Epley maneuver at home: step-by-step guide for BPPV vertigo

A safe, illustrated walkthrough of the Epley maneuver — the same repositioning sequence ENTs use in clinic — that you can do on your own bed in under 5 minutes.

What the Epley maneuver does

Benign Paroxysmal Positional Vertigo (BPPV) happens when tiny calcium crystals (otoconia) come loose inside your inner ear and drift into one of the semicircular canals — usually the posterior canal. Every time you tilt your head, those crystals slosh through the fluid and trick your brain into thinking you're spinning.

The Epley maneuver uses gravity to guide the crystals back out of the canal and into a part of the inner ear (the utricle) where they no longer cause symptoms. It works in roughly 80% of cases within 1–3 sessions.

Before you start

  • Confirm with a clinician that your vertigo is BPPV (not migraine, Meniere's, or vestibular neuritis).
  • Identify the affected ear — usually the one that's down when spinning starts.
  • Clear 5 minutes and 15 minutes after to stay upright.
  • Have someone nearby the first time, in case nausea is strong.
  • Skip the maneuver if you have severe neck arthritis, recent neck/back injury, carotid disease, retinal detachment, or recent eye surgery.

The four positions, step by step

The steps below are for a right-ear BPPV. For a left-ear problem, mirror every direction.

  1. 1. Sit and turn your head 45° to the right

    Sit upright on the edge of a bed. Place a pillow behind you so that, when you lie back, it ends up under your shoulders — not your head. Turn your head 45° to the right.

  2. 2. Lie back quickly, head hanging

    Keeping your head turned 45° right, lie down quickly so your head extends slightly past the pillow and hangs at about a 20° angle below horizontal. Vertigo usually starts here. Hold for 30 seconds or until the spinning stops, whichever is longer.

  3. 3. Rotate head 90° to the left

    Without lifting your head, turn it 90° to the left so it's now angled 45° to the left side. Hold for 30 seconds.

  4. 4. Roll onto your left side

    Roll your entire body onto the left side so you're now looking down at the floor at a 45° angle. Hold for 30 seconds.

  5. 5. Sit up slowly

    Slowly bring yourself up to sitting on the edge of the bed. Stay upright for the next 15 minutes.

After the maneuver

  • Stay upright for at least 15 minutes — no lying flat.
  • Sleep slightly propped up (two pillows) the first night.
  • Avoid tipping your head far back or far forward for 24 hours.
  • Mild imbalance for a day or two is normal as your brain recalibrates.

How often to repeat it

Run the full 4-position sequence 3 times in a row, once or twice per day, until symptoms have been gone for 24 hours. Most people are symptom-free within 1–3 days. If nothing has changed after a week, stop and see a clinician — it may be the horizontal canal (a different maneuver) or another condition entirely.

When to see a doctor

Stop and seek care if you experience any of:

  • Weakness, numbness, slurred speech, or double vision
  • Severe or new headache
  • Hearing loss or constant ringing in one ear
  • Vertigo lasting longer than a minute at a time, or constant dizziness between episodes
  • No improvement after a week of correct maneuvers

Doing it solo is hard — that's why we built Unspin

The Epley only works if your head angle and timing are right — and it's almost impossible to verify either while the room is spinning. Unspin uses your phone's motion sensors to coach the exact angles in real time and hold the timer for you, so the maneuver works first try.

Related BPPV guides

Frequently asked questions

Can you do the Epley maneuver at home?
Yes. The Epley maneuver is safe to perform at home for most people with diagnosed posterior-canal BPPV. It's a sequence of four head and body positions you hold for about 30 seconds each. If you've never had vertigo evaluated, see a clinician first to confirm BPPV and rule out other causes.
How do you do the Epley maneuver at home step by step?
Sit on a bed with a pillow placed so it will be under your shoulders when you lie back. Turn your head 45° toward the affected ear, lie back quickly so your head hangs slightly off the pillow, and hold for 30 seconds. Turn your head 90° to the opposite side and hold for 30 seconds. Roll onto that side so you're looking at the floor and hold for 30 seconds. Sit up slowly. Stay upright for the next 15 minutes.
How often should I do the Epley maneuver at home?
Most people do the full sequence 3 times in a row, once or twice per day, until symptoms stop — usually within 1–3 days. If vertigo hasn't improved after a week of daily attempts, stop and see a clinician.
How do I know which ear is affected?
The affected ear is usually the one that's down when vertigo starts. If lying on your right side or rolling right in bed triggers the spinning, your right ear is affected. A Dix-Hallpike test from a clinician confirms it.
Is the Epley maneuver safe?
For most adults with BPPV, yes. Avoid it if you have severe neck arthritis, recent neck or back injury, vascular disease in the neck, retinal detachment, or recent eye surgery. Stop and call your clinician if you develop new symptoms like weakness, double vision, slurred speech, or severe headache.
How long until the Epley maneuver works?
Many people feel substantial relief after a single correctly performed sequence. About 80% are symptom-free within 1–3 sessions. Mild imbalance can linger for a few days as your brain recalibrates.
What should I do after the Epley maneuver?
Stay upright (no lying flat) for at least 15 minutes. For the rest of the day, avoid sudden head movements, sleep slightly propped up the first night, and don't tilt your head far back (e.g., at the dentist or hair salon) for 24 hours.
What if the Epley maneuver doesn't work?
Repeat the full sequence the next day. If three days of correct attempts haven't helped, the affected canal may be the horizontal one (a different maneuver — the Lempert/BBQ roll — is used), or it may not be BPPV. See an ENT or vestibular physiotherapist.