Canalith
Canalith
There is a cruel arrangement at the heart of keeping a vertigo record: the details are at their most accurate exactly when you are least able to write anything down. You cannot read a screen, you should not be moving your head, and one hand is holding onto the mattress. By the time you can comfortably type, the trigger has already softened into "I think I rolled over". This guide is about closing that gap.
Everything that follows depends on there being nothing to decide during the episode. Decide now.
Pick one place the record lives and use only that. The format matters far less than not having three half-kept records that cannot be summarised.
Put it within arm's reach of where you sleep, since a large share of positional episodes happen in bed. A notebook needs a pen attached and a light you can turn on without standing up.
Reduce it to one action. A shortcut on the lock screen, a pinned note at the top of the list, or a voice recorder you can start by feel. Practise it once with your eyes shut. If it takes more than one deliberate action, you will not do it at three in the morning — and those are the episodes that matter most.
Fix your severity scale once. Write down what a 3, a 6 and a 9 mean for you — for instance: 3, the room shifted and I carried on; 6, I had to stop and hold something; 9, I could not stand. Nobody else can calibrate your numbers; what makes them readable over months is using them the same way each time.
If you capture one thing, capture when it started. It carries the most structure — clustering, time of day, frequency over weeks, the gap between episodes — and it decays fastest, because "yesterday evening" is what you will have by tomorrow.
Anything that stamps a time counts: starting a voice memo, creating a note, tapping a button on a watch. You do not have to write a word for the record to begin. Do it without lifting or turning your head, reaching for the device by feel. Record the time the spinning began, not the time you got round to logging it, and if those differ by more than a few minutes, note the difference.
Speech needs no eyes, no steady hand and no fine motor control, which makes a voice memo the most under-used tool here. Ten seconds of talking, in a fixed order, gets you almost everything:
Say it in the same order every time and it becomes automatic. If speaking aloud is not practical — someone asleep next to you, an office — use a fixed shorthand you can thumb without looking, or tappable options large enough to hit blind. What you want to avoid is composing prose one-handed while the room turns; that is how people end up recording nothing at all.
Duration is one of the sharpest dividing lines between the causes of vertigo, and more informative than severity. You do not need a stopwatch, but you do need to notice the moment the room stops moving rather than the moment you feel normal again.
Use consistent bands: seconds; under a minute; a few minutes; an hour or more; all day. If the voice memo is still running when the spinning stops, say so — the recording length gives you the answer for free.
Record the tail separately. Many people are shaky, foggy or queasy for far longer than the vertigo lasted, and that residual unsteadiness is worth its own line: it often shapes the day more than the episode did.
As soon as you can look at a screen or a page comfortably, complete the entry. Do not leave it to the evening: detail accuracy drops noticeably within the first hour, and severity in particular drifts towards whatever the last bad episode felt like.
Add, from a fixed checklist rather than from memory:
Two rules keep this fast. Never add fields; every extra column is a reason to skip an entry at two in the morning, and skipped entries are usually the bad ones. And keep it to observations, not theories — a record of what happened is evidence, one of what you concluded is an argument.
Log the episode, not the day. Twelve short spells one morning should read as twelve entries, not "a bad Tuesday".
Log the mild ones. A record containing only dramatic episodes exaggerates severity and hides frequency, which is a worse distortion than a few missed entries.
Mark reconstructions as reconstructions. If you are writing something up hours later, say so and give a range rather than false precision. An honest gap beats an invented entry, and a clinician can weight an entry marked "estimated" appropriately.
Keep the clear days visible. A calendar view where nothing happened is as meaningful as a run of bad ones, and it is the only way to see improvement.
Keep going for six to eight weeks. Patterns in vertigo rarely resolve inside a fortnight. Then summarise onto one page, as in keeping a diary your doctor can use, and take it with you — our guide to preparing for a vestibular or ENT appointment covers the rest. For background on why the same few head movements keep doing this, the blog explains why the room spins when you roll over in bed.
Canalith was designed around the thirty seconds this guide is about. Severity is a single drag on a dial you can find without looking, symptoms are a checklist of taps, the time is taken for you, and the barometric pressure and weather at that instant are attached with no action from you. On Apple Watch, severity is the crown, so the record can start without reaching for a phone at all. It keeps the diary, follows along with the exercise your clinician prescribed and taught you, and exports the one-page summary. It does not diagnose or treat anything. It is not on the App Store yet — join the waitlist for the release.
This guide is about record-keeping. It is not medical advice, and a diary is not a substitute for an examination. Nothing here describes how to perform a repositioning manoeuvre; only a clinician who has examined you should prescribe and teach one. See a clinician about new or recurring vertigo, and treat it as urgent — emergency care, the same day — if vertigo comes on suddenly together with any of: double vision, weakness or numbness on one side, trouble speaking or swallowing, a severe or unusual headache, difficulty walking or standing, new hearing loss in one ear, chest pain or fainting.