Part of Dizziness and BPPV

Sleeping position with BPPV: what is known and what is not

There is less to sleeping position with BPPV than the internet suggests, and that is genuinely good news rather than a dodge. No sleeping position treats the condition, and after a repositioning treatment for the common type of BPPV the guideline tells clinicians not to hand out postural restrictions, because a Cochrane review of the restrictions people used to be given, among them sleeping propped upright, found they added only a small benefit to the treatment on its own. The NHS does give bedtime advice for vertigo, and it is modest: 2 or more pillows so your head is slightly raised, no rushing as you get out of bed, a pause on the edge of the bed before you stand, the light on before you move about at night, and sitting down the moment you feel dizzy. What you will not find here is an instruction to sleep on your good ear. That advice needs you to know which ear is affected, only a clinician can tell you that, and anyone who has been told it has also been given their own instructions to follow instead of ours. A position that stops the spinning stops the symptom, not the cause. And if the dizziness has stopped coming in short spells and has simply been there all the time for a day or more, no pillow is the answer to that and it needs medical advice the same day.

Warning signs, and when to get help

How to sleep with vertigo: the short answer

Sleep in whatever position lets you sleep, with your head slightly raised if that helps, and stop looking for the position that fixes it. There is not one.

That sounds dismissive and it is not meant to be. People arrive at this question frightened of their own bed, which is a reasonable thing to be frightened of when lying down is what sets the room spinning, and the fear is usually worse than the problem. So here is what is actually established, and it is a short list.

The NHS advises people with vertigo to sleep with the head slightly raised on 2 or more pillows, to get out of bed slowly and sit on the edge for a while before standing, to put the light on if they get up in the night, and to sit down the moment they feel dizzy. After repositioning treatment for the common type of BPPV, the guideline advises clinicians not to impose restrictions on posture afterward, and a Cochrane review found that those restrictions added only a small benefit over the treatment on its own (Hunt 2012, Bhattacharyya 2017). Beyond that, the research on sleeping side is observational, and the next few sections go through what it does and does not show.

What positional vertigo is, in a line, because the rest of this page assumes it. St George's NHS describes it as brief spinning brought on by a change of head position, and names rolling over in bed, looking up or down and tilting the head. Dizziness and BPPV is the page that covers what it is, how it is confirmed, how it is treated and what recovery looks like.

Here is the limit on everything below, stated once so it does not have to be repeated. A position that avoids the spinning avoids the symptom. It does not touch the cause, which is loose crystals sitting where they should not be, and that is the subject of what causes BPPV and the loose crystals.

Do you have to sleep sitting up after a repositioning treatment?

For most people, no, and this is the question where the honest answer is also the kindest one.

Sleeping upright for a week after a maneuver used to be routinely advised, and plenty of people still get told it. The evidence turned out to be much thinner than the practice. A Cochrane review of modifications to the Epley maneuver pooled nine trials of postural restrictions afterward, which in those trials meant things like a neck collar and sleeping propped upright, and found only a small improvement in how many people had a positive positional test turn negative, with no difference in how people rated their own vertigo or their own improvement (Hunt 2012). The BPPV guideline went further and now advises clinicians against recommending restrictions on posture after repositioning treatment for posterior canal BPPV, the type in the back canal (Bhattacharyya 2017). Our parent page sets out what that guideline says in more detail.

So a night propped bolt upright in an armchair is not something the evidence asks of you, and neither is a week of keeping off one side.

One qualification: your own clinician may ask for something different, and they are the one to follow. They have examined you, they know which canal was involved, and they know what else is going on with your neck, your balance and your medicines.

The other one is narrower, and it is the reason this page exists in the shape it does: do not build your own restriction. A reader who decides to sleep in a particular arrangement of positions in order to move the crystals somewhere has designed a repositioning maneuver and called it a sleeping position. This site publishes no maneuver steps, and the parent page explains why in print.

Which side should you sleep on?

The advice circulating online is to sleep on the unaffected side. This page is not going to give you that instruction, and the reason is practical.

To follow it you need to know which ear is affected. That comes from a positional examination, where a clinician moves your head and watches your eyes, and it cannot be worked out from how your nights feel. Anyone who has been told which ear it is has been told by somebody who also gave them advice about positions, and that advice is specific to them. So the instruction is either unusable or already superseded.

There is a sharper version of the same problem. A reader who guesses wrong spends the week deliberately lying on the ear that provokes the spinning, which is the opposite of what they were trying to do, and does it in the dark on their own. That is not a theoretical risk. It is the ordinary consequence of applying a side-specific instruction without the side.

What is reasonable is much plainer. If one side reliably starts the room moving and the other does not, sleep on the other one, because you want to sleep. That is a comfort decision and it treats nothing. Keep whatever you notice about it for the appointment, which is where it becomes useful, and there is more on what to collect on why vertigo is worse in the morning.

Does your usual sleeping side have anything to do with it?

There is research on this, it is more interesting than most of what you will find on the subject, and it stops well short of an instruction.

Li and colleagues followed 150 people with one-sided BPPV at a university hospital in Shanghai, all treated with a repositioning maneuver, most of them with the back canal type. One group was told to sleep semi-sitting, propped at about 30 degrees, and to stay off the affected side for a week. The other group slept however they liked. Recurrence meant the return of brief rotational vertigo lasting seconds, and they were checked at one week and again at a month (Li and colleagues, 2013).

The headline result is the one that never gets quoted. At one week, the return of spinning was 9.7 percent in the restricted group and 16.7 percent in the group with no restrictions, and the difference was not statistically significant. In other words, telling people how to sleep did not beat letting them sleep normally. The authors also reported that people complied poorly with the instructions, which is its own finding about advice of this kind.

The result that gets quoted comes from a second analysis, where the authors sorted people by the position they said they had actually slept in. Those who had slept on the affected side had the spinning return in 31.3 percent of cases, against 9.5 to 13.3 percent in the other position groups. Read the denominator before you act on the percentage: that was 5 people out of 16. The positions were reported by patients and their families rather than measured, follow-up ran to a month rather than a year, and it is one hospital. The authors say as much themselves and suggest monitoring sleep position properly in future work.

The genuinely intriguing finding is a different one. About 57 percent of the group were habitual side sleepers, and their usual side matched the affected ear more often than chance would predict. That is an association and it cannot tell you which came first. Sleeping on a side for years might make that ear the one that gives trouble, or an ear that gives trouble might be the one you end up favoring, and nothing in a study of this design separates the two. So this page states no claim that a sleeping position causes BPPV, and none that changing it prevents BPPV.

Prevention, properly asked, is a bigger question than bedding, and why BPPV keeps coming back is where it belongs.

Do extra pillows help?

This one has a source, which puts it ahead of most bedtime advice. The NHS tells people with vertigo to sleep with the head slightly raised on 2 or more pillows.

What it does not have is a trial. We found nothing we could read that compares raised against flat for BPPV, so treat the pillows as what they are: free, harmless and worth a few nights of your own experiment. If your nights are better, keep them. If they are the same, you have learned something and lost nothing.

Build the height under your head and your neck together rather than shoving a stack under the head alone, which tips the chin toward the chest and tends to produce a sore neck by morning. That is a comfort point rather than a safety one, but a stiff neck on top of a swimmy head makes everything harder to interpret.

One group should not experiment at all. If you have been given a sleeping position for your breathing, for reflux or for a heart condition, that instruction was given for a reason and it comes before anything on this page. Ask the clinician who gave it to you before you change how you sleep.

The neck has come up twice now, so a word about it while we are here. This page gives no neck treatment and makes no claim that the neck causes vertigo. And if anybody is going to put their hands on your neck for dizziness, the international framework for the neck asks physios to examine you and check for blood vessel risk factors before any thrust technique (Rushton 2023). The emergency and same-day lines at the end of this page cover a new headache or neck pain that does not behave like ordinary neck pain. Read those before the appointment rather than after it.

Pregnancy changes the position question regardless of what your ears are doing. From about 28 weeks of pregnancy the NHS advises going to sleep on your side rather than on your back, because it says sleeping on your back after that point can double the risk of stillbirth. So use a side position, and leave lying on your back until after the birth. The NHS also says not to worry if you wake up on your back: settle onto your side again and carry on.

We name no pillow, no wedge, no mattress and no brand. Half the pages you will find on this question are selling something, and there is nothing to buy here.

Rolling over in the night, and the spell that wakes you

Being woken by the room moving is a particular kind of unpleasant, because you are asleep when it starts and you have no idea yet what is happening.

The thing to do is almost nothing. Stay where you are, keep your eyes open and let them settle on anything that is not moving, and wait. A positional spell fades while you hold still, and holding still is the whole of the treatment available to you at that hour.

The instinct runs the other way. People roll back to undo it, or sit up fast to get away from it, and both of those are another change of head position landing on top of the first one. If you are going to move at all, wait until the room has stopped, then move once, slowly, and in stages.

Do not stand up while it is still going. If you have to get up, put the light on first, sit on the edge of the bed until your head is quiet, and keep a hand on something solid as you rise. The night trip to the bathroom is where falls actually happen, and a dark landing is a worse hazard than the dizziness itself. Balance and falls prevention covers home safety and a falls assessment properly, and getting up from the floor covers what to do if you have already come down.

This warning belongs here word for word, because it is the one this site gives wherever somebody moves in bed.

You feel dizzy, lightheaded or faint, or the room seems to spin, as you move in bed or sit on its edge. Stop, lie back down on the bed if you can, and keep still until it passes. If it does not pass within a minute or two, or it keeps happening, get medical advice the same day before you practice again. If you faint, it does not settle within a few minutes of keeping still, or your vision suddenly blurs or goes double, call emergency services.

One pattern does not belong to this section at all. If what woke you has not stopped, if it is still there an hour later or in the morning, then it is not behaving like a positional spell and it is not a bedding problem. That has a same-day line in the list below.

Getting into bed and getting out of it

Lying down is a change of head position, which makes bedtime a provoking movement in its own right, and most people work that out the hard way.

Go down in stages, the way you come up. Sit on the edge, get your legs up, lower your trunk, and let your head arrive last and slowly rather than dropping it back onto the pillow in one movement. If a spell starts partway through, stop there and wait it out before finishing. Half a minute of patience at that point saves the next twenty.

Set the room up once and you stop having to think about it. A lamp or a switch you can reach without rolling. A clear floor between the bed and the door. Something solid at the bedside to put a hand on, used on the way up rather than grabbed at after a wobble. Shoes or slippers that grip, rather than bare feet or socks on a hard floor.

Keep a phone or a personal alarm where you could reach it from the floor as well as from the bed. If you cannot get up, use your phone or personal alarm, or shout or bang on the wall or floor to get someone's attention (NHS falls). An hour on a cold floor costs more than the fall did, and it has its own same-day line in the list below.

The first two minutes after you wake belong to a different page, because the morning version of this has its own pattern and its own warning about standing up. Why vertigo is worse in the morning has it, including the symptom that is a drop in blood pressure rather than an ear problem.

What a bad night means for the next day

It means you had a bad night. It does not mean you did damage, and it does not mean you slept wrong.

That is worth saying because people lie awake auditing their own pillow arrangement. A provoked spell is the symptom doing what the symptom does when the head changes position, and the position provoked it rather than caused the condition. Nothing about a night of spinning makes the underlying problem worse than it was the evening before.

What a bad night does do is shape the day after it. Expect to be more unsteady, more wary of your own head, and more tired than the hours of sleep alone would explain. Do not drive, climb ladders or use machinery while you feel dizzy (NHS dizziness), and that includes the first part of a morning after a night like that.

Tiredness that has run on for weeks, that you cannot account for, or that is getting in the way of your daily life is a different matter from the day after a bad night, and it is not an ear symptom. Book an appointment with your doctor about the tiredness itself. The warning list below carries that line in full, with what else to mention.

Dizziness and BPPV covers what the lingering unsteadiness is and the vestibular exercise program that is used for it. Start these exercises only after a doctor or vestibular physio has found the cause of your dizziness. New dizziness, or dizziness that has changed, needs checking first.

A run of bad nights is a different signal, and it is the one to act on. Nights that are getting worse, or spells that are arriving more often or lasting longer, are a reason to be seen again rather than to keep refining the bedroom, and that is as true for somebody already treated as for somebody who has never been assessed. If it has come back after treatment, why BPPV keeps coming back is the page for it.

When a bad night needs more than a pillow

Everything above is written for spinning that answers to a position: it starts when your head moves and it stops when you hold still. Some night dizziness does not behave like that, and no arrangement of pillows is the right response to it.

The one this page worries about most is dizziness that has stopped coming in spells. Spinning or dizziness that has been there all the time for a day or more, rather than arriving in short bursts when you move your head, needs medical advice the same day. So does sudden new dizziness, and so does feeling faint or lightheaded on standing that is new for you, keeps happening, does not pass within a minute or two, or has made you fall. Fainting, even for a moment, has its own same-day line below.

Some signs do not wait for morning. Any sign of a stroke, even if it passes, which includes sudden dizziness with unsteadiness or falling over, a drooping face, a weak arm, speech gone wrong, a change in vision, trouble swallowing, or a sudden fall where the legs give way without blacking out. Vertigo with new hearing loss, double vision, trouble speaking, or weakness or numbness in an arm or leg.

The list below carries three more at that level: dizziness with a new, severe headache, a racing or irregular heartbeat with dizziness or faintness, and the neck lines described above.

If the hearing in one ear has changed, if the spinning lasts hours rather than seconds, or if it came on after a cold, a flu or a knock to the head, you may not be reading the right page at all. What else vertigo can be is the one place on this site that covers the other diagnoses, and it covers all of them together rather than in fragments.

And if nobody has confirmed what is happening to you yet, the route is an appointment rather than another week of experiments. Short spells of spinning when you lie down, roll over in bed or look up, or dizziness that keeps coming back, means seeing your GP or a physio within a few days so the cause can be confirmed and treated. Every line below carries its own timing. The rest of this area of the site is listed under balance and dizziness.

Related exercise programs

Warning signs

Get emergency help now

  • Emergency: call emergency services straight away for any sign of a stroke, even if it goes away: sudden dizziness with unsteadiness or falling over, a face that droops on one side, an arm you cannot lift or keep up, slurred or muddled speech, weakness or numbness on one side of your body or face, sudden blurred vision, double vision or loss of sight, trouble swallowing, a sudden severe headache, or a sudden fall where your legs give way but you do not black out (a drop attack).
  • Emergency: vertigo or dizziness together with new hearing loss, double vision or loss of vision, trouble speaking, or weakness, numbness or tingling in an arm or leg. Call emergency services or go to an emergency department straight away.
  • Emergency: dizziness with a new, severe headache, or a sudden, severe headache that feels unlike anything you have had before. Call emergency services straight away.
  • Emergency: a new headache or neck pain, or both, that does not feel like ordinary neck pain. If this is your first bout, judge it by how it behaves rather than by how it compares. Either of the next two is enough on its own. One, it came on suddenly, in a single moment, even if it is not severe and even if it has eased since. Sudden onset counts on its own. Two, nothing you do changes it much: no position or rest makes a real difference, and after the first day or two it has not started to settle. It counts even if you have none of the other emergency signs above, and it matters more if it started after a neck injury or strain, even a minor one, a bout of heavy coughing, or having your neck manipulated. Go to an emergency department straight away, or call emergency services if you cannot get there safely, and do not drive yourself. Do not start these exercises, and do not have any hands-on treatment to your neck, until your neck has been checked. A tear in an artery in the neck can start as pain alone, often on one side, with nothing else to find. If you can find a position that eases it, follow the same day warning sign for this below instead.
  • If chest pain, pressure or tightness does not ease quickly when you rest, spreads to your arm, neck, jaw, stomach or back, or comes with sweating, feeling sick, feeling light-headed or being short of breath, call emergency services straight away, as this can be a heart attack. If it eases quickly and none of these happen, get medical advice the same day, and do not exercise again until you have been checked.
  • Emergency: a racing, pounding, fluttering or irregular heartbeat that does not settle when you rest, or that comes with dizziness, feeling faint or fainting, chest pain or shortness of breath. Call emergency services straight away. If it has already stopped, get medical advice the same day.
  • Emergency: you have just fallen and cannot get up, or you think you may have hurt your head, neck, back or hip. Stay where you are, keep warm and call emergency services, or get someone to call for you. If you got up and walked without trouble and only notice pain later, use the same-day lines in this list instead.
  • Emergency: you fell and cannot remember the fall or how it happened. Go to an emergency department straight away, and do not drive yourself. You may have blacked out or hit your head without knowing it.

Get help today

  • Same day: a new headache or neck pain, or both, that does not feel like ordinary neck pain, that started after a neck injury or strain, even a minor one, a bout of heavy coughing, or having your neck manipulated, but that does ease when you change position or rest. Get checked the same day before you start these exercises or have any hands-on treatment to your neck. If nothing you do changes it much any more, or it has not started to settle after a day or two, follow the emergency warning sign for this above.
  • Same day: you blacked out or fainted, even for a moment. Get medical advice the same day. Call emergency services instead if the person is not breathing, cannot be woken within 1 minute, has not fully recovered or has trouble speaking or moving, has chest pain or a pounding, fluttering or irregular heartbeat, fainted while exercising or lying down, is shaking or jerking, or was badly hurt.
  • Same day: dizziness, lightheadedness, blurred vision or feeling faint when you stand up that is new for you, does not pass within a minute or two, keeps happening, or has made you fall. Sit or lie down, and get medical advice the same day. This can be a drop in blood pressure on standing (postural hypotension), a type of low blood pressure, which the NHS lists among the causes of falls, and your doctor can check it. Tell them about your medicines, because some can cause it. If it does not settle within a few minutes of sitting or lying still, call emergency services. If you faint, use the fainting line above.
  • Same day: sudden new dizziness, or feeling faint or unsteady, other than the brief lightheadedness as you stand up covered in the line above, without any of the stroke signs above. Stop, sit down and get medical advice the same day. If you faint, it does not settle within a few minutes of sitting still, or you cannot stand or walk steadily, call emergency services.
  • Same day: dizziness or spinning that has been there all the time for a day or more, rather than coming in short spells when you move your head, without any of the emergency signs above. Get medical advice the same day. If you cannot stand or walk steadily, call emergency services.
  • Same day: vertigo with being sick or feeling very sick, a very high temperature, or feeling hot, cold or shivery, without any of the emergency signs above. Get medical advice the same day.
  • Same day: you are more short of breath than usual, or short of breath while you are resting or lying down, without any of the emergency signs above. Get medical advice the same day. Call emergency services if you have severe difficulty breathing, are gasping, choking or cannot get your words out, or your lips or skin turn very pale, blue or gray. Breathlessness is not a symptom of the inner ear: the NHS names heart failure and lung conditions among the causes, and it is easy to put down to being run down.
  • Same day: after a fall, you are in pain, have hurt yourself or feel unwell, or you were on the floor for an hour or more, without any of the emergency signs above. Get medical advice the same day, even if you managed to get up.

Book an appointment

  • Within a few days: short spells of spinning when you lie down, roll over in bed or look up, or dizziness that keeps coming back, without any of the signs above. See your GP or a physio within a few days so the cause can be confirmed and treated.
  • Within a few days: you have had a fall, even if you were not hurt, or you keep tripping, stumbling or feeling that your legs might give way. Book an appointment with your doctor within a few days and ask about a falls assessment. Tell them about every fall, even the ones where you were not hurt.
  • Routine: you have been tired for a few weeks and you are not sure why, your tiredness is getting in the way of your daily life, or you are tired along with other symptoms such as losing weight without meaning to or a change in your mood. Book an appointment with your doctor about the tiredness itself, say how long it has been there and what else has changed, and let them decide what to test. Tiredness is not a symptom of the inner ear: the NHS names sleep apnea, iron deficiency anemia, diabetes, an overactive thyroid and ME or chronic fatigue syndrome among the conditions behind it, and a blood test settles several of them. Tell your doctor as well if anyone has said you gasp, snort or choke in your sleep. If the tiredness comes with chest pain, feeling faint, or being short of breath while you are resting, use the emergency and same day lines above instead.

Common questions

What is the best sleeping position for BPPV?

There is no tested best position, and nobody has shown that one position beats another for the condition itself. The NHS gives one piece of bedtime advice for vertigo, which is to sleep with your head slightly raised on 2 or more pillows, and it pairs that with getting out of bed slowly, sitting on the edge of the bed before you stand, turning the light on if you get up at night, and sitting down the moment you feel dizzy. That is advice for living with the symptom rather than treatment for the cause. What you should not do is pick a position in the hope of moving the crystals back, because that is a repositioning maneuver by another name, it depends on which ear and which canal are affected, and this site publishes no maneuver steps for exactly that reason. If a doctor or physio has given you a position or an instruction for your own diagnosis, follow theirs. One position does come with national advice attached, whatever your ears are doing. From about 28 weeks of pregnancy the NHS advises going to sleep on your side rather than on your back, because it says sleeping on your back after that point can double the risk of stillbirth. So use a side position, and leave lying on your back until after the birth. The NHS also says not to worry if you wake up on your back: settle onto your side again and carry on.

What side should I sleep on with BPPV?

This page will not tell you to sleep on the unaffected side, and the reason is practical rather than cautious. To act on that advice you have to know which ear is affected, and only a positional examination by a doctor or physio establishes that. Anyone who does know it was told by a clinician who will have given their own advice about positions, and that advice comes first. There is observational research on the question. Li and colleagues followed 150 people with one-sided BPPV after a repositioning maneuver at one hospital in Shanghai and found that those who reported sleeping on the affected side during the first week had a higher return of brief spinning than the other position groups, 31.3 percent against 9.5 to 13.3 percent, although that was 5 people out of 16 and the positions were reported by patients and families rather than measured (Li and colleagues, 2013). An association in a subgroup that size is a reason for researchers to keep looking, not an instruction. If a position reliably sets your spinning off, it is reasonable to avoid it so you can sleep, and that is a comfort decision, not a treatment.

Do you have to sleep sitting up after the Epley maneuver?

Usually not. After repositioning treatment for the common type of BPPV, the one in the back canal, the guideline advises clinicians against handing out restrictions on posture afterward, and a Cochrane review found that adding those restrictions gave only a small benefit over the maneuver on its own (Hunt 2012, Bhattacharyya 2017). So sleeping propped up all night, or keeping off one side for a week, is not something most people need to do. Your own clinician may still ask you to do something different, because they have examined you and know which canal was involved and what else is going on with your neck and your balance, and their instruction beats a web page. What nobody should do is invent a restriction, or a sequence of positions, from a search result. Our main page on dizziness and BPPV explains why there are no maneuver steps anywhere on this site.

How should I sleep to avoid BPPV?

No position has been shown to prevent it, and this page does not offer one as prevention. That is the honest answer to a question a lot of people arrive with, and it is worth saying clearly because the alternative is a reader rearranging a bedroom in the belief that it is treatment. Avoiding a position that sets the spinning off will spare you the symptom on the night, which is worth having when you are not sleeping, and it does nothing to the loose crystals in the canal. Whether anything reduces the chance of BPPV returning is a separate question with its own page, and our page on why BPPV keeps coming back deals with it. If it has come back, the thing that helps is being seen and treated again rather than managing it in bed.

Do extra pillows help with BPPV?

The NHS advises sleeping with your head slightly raised on 2 or more pillows if you have vertigo, so there is a national health service recommendation behind it, and no trial that we could read has tested it against sleeping flat. Treat it as what it is: cheap, harmless and worth trying for a few nights to see whether your own nights are better. Two things to watch. A stack that props your head without supporting your neck tends to produce a sore neck by morning, so build the height under the head and the neck together rather than wedging the head forward. And if you have any trouble with breathing, reflux or heart problems, your own clinician may already have told you how to sleep, and that comes first. We name no pillow, no wedge, no mattress and no brand, here or anywhere else on this site.

References

  1. NHS. Vertigo. https://www.nhs.uk/conditions/vertigo/
  2. NHS. Dizziness. https://www.nhs.uk/symptoms/dizziness/
  3. Li S, Tian L, Han Z, Wang J. Impact of postmaneuver sleep position on recurrence of benign paroxysmal positional vertigo. PLoS One. 2013;8(12):e83566. https://doi.org/10.1371/journal.pone.0083566
  4. Hunt WT, Zimmermann EF, Hilton MP. Modifications of the Epley (canalith repositioning) manoeuvre for posterior canal benign paroxysmal positional vertigo (BPPV). Cochrane Database of Systematic Reviews. 2012;(4):CD008675. https://doi.org/10.1002/14651858.CD008675.pub2
  5. Bhattacharyya N, Gubbels SP, Schwartz SR, et al. Clinical practice guideline: benign paroxysmal positional vertigo (update). Otolaryngology-Head and Neck Surgery. 2017;156(3 Suppl):S1-S47. https://doi.org/10.1177/0194599816689667
  6. St George's University Hospitals NHS Foundation Trust. Benign paroxysmal positional vertigo (BPPV). https://www.stgeorges.nhs.uk/service/therapies/neurology-vestibular-physiotherapy-outpatients/benign-paroxysmal-positional-vertigo-bppv/
  7. NHS. Symptoms of a stroke. https://www.nhs.uk/conditions/stroke/symptoms/
  8. NHS. Fainting. Page last reviewed 17 August 2026. https://www.nhs.uk/symptoms/fainting/
  9. NHS. Falls. Page last reviewed 06 March 2025. https://www.nhs.uk/conditions/falls/
  10. NHS. 27 weeks pregnant: the best sleeping positions during pregnancy. Best Start in Life week by week guide. https://www.nhs.uk/best-start-in-life/pregnancy/week-by-week-guide-to-pregnancy/2nd-trimester/week-27/
  11. Rushton A, Carlesso LC, Flynn T, et al. International framework for examination of the cervical region for potential of vascular pathologies of the neck prior to musculoskeletal intervention: International IFOMPT Cervical Framework. Journal of Orthopaedic and Sports Physical Therapy. 2023;53(1):7-22. https://doi.org/10.2519/jospt.2022.11147
  12. NHS. Heart palpitations. https://www.nhs.uk/conditions/heart-palpitations/
  13. NHS. Chest pain. https://www.nhs.uk/symptoms/chest-pain/
  14. NHS. Low blood pressure (hypotension). https://www.nhs.uk/conditions/low-blood-pressure-hypotension/
  15. NHS. Shortness of breath. Page last reviewed 30 January 2024. https://www.nhs.uk/symptoms/shortness-of-breath/

Written and checked by the PocketPhysio editorial team. Last updated 2026-10-18.

This page is general education, not a diagnosis or a personal treatment plan. See a physiotherapist or doctor for advice about your own situation.