Juan Garcia Arteaga, ENT Patient information
Dr. Juan García Arteaga
ENT specialist

Brandt-Daroff exercises

Brandt-Daroff exercises for positional vertigo (BPPV): how to do them at home, the classic routine, what is normal and when to stop and seek advice.

Written by Dr. Juan García Arteaga · Last reviewed:

What are they for?

Brandt-Daroff exercises are a series of position changes you can do at home, on your bed. They are used for benign paroxysmal positional vertigo (BPPV) and have two effects:

  • They are thought to help move the crystals that have slipped into the balance canals.
  • They train the brain to get used to the movement, so dizziness and unsteadiness gradually decrease.

They are a supporting measure. To cure BPPV, the repositioning manoeuvre we do in clinic (such as the Epley manoeuvre) is more effective: in studies, a single Epley manoeuvre resolved the vertigo more often than a week of Brandt-Daroff exercises. The exercises are useful when some unsteadiness remains after the manoeuvre, when the manoeuvre cannot be done, or to manage relapses, as long as your doctor has recommended them.

Before you start

  • Only do them if you have been diagnosed with BPPV. Not all vertigo is the same.
  • Sit in the middle of a wide bed, with room to lie down on either side.
  • The first few times, ask someone to stay with you, especially if you are at risk of falls.
  • Use a stable bed that is not too high, and move away objects or furniture you could hit if you feel dizzy.
  • Feeling dizzy during the exercises is normal. That is exactly the point: the vertigo should get milder day by day.
  • If you have neck or back problems, talk to your doctor first.
  • When you finish, stay seated for a few minutes before standing up, and do not drive straight afterwards.

How to do them

  1. Man sitting on the edge of the bed, looking straight ahead.

    Position 1

    Sit in the middle of the edge of the bed, feet on the floor, looking straight ahead.

  2. Sitting, with his head turned towards his left shoulder. Lying on his right side, face looking diagonally up at the ceiling.

    Position 2

    Turn your head 45° to the left and, keeping it turned, quickly lie down on your right side. Your face ends up looking diagonally at the ceiling.

  3. Man sitting on the edge of the bed, looking straight ahead.

    Position 3

    Sit back up and look straight ahead.

  4. Sitting, with his head turned towards his right shoulder. Lying on his left side, face looking diagonally up at the ceiling.

    Position 4

    Turn your head 45° to the right and quickly lie down on your left side, looking diagonally at the ceiling.

  5. Man sitting on the edge of the bed, looking straight ahead.

    Position 5

    Sit back up and look straight ahead. That completes one cycle.

Routine

ItemInstruction
Time in each position30 seconds, or until the vertigo stops if it lasts longer
Repetitions per session5 full cycles (5 times to each side), about 10 minutes
Sessions3 times a day: morning, midday and evening
Duration2 weeks, or until you have gone 2 days in a row without vertigo

This is the classic routine described by Brandt and Daroff. Always follow the one your doctor has given you, which may differ.

Common mistakes

  • Doing the movements slowly or only halfway. They should be quick, and you should lie all the way down.
  • Turning your head the wrong way. Follow the positions in the order shown.
  • Getting up suddenly at the end. Stay sitting for a few minutes.
  • Stopping too soon. If you have no vertigo, keep going until you have had 2 days in a row without symptoms.

Demonstration video

If it helps to see it, you can watch this video of the Brandt-Daroff exercises on YouTube. It is external content that I did not produce.

What is normal and when to seek advice

It is normal to:

  • feel vertigo or nausea during the first days, especially when lying towards the affected side;
  • find the symptoms get milder as the days go by.

Stop the exercises and seek advice if:

  • you have severe vomiting or the vertigo gets worse;
  • you notice no improvement after two weeks;
  • new symptoms appear, such as a severe headache, double vision, difficulty speaking, weakness or tingling on one side of the body, or sudden hearing loss. In that case call 112 (in Spain) or your local emergency number, or go to the emergency department.

Frequently asked questions

How long do they take to work? Many people feel less dizzy within a few days. If there is no improvement after two weeks, come back to see us.

Can I do them without a diagnosis of BPPV? No. Other types of vertigo do not improve with these exercises, and some need different treatment.

Are they better than the Epley manoeuvre? No. The manoeuvre we do in clinic usually clears the vertigo sooner. The exercises are a supporting option when unsteadiness persists or a manoeuvre cannot be done.

Can I drive afterwards? Better not straight away. Wait until the dizziness passes, and do not drive while you have vertigo.

References

  1. Brandt T, Daroff RB. Physical therapy for benign paroxysmal positional vertigo. Arch Otolaryngol. 1980;106(8):484-485.
  2. Bhattacharyya N, et al. Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (Update). Otolaryngol Head Neck Surg. 2017;156(3 Suppl):S1-S47.
  3. Alkhalefah F, et al. Epley-type maneuvers versus Brandt-Daroff exercises for posterior-canal BPPV: a systematic review and meta-analysis. Cureus. 2026;18(7):e112282.
  4. Hilton MP, Pinder DK. The Epley (canalith repositioning) manoeuvre for benign paroxysmal positional vertigo. Cochrane Database Syst Rev. 2014;(12):CD003162.
For general information only. It does not replace a medical consultation and cannot be used for diagnosis. In an emergency in Spain, call 112.

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