Problem: The literature has many papers that discuss the effectiveness of Epley's canalith repositioning maneuver to treat benign paroxysmal positional vertigo of the posterior semicircular canal, but few studies actually compare the maneuver's variations. We tested 2 variations on the maneuver, using home instructions and an additional partial turn.Methods: The subjects were adult patients referred for vestibular rehabilitation at a tertiary care facility where patients who need to be treated for BPPV are all referred for vestibular rehabilitation. Our subjects were randomly assigned to 3 groups: (1) standard Epley maneuver with the head turned 90 degrees only; (2) augmented Epley with the head turned 90 degrees, the body was rotated 90 degrees, and the head turned an additional 45 degrees; and (3) standard Epley maneuver as in group 1 with home instructions to avoid sleeping on the involved side, to wrap a towel around the neck at night, and to prop up on extra pillows while sleeping.Results: On measures of vertigo intensity and frequency, vertigo intensity elicited by the Dix-Hallpike maneuver, amplitude of nystagmus elicited by the Dix-Hallpike maneuver, and on posturography scores no differences were found among groups. Age and sex had no influence on outcome.Conclusion: Adding home instructions does not improve the effectiveness of treatment and can be distressing for the patient who is unable to sleep well when semireclined. The additional turn does not significantly influence the effectiveness of treatment.Significance: These results suggest that the maneuver can be performed whichever way is most comfortable for the patient and most compatible with the patient's strength and range of motion, and the results confirm previous findings that home instructions are not necessary.Support: None reported.