BPPV is quite common among older people. Further, it can be COMBINED with some other hearing/balance diseases, like Meniere's. Because inner ear disease is extremely hard to diagnose correctly, 80% of people diagnosed with Meniere's do not actually have THAT disease. A fair number of those have a disease only more recently recognized: MAV, or migraine-associated vertigo, which can be treated with standard migraine meds. (And, no, it doesn't mean that the person has headaches, but problems with balance and, often, hearing.)

I have true Meniere's, plus BPPV. The solution to Meniere's is daily vestibular rehab. As long as I work on proprioception (the third balance system), I do not have problems with BPPV. The aim of vestibular rehab (VRT) is to learn to rely on proprioception instead of your inner ear (the primary balance system) or vision (the secondary balance system). When your inner ear doesn't work as well as it should, you automatically begin to rely on vision, which is all bad: every time you move your head or drive around a corner, etc., your focal point changes and you temporarily do not know where you are in space. Proprioception is the assurance of where you are in space offered by your feet, knees, hips, etc. Simply put, if you stand on a windy point, you will probably automatically lean just enough toward the wind to maintain balance: that proprioception in a nutshell.

Today, there are a few vestibular clinics that offer VRT, and some PTs know about it. The exercises are easy to do and can become part of your daily routine. For example, one thing that I do every day is walk the quarter mile on a gravel road to my mailbox...with my eyes closed, concentrating on what my feet are telling me. Another daily exercise is to walk through the house with all the lights turned off late at night, or to walk around our hilly acreage in the total dark (no ambient light of any kind). The advice that older folks should all use night lights is wrong, as it only encourages reliance on vision. Naturally, you only walk with eyes closed or in the dark in places where you know there's nothing to trip you! Before you turn out the lights, check to make certain that neither kids nor pets have left their toys in your path!

As you age, you will naturally lose some nerve function in your lower legs, so you need to work a little harder on proprioception. I have a tiny platform about 6" high so that I can practice stepping down with one foot, getting balanced, stepping back up, first 6X with eyes open, then 6X with eyes closed, then repeating the exercise with the opposite foot. You also could put a long 2x4 flat on the floor and practice walking "the plank!"