Dizziness when you lie down can have several possible causes, with benign paroxysmal positional vertigo (BPPV) being the most common. Here’s a clear overview to help you gauge what might be happening and what to do next. Key possibilities

• Benign paroxysmal positional vertigo (BPPV): Tiny calcium crystals in the inner ear become dislodged and move into one of the ear’s semicircular canals. Changes in head position (like lying down, rolling over, or tilting the head) trigger brief dizziness or a spinning sensation that lasts seconds to a minute. BPPV is common, often reversible, and can be treated with specific head-position maneuvers performed by a clinician or trained therapist. [general medical guidance, commonly cited across reputable sources]
• Inner ear or vestibular problems: Infections, inflammation, Menière’s disease, or labyrinthitis can cause dizziness that worsens with changes in position or even at rest. [medical references]
• Blood pressure changes: Postural or orthostatic changes, dehydration, or medications can cause lightheadedness when changing positions, including lying down or getting up. [medical guidance]
• Sleep-related or central issues: Sleep apnea, migraines, anxiety, or other central nervous system factors can contribute to dizziness that’s noticeable when lying down or changing position. [medical guidance]

What to do now

• Monitor patterns: Note when dizziness occurs (only on lying down, with turning in bed, upon waking, associated with vision changes, hearing loss, or headaches). Also track duration, intensity, and any accompanying symptoms (nausea, vomiting, unsteadiness, weakness, fainting). This helps distinguish BPPV from other causes. [clinical guidance]
• Safety first: If dizziness occurs, sit or lie down safely to reduce the risk of falling. Avoid driving or operating heavy machinery until you understand the cause. [safety guidance]
• Hydration and routine: Ensure adequate hydration, regular meals, and consistent sleep—these can influence dizziness related to blood pressure or metabolic factors. [lifestyle guidance]
• When to seek urgent care: Seek immediate evaluation if dizziness is accompanied by severe headache, weakness or numbness on one side, slurred speech, chest pain, confusion, fever with neck stiffness, or fainting. Also seek care if there is sudden, persistent dizziness with hearing loss or ringing in the ears. These can indicate more serious conditions. [warning signs]

Diagnosing and treating

• Evaluation: A clinician can perform a focused exam for vertigo and may use maneuvers like the Epley or Semont repositioning procedures if BPPV is suspected. They may also check for other vestibular causes, dehydration, anemia, infections, or cardiovascular issues. [clinical guidance]
• Treatments:
  • BPPV maneuvers: Repositioning maneuvers (e.g., Epley) often resolve symptoms in a few sessions.
  • Medications: Often not needed for BPPV, but doctors may suggest vestibular suppressants short-term if severe symptoms are present; for other causes, treatment targets the underlying condition.
  • Rehabilitation: Vestibular rehabilitation therapy can help with persistent dizziness from various vestibular disorders.
  • Addressing other causes: If dehydration, anemia, or blood pressure issues are contributing, appropriate treatment or lifestyle changes are recommended. [clinical guidance]

What you can ask your clinician

• Do I have BPPV, and would a simple head-rotation maneuver help?
• Should I try vestibular rehab or balance therapy?
• Are there any red-flag symptoms I should watch for, or tests you recommend (blood tests, imaging, hearing tests)?
• What lifestyle adjustments could reduce my symptoms (hydration, salt intake, caffeine/alcohol,睡眠 habits), and should I avoid certain positions?

If you’d like, share any additional details about your symptoms (e.g., duration, associated hearing changes, triggers beyond lying down, recent illnesses, medications), and this can help narrow the likely causes and give more targeted guidance.