Have you ever experienced this?
The alarm goes off, and as usual, you get ready to turn over and get up.
But the moment you move your body—the whole room suddenly starts spinning!
The ceiling is spinning, the windows are spinning, and you even feel like you're about to be flung out of bed.
If this scene sounds familiar, you've likely encountered a problem that sounds a bit strange but is actually quite common—Benign Paroxysmal Positional Vertigo (BPPV).
Simply put, it's when the "little rocks" in your ear that help maintain your balance go to the wrong place.
1. There Are Actually "Rocks" in Our Ears?
Our ears are divided into the outer ear, middle ear, and inner ear.
Deep within our inner ear are two sac-like structures responsible for sensing balance: the utricle and the saccule. Their surfaces are covered by a gelatinous layer called the otolithic membrane, upon which many tiny "rocks" reside—these are actually calcium carbonate crystals, medically termed otoconia.
These otoconia seem insignificant, only 5–30 micrometers in size, even smaller than a sesame seed. But they are the "secret weapon" for maintaining balance. For example, when you ride an elevator with your eyes closed, you can still sense whether you're going up or down—that's the otoconia sending information to your brain.
Normally, the otoconia stay firmly attached to the otolithic membrane. But once they become dislodged, they can drift with the inner ear's lymph fluid into the semicircular canals, stimulating the sensory cells inside and sending false signals to the brain: "The body is spinning violently!" As a result, even if you're lying still in bed, your brain receives an alarm of "the world turning upside down," causing that sudden episode of vertigo.
This brief, intense dizziness is what we call BPPV, medically known as Benign Paroxysmal Positional Vertigo.
2. Why Do the "Rocks" Fall Out, and Why More Often in Winter?
Sometimes there's a clear cause for the detachment of otoconia, while other times it seems like an inexplicable accident.
Head trauma, brittle bones, insufficient local blood supply, ear conditions like otitis media or viral labyrinthitis, or even extreme fatigue and stress can all cause them to dislodge.
This tends to happen more easily, especially when the weather turns cold.
01. Cold Weather Causes Vasoconstriction, Affecting Ear Blood Supply
When the weather gets cold, the body automatically constricts peripheral blood vessels to maintain core temperature. During this process, the small blood vessels in the ears may also constrict. When blood supply becomes slightly insufficient, the "gel" that holds the otoconia in place becomes brittle more easily, making the otoconia prone to loosening and falling out.
02. Cold and Flu Season Affects the Ears
Autumn and winter are peak seasons for respiratory infections, which can affect not only the respiratory tract but sometimes also inner ear function, potentially disrupting the stable state of the otoconia. Many people experience vertigo after a cold for this reason.
03. Reduced Activity Slows Circulation and Metabolism
In winter, people are generally less willing to go out and be active. With less exercise, overall blood circulation and metabolism slow down. The inner ear, being a precise organ that requires ample blood supply, can be affected as a result.
3. How to Tell If You Have BPPV?
BPPV has its own distinct personality—its arrival and departure come with clear characteristics:
1. It's picky about timing: It only occurs during specific movements—getting up, lying down, turning over, bending over, or looking up. Once you remain still, the vertigo usually subsides rapidly within a minute.
2. It's brief: Each true spinning sensation typically lasts only 20 seconds to 1 minute, rarely exceeding two minutes. Like a sudden wave, it hits hard and recedes quickly.
3. It's repeatable: It may flare up frequently for several days in a row, or it might suddenly improve on its own, with varying intervals between episodes.
4. It's specific: There's a real sensation of spinning—the room is spinning, the bed is spinning, or you yourself are spinning. After an episode, you might feel an unreal, cotton-like sensation under your feet or feel unsteady as if floating on a cloud.
If you match these descriptions, BPPV is a strong possibility.
Although BPPV is termed "benign" because it doesn't involve nerve or vascular damage and doesn't cause long-term harm, the discomfort during an episode can significantly disrupt daily life and work.
4. Good News: A Doctor Can Fix It With Their Hands!
This is the most reassuring part—treating BPPV often doesn't require injections, medication, or surgery.
An experienced doctor can solve the problem for you with just their hands.
The doctor will have you lie on an examination table and perform a series of slow, gentle head-turning maneuvers. It's like giving directions to the lost otoconia, using gravity to guide them slowly back to their original position.
This process is called "canalith repositioning maneuver" (like the Epley maneuver).
Important: Please go to a professional medical institution for this procedure performed by a qualified doctor. Do not attempt it yourself, as incorrect handling could make you even dizzier!
During these maneuvers, you might experience brief vertigo again, but don't be alarmed—this indicates the otoconia are moving, which is normal. Many people find, to their delight, that after one repositioning treatment: the dizziness is gone!
5. If You Suspect You Have BPPV, What Should You Do?
Step 1: Go to the Right Department
Please be sure to visit the Otolaryngology (ENT) Department at a正规的正规 medical institution, or a specialized "Vertigo Clinic."
Step 2: Prepare in Advance
You can think about these questions beforehand to tell the doctor:
What movement triggers your dizziness? (e.g., turning to the right? Getting up?)
How long does each episode last? (Try counting the seconds roughly.)
What does the dizziness feel like? (Does the room spin, or do you feel yourself spinning?)
This information is very helpful for the doctor's diagnosis.
Step 3: Cooperate with the Examination
The doctor may ask you to perform specific head-turning movements while observing your eye reactions. All of this is to pinpoint the problem more accurately.
Although BPPV can be frightening when it strikes,
it is one of the most "friendly" types of vertigo.
It is not life-threatening, leaves no sequelae,
and has clear, effective treatment methods.
Understanding it is the first step to no longer fearing it.
When you or someone around you experiences this brief vertigo,
walk into the clinic and let a professional doctor help the "little rocks" find their way home.
After all, a steady, stable life is what brings the most peace of mind.
