By Dr. Srinivas Kishore Sistla
MBBS, MS (ENT)
Director & HOD – Otolaryngology, AIG Hospitals, Hyderabad
Have you ever turned your head, woken up in the morning, or simply bent down — and suddenly felt the entire world spin for a few seconds?
That unsettling, whirling sensation is vertigo, one of the most common and most misunderstood ENT problems.
While it feels dramatic and frightening, in many people the root cause is surprisingly tiny — microscopic crystals inside your inner ear.
Let’s explore this fascinating “inner ear mystery,” why vertigo is strongest in the morning, and when you should seek medical help.
Inside your inner ear lies one of the most advanced balance systems in the human body. It contains:
Semicircular canals (detect rotation)
Otolith organs (detect gravity and movement)
Tiny calcium crystals called otoconia
These crystals normally sit in a gel-like structure and help your brain understand motion.
Sometimes, due to age, minor trauma, dehydration, or even a simple head movement, these crystals shift from their normal position and fall into the semicircular canals.
This creates false signals of movement.
So even when you are perfectly still, your brain thinks:
“You’re spinning!”
This mismatch causes:
Sudden vertigo
Nausea
Eye flickering (nystagmus)
Imbalance
It often lasts 10–30 seconds, but feels much longer.
Many patients say:
“Doctor, the moment I wake up and turn my head on the pillow, the room starts spinning!”
Here’s why:
When you lie still all night, the displaced crystals settle inside the canal.
The moment you turn your head on waking up — the crystals shift suddenly, sending a strong burst of motion signals to the brain.
Turning from one side to another
Getting up from the bed quickly
Looking up or down
Bending to brush your teeth
Sudden head movements
This is classic BPPV, and thankfully, it is one of the most treatable forms of vertigo.
While BPPV is harmless, not all vertigo is benign.
Seek urgent medical attention if you experience:
Slurred speech
Double vision
Sudden severe headache
Facial weakness
Persistent vomiting
Difficulty walking
Vertigo lasting hours instead of seconds
These may be signs of neurological or vascular problems requiring immediate evaluation.
At AIG Hospitals, vertigo evaluation includes:
To determine if symptoms arise from your inner ear, nerves, or brain.
A gentle clinical maneuver to check for BPPV.
Advanced technology to record eye movements and pinpoint which part of the inner ear is affected.
Because inner ear problems often affect both hearing and balance.
MRI/CT in case of red-flag symptoms.
This simple, non-invasive procedure guides the displaced crystals back to their normal chamber.
Most patients experience instant or same-day relief.
Brandt-Daroff exercises can help maintain stability.
Vertigo often worsens with dehydration, stress and poor sleep.
Medicines help only with symptoms, not the root cause. Maneuvers remain the gold standard.
AIG Hospitals, Gachibowli, Hyderabad
📞 040 4244 4222
📧 drsrinivas.sistla@gmail.com
Most vertigo is harmless (like BPPV), but sudden, severe, or persistent vertigo needs medical attention.
This is typical of BPPV, where loose crystals stimulate the balance canal when your head changes position.
Because crystals settle overnight and shift suddenly when you move your head upon waking.
BPPV does not, but other inner ear conditions like Ménière’s disease can.
BPPV has a recurrence rate of 20–30% yearly, but it is easily treatable every time.
Crystal repositioning maneuvers often fix the issue. Some people may need occasional repeat sessions.
If vertigo is:
✔ frequent
✔ triggered by head movements
✔ accompanied by ringing, ear fullness, nausea
✔ affecting daily life
✔ associated with imbalance or headaches
Some exercises help, but self-treatment without diagnosis is risky. Proper evaluation ensures it’s not a more serious cause.
Poor sleep and nighttime oxygen drops can worsen dizziness and balance issues.
Just 2–5 minutes, and many patients feel dramatic relief immediately.