Semont maneuver: step-by-step guide for BPPV

The Semont (liberatory) maneuver is a faster two-position alternative to the Epley for posterior-canal BPPV. Here's how to do it safely at home.

When to use the Semont

The Semont is most useful when limited neck extension makes the Epley maneuver awkward, or when the Epley hasn't fully resolved symptoms after three days. Both target the same posterior-canal BPPV. Confirm the diagnosis first with a Dix-Hallpike test and identify the affected ear.

The four steps

Steps below assume a right-ear BPPV. Mirror for a left-ear problem.

  1. 1. Sit and rotate head 45° left

    Sit on the edge of a bed. Turn your head 45° to the left (away from the affected right ear).

  2. 2. Quickly lie down on your right side

    Keeping the head turned, drop quickly onto your right side so your nose points up toward the ceiling. Hold for 60 seconds. Vertigo usually peaks here.

  3. 3. Swing rapidly to your left side

    Without changing the head's rotation relative to your body, swing through sitting and drop onto your left side. Your nose should now point down at the floor. Hold for 60 seconds.

  4. 4. Sit up slowly

    Slowly return to sitting. Stay upright for the next 15 minutes.

After the maneuver

  • No lying flat for 15 minutes.
  • Sleep slightly propped up the first night.
  • Avoid sudden head movements for 24 hours.
  • Repeat once per day until 24 hours symptom-free.

Related BPPV guides

Frequently asked questions

What is the Semont maneuver?
The Semont (liberatory) maneuver is a rapid two-position swing used to dislodge calcium crystals from the posterior semicircular canal in BPPV. It's an alternative to the Epley maneuver and works in roughly the same percentage of cases.
Semont vs. Epley — which is better?
Both are about equally effective (~80% success after 1–3 sessions). The Epley uses four slower positions and is gentler. The Semont is faster (two quick positions) and is preferred when neck mobility makes the Epley's 45° head turn uncomfortable.
How do you do the Semont maneuver?
Sit on the edge of a bed. Turn your head 45° away from the affected ear. Quickly lie down on the affected side and hold 60 seconds. Without changing head position, swing rapidly through sitting to lie on the opposite side, nose now pointing down. Hold 60 seconds. Slowly sit up.
Is the Semont maneuver safe to do at home?
For confirmed posterior-canal BPPV in otherwise healthy adults, yes. Avoid it with severe neck or back problems, recent eye surgery, or vascular disease in the neck — the rapid swing is more forceful than the Epley.