When vertigo strikes, the most important thing you can do is stop moving, sit or lie down in a safe spot, and wait for the spinning to ease. Most vertigo episodes come from your inner ear, not your brain, and they pass on their own within seconds to minutes. What you do during and after an episode depends on what’s causing the spinning, how long it lasts, and whether other symptoms show up alongside it.
During an Episode: Stay Still and Stay Safe
The sensation of the room spinning can be intense enough to make you stumble or fall, so your first priority is getting somewhere stable. Sit down on the floor or in a sturdy chair (not one with wheels). If you’re already lying down, stay there. Avoid sudden movements, especially of your head, since quick position changes tend to make vertigo worse.
Close your eyes or avoid looking at screens, bright lights, or anything with a lot of visual movement. Your brain is getting conflicting signals about where you are in space, and reducing visual input helps calm that conflict. If the dizziness triggers nausea, focus on slow, deliberate breathing: inhale through your nose for about four seconds, feeling your stomach expand, then exhale through pursed lips for about eight seconds. This activates your body’s relaxation response and can ease both the dizziness and the nausea that often comes with it.
If you need to walk, ask someone nearby for help. Don’t try to push through the episode. And for at least a week after a severe spell, hold off on driving, climbing ladders, or operating heavy machinery.
Figuring Out What Type of Vertigo You Have
How long an episode lasts is one of the best clues to what’s causing it. The three most common types have very different patterns.
BPPV (benign paroxysmal positional vertigo) is the most common cause. It happens when tiny calcium crystals in your inner ear shift out of place and tumble into the wrong canal. Episodes are triggered by specific head movements: rolling over in bed, looking up, or bending down. The spinning feels intense but is surprisingly brief, typically lasting 20 to 40 seconds, almost always under a minute. There’s no hearing loss.
Meniere’s disease causes episodes lasting 30 minutes to a couple of hours. These can be severe and completely incapacitating, and they’re unpredictable. A key difference: Meniere’s almost always involves hearing loss or ringing in the affected ear, either right before or during the vertigo attack. High salt intake is a known trigger.
Vestibular neuritis is usually caused by a viral infection in the inner ear. Unlike BPPV’s brief spells, this type hits one day and the vertigo can persist for days. If vertigo and hearing loss happen at the same time, that’s potentially an emergency because the hearing loss may become permanent without prompt treatment.
The Epley Maneuver for BPPV
If your vertigo is triggered by head position changes and lasts under a minute, you likely have BPPV, and the most effective treatment is a simple series of head movements called the Epley maneuver. A healthcare provider can do this in the office, and it often resolves the problem in a single visit.
The basic sequence: your provider turns your head toward the side that causes vertigo, then quickly lays you back so your head hangs slightly off the edge of the table. You’ll feel the vertigo intensify briefly as the crystals move. Then they slowly rotate your head to the opposite side, turn your body to match, and sit you back up. The goal is to guide those loose crystals out of the semicircular canal and back to where they belong.
To confirm BPPV before treatment, providers use the Dix-Hallpike test, which moves you from sitting to lying down with your head turned to one side. If the crystals are displaced, your eyes will make involuntary jerking movements called nystagmus. Whichever ear is facing the floor when the nystagmus appears is the one with the loose crystals.
Medications That Help
For vertigo that doesn’t resolve with repositioning or that comes from conditions like Meniere’s disease or vestibular neuritis, medications can reduce the spinning and nausea. The most commonly used is meclizine, an antihistamine that blocks the signals to your brain causing dizziness and nausea. It’s available over the counter in many countries and is taken in divided doses throughout the day.
Meclizine works best as short-term relief. It doesn’t fix the underlying problem, and using it for too long can actually slow your brain’s ability to adapt and recover, which matters for long-term improvement.
Vestibular Rehabilitation Exercises
For vertigo that keeps coming back or leaves you feeling off-balance between episodes, vestibular rehabilitation therapy retrains your brain to process movement signals correctly. The core principle, as Stanford Medicine’s dizziness program puts it, is that movement is medicine for your balance system.
One foundational exercise is gaze stabilization. You sit upright, stretch your arms out with thumbs up and hands clasped together, then slowly turn your head and body left and right while keeping your eyes locked on your thumbs. This teaches your eyes to stay focused during movement instead of triggering a dizzy response. Another staple is diaphragmatic breathing, the same slow-breathing technique useful during acute episodes, practiced regularly to reduce your brain’s stress response to dizziness.
The general recommendation is to practice these exercises three times a day and go for a daily walk. If an exercise makes you too dizzy, start with just 10 seconds and gradually build up. Most people notice improvement within a few weeks, though the timeline varies with the underlying cause.
Dietary Changes for Meniere’s Disease
If your vertigo is tied to Meniere’s disease, reducing sodium is one of the most effective things you can do. The recommended target is under 2 grams of sodium per day. In one study, patients who actually achieved low sodium levels (confirmed through urine testing) had a 100% rate of complete vertigo control, while those who didn’t reduce sodium enough had significantly worse outcomes. This means reading labels, cooking more at home, and being cautious with restaurant food, processed meats, canned soups, and soy sauce.
Making Your Home Safer
Falls are the biggest physical risk of recurring vertigo, and most happen at home. A few changes make a significant difference. Remove loose throw rugs, floor clutter, and any cords or wires crossing walkways. Install grab bars near the toilet and inside the shower, and consider a shower chair so you don’t have to stand with your eyes closed under running water. Keep a sturdy, non-wheeled chair in any room where you spend time, so you always have something to sit on quickly.
Good lighting matters more than most people realize. Add night lights or motion-sensor lights along the path from your bedroom to the bathroom, since vertigo episodes often happen when getting out of bed. Keep your glasses, a light source, and any mobility aids within arm’s reach of where you sleep.
Outside, avoid stepping stones and loose gravel. Paths should be level, wide, and well-lit, with handrails on any slopes. In the garage, store frequently used items at waist or chest height so you’re not reaching overhead or bending down. If you use a cane, keep one on each floor of your home and add a wrist strap so it stays with you when your hands are occupied.
Warning Signs That Need Urgent Attention
Most vertigo is uncomfortable but not dangerous. A few specific combinations of symptoms, however, suggest something more serious, particularly a stroke affecting the back of the brain.
Get emergency care if vertigo comes with sudden severe headache or neck pain, loss of vision, fainting, difficulty speaking (slurred or broken-up words), weakness on one side of your body, or trouble with coordination like being unable to touch your finger to your nose accurately. The risk is highest in people who already have stroke risk factors like high blood pressure, diabetes, or an irregular heartbeat.
One important detail: in strokes affecting the cerebellum, vertigo and balance problems can sometimes be the only symptoms, with an otherwise normal-seeming neurological picture. A specialized bedside exam called the HINTS test, which checks eye movements and alignment, is actually more sensitive for detecting these strokes than an early MRI. If your vertigo is continuous (not triggered by position changes), started suddenly, and isn’t improving, that pattern warrants medical evaluation rather than waiting it out at home.