedback Loop

Vertigo and anxiety have a bidirectional relationship that complicates home management in ways people do not always expect. Among patients who seek help for dizziness, rates of panic disorder are five to fifteen times higher than in the general population.¹⁶ The relationship runs in both directions: vestibular dysfunction can trigger panic attacks, and panic disorder can produce significant dizziness even when the vestibular system is structurally intact.

This matters for home management because anxiety about triggering vertigo often leads people to avoid the very movements that would help them recover. If you have BPPV and dread rolling over in bed, you might unconsciously keep your head rigidly still, which slows habituation and keeps you more sensitive to small movements. Controlled breathing, progressive muscle relaxation, and gradually increasing your movement repertoire can help break this cycle. Some vestibular rehabilitation programs explicitly include anxiety management alongside the physical exercises, recognizing that treating the balance problem without addressing the fear response often gives incomplete results.

Using Apps to Stay on Track

One of the biggest challenges with home vestibular exercises is doing them correctly and consistently when nobody is watching. Researchers have begun testing gamified apps that guide users through gaze stabilization and balance exercises using the phone’s sensors to track head and body movement. A study of one such app found that when participants used it, they performed vestibulo-ocular reflex exercises closer to the prescribed frequency and with more consistent body motion during balance tasks compared to doing the same exercises without guidance. Participants also reported finding the game-based format more motivating than standard exercises.¹⁷

The app space for vestibular rehab is still young, and most products have not been rigorously validated. But the principle is sound: if you are supposed to do gaze stabilization exercises for six weeks and you quit after ten days because it is tedious, even a modestly helpful app that keeps you going is better than a theoretically perfect program you abandon. Look for apps developed in partnership with vestibular researchers or physiotherapists rather than generic “dizziness cure” offerings, and treat them as a supplement to professional guidance rather than a replacement for diagnosis.

The Semont-Plus Maneuver

Most home vertigo advice centers on the Epley, but the Semont maneuver and its newer variant, the Semont-Plus, deserve mention because they may actually resolve BPPV faster. In a randomized study, patients performing the Semont-Plus maneuver recovered in an average of two days, compared to about three days for the Epley group, a statistically significant difference.¹⁸ The Semont-Plus also appears to carry a lower risk of canal switching, possibly because it involves fewer intermediate positions where the head is tilted downward.¹⁵

The Semont involves sitting on the edge of a bed, quickly falling to the affected side with the head turned away from that ear, holding the position, then rapidly swinging through to the opposite side. It requires faster, more forceful movements than the Epley, which can be uncomfortable and is harder to perform solo without practice. The Semont-Plus adds a brief vibration or oscillation step during one of the positions. Because the Semont variants are less intuitive than the Epley, most clinicians will demonstrate them in person before recommending home practice. If the self-Epley is not working for you after a reasonable trial, asking your doctor or physiotherapist about the Semont-Plus is a conversation worth having.

When Horizontal Canal BPPV Changes the Playbook

About 5% to 15% of BPPV cases involve the horizontal semicircular canal rather than the posterior one. The vertigo pattern is different: spinning is triggered mainly by rolling over in bed or turning the head side to side while lying down, and the episodes tend to last longer than classic posterior canal BPPV. Home exercises for this variant are less well established, partly because the diagnosis itself is trickier to make without a clinician watching your eye movements.

The repositioning techniques for horizontal canal BPPV involve log-rolling maneuvers, where you rotate your body in stages along the long axis while lying flat, essentially using gravity to walk the crystals around the loop of the horizontal canal and out. The Gufoni maneuver is one of the more practical options, with reported success rates around 78% to 86% in a single session and up to 100% over two sessions.¹⁹ However, the direction of the maneuver depends on which subtype of horizontal canal BPPV you have (geotropic versus apogeotropic), and getting this wrong means you are rolling the crystals further in rather than guiding them out. This is one situation where a professional assessment before you start home exercises is particularly worthwhile.