Motion sickness

 

Motion sickness is a feeling of dizziness with nausea and vomiting that occurs as a response to motion (travel). It is a common condition that makes traveling uncomfortable and unpleasant for many people.

It can occur as car sickness, train sickness, air sickness, or sea sickness. It can also occur in a motion simulator where there is no real motion.

 

 

Motion (real or apparent) causes motion sickness. Flight simulators or car simulators can induce motion sickness. Sophisticated graphics on smartphones and amusement park rides may also cause motion sickness.

It occurs when there is a visual-vestibular conflict and contradictory signals are sent to the brain by our eyes and vestibular system, part of the inner ear that provides information about motion and equilibrium to the brain. While traveling by car, train or plane, the eyes perceive motion and send the signal to the brain. However, the body is at rest and hence the vestibular system sends the signal to the brain that the body is at rest. This creates confusion leading to motion sickness.

The risk factors for motion sickness include:

1. Anxiety, tiredness and insufficient sleep

2. Reading while traveling

3. Smoking, alcohol intake, or use of drugs

4. Being pregnant

5. Migraine

6. Strong fumes or odors

7. Lack of ventilation

Children (2 to 12 years old) and women are at a higher risk of motion sickness. It occurs less frequently in people older than 50 years.

 

 

The symptoms of motion sickness may include:

1. Dizziness

2. Nausea and vomiting

3. Headache

4. Drowsiness

5. Pale appearance

6. Sweating

7. Excessive secretion of saliva

8. Loss of appetite

 

 

Diagnosis of motion sickness is usually based on the patient’s complaint of the relevant symptoms during travel. The doctor will take history related to traveling and symptoms of motion sickness.

The doctor may check for the presence of any inner ear problem that can exaggerate the symptoms of motion sickness.

 

 

Treatment for motion sickness comprises removing the patient from the factor that is causing motion sickness. The symptoms of motion sickness usually subside once you stop traveling.

In the case of severe motion sickness, treatment may include:

1. Administration of IV fluids to replace fluid loss due to vomiting.

2. Medicines such as promethazine, cinnarizine, scopolamine, dimenhydrinate, and chlorpheniramine to treat nausea and vomiting.
3. Scopolamine is also available as a patch that can be placed behind the ear at least 4 hours before traveling. A single scopolamine patch will work for 3 days. 

Follow these tips while traveling to ease symptoms due to motion sickness:

1. Choose a seat where movement is felt the least. Prefer sitting in the middle of the plane or boat. Occupy aisle seat on the plane.

2. Eat light

3. Chew some ginger candies or dried ginger while traveling.

4. Apply light pressure on your inner arm about 6 cm to 7 cm away from the wrist. You can also use a wristband for this purpose.

5. Vomiting may cause fluid loss. Make up for the loss by drinking tea or fruit juice.

6. Try relaxing by slow breathing and lying back on your seat.

Avoid the following while traveling:

1. Overeating

2. Traveling on an empty stomach

3. Carbonated drinks before or during travel

4. Alcohol before or during the journey

5. Active or passive smoking -- tobacco smoke may aggravate symptoms

6. Reading a book or looking continuously at smartphone’s screen

 

 

Vomiting due to motion sickness can cause excessive loss of fluids from the body and may lead to dehydration, electrolyte imbalance, low blood pressure, and tachycardia (rapid heart rate).

See a doctor if you continue to have symptoms of motion sickness even after you have stopped traveling. It could be due to migraines or some inner ear disease.

 

 

Gradually increasing the exposure to motion (habituation training) can help you get used to traveling and reducing the intensity and frequency of motion sickness. Limiting the activities that cause motion sickness can help you avoid it.

 

 

Crane BT, Eggers SDZ, Zee DS. Central vestibular disorders. In: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology. 6th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 166.

FIRST CONSULT. Motion sickness. Philadelphia, PA: Elsevier. Revised: May 11, 2012.