What patient education should I provide to individuals diagnosed with BPPV regarding lifestyle modifications and self-management strategies?

Patient education for individuals diagnosed with benign paroxysmal positional vertigo (BPPV) should include the following lifestyle modifications and self-management strategies:

• Explain that symptoms may resolve spontaneously, so watchful waiting is an option, but treatment can help symptoms resolve more quickly.
• Advise on performing particle repositioning manoeuvres such as the Epley manoeuvre, ideally under professional guidance at first presentation, but also instruct on how to perform Brandt-Daroff exercises at home if immediate treatment is not possible.
• Teach the Brandt-Daroff exercises: sit on the edge of a bed or couch with eyes closed, quickly lie down sideways on one side with the head rotated 45 degrees upwards, rest for at least 30 seconds until vertigo subsides, then sit upright for 30 seconds, and repeat on the other side. Repeat the sequence 3–4 times until symptom-free, and perform 3–4 times daily until 2 consecutive days without symptoms.
• Inform that transient vertigo during manoeuvres is expected and to maintain each head position for at least 30 seconds, waiting for vertigo to subside before moving.
• Advise that there is usually no need for positional restrictions after treatment.
• Caution patients with neck or back problems, unstable cardiac disease, suspected vertebrobasilar disease, carotid stenosis, or morbid obesity to seek specialist advice before performing manoeuvres.
• Encourage patients to return for follow-up if symptoms persist beyond 4 weeks or do not improve after 1 week to reconsider diagnosis or repeat manoeuvres.
• Symptomatic drug treatment is generally not helpful for BPPV.

These strategies empower patients to manage their condition safely at home while understanding when to seek further medical advice.

References: ¹, ²