Dizziness that occurs instantly when lying down and waking up is mostly caused by otoliths. Otolithiasis is a form of peripheral vertigo in which the patient mainly presents with sudden dizziness, nausea, and vomiting when the head position is rotated, along with visual rotation as well as deafness and tinnitus. The symptoms of dizziness are usually severe and are usually not accompanied by balance disorders or ataxia. The dizziness is mainly caused by the detachment of the otolith from the semicircular canal. The patient’s dizziness is usually short-lived, lasting for a few seconds or minutes, and is mainly treated with repositioning. If the dizziness is frequent or severe, symptomatic treatment can be given at the same time, such as oral vertigo stop or oral pethidine. It may also be caused by cervical spondylosis, which may occur when the patient lies down or wakes up, but the symptoms of dizziness are usually mild and may be accompanied by nausea, vomiting, balance disorders and ataxia. Usually, it is not accompanied by rotation of vision, deafness and tinnitus, but if necessary, a cervical spine MRI should be performed to clarify the diagnosis.