Motion Sickness

By Dr. Loretta Lanphier, ND, CN, HHP, CH

If you’ve ever experienced car sickness (your own or someone else’s), or had to reach for the “service bag” on an airplane, then you have been exposed to the very unpleasant condition known as motion sickness. It seems a common enough disorder, but what brings it about and can we do anything to prevent it? Let’s see if we can cover the basics.

What is Motion Sickness?

Motion sickness, or travel sickness as it is sometimes called, is an illness caused by the effect of motion on the body. In individuals who suffer from motion sickness, repetitive or unusual motions experienced while moving can trigger nausea, vomiting, and other symptoms. Terms like “car sickness,” “air sickness,” or “sea sickness” are all other names for motion sickness that are linked to a particular mode of travel. This malady is the result of a disturbance in the normal balance and equilibrium mechanisms of the body, and is due to conflicting sensory perceptions that are received by the central nervous system.

Motion sickness is so common that over 80% of individuals will experience it at some point in their lives, to one degree or another. It can occur at any age, but is most often found in children over the age of two, who typically tend to outgrow it as they get older. Certain types of motion, such as a spinning carnival ride, seem to bring on motion sickness in many adults as they age. You know you’re getting older when you can’t ride the Tilt-a-Whirl with your grandkids at the county fair anymore!

Some folks are only affected by certain kinds of travel, such as on an airplane or a ship, while others suffer from motion sickness across the board with just about any kind of movement. Some people can even get sick from watching a chase scene on a television or movie screen, or taking a swing at the local park. As varied as the situations may be that bring on motion sickness, the basic cause is the same:  A disruption of the normal functioning of the inner ear and other sensory organs that cause conflicting information to reach the brain.

What Are the Symptoms of Motion Sickness?

The signs of motion sickness, in most cases, start out on the mild side, and worsen as the journey continues. Initial symptoms include a feeling of general discomfort, perspiration, excess production of saliva, and malaise (a vague sense of not feeling well), pale appearance, yawning, dizziness (vertigo), headache, cold sweats, increase in respiration, and rapid heartbeat. In the more advanced stages, nausea and vomiting are very characteristic. Motion sickness is not considered to be a serious illness, but it can be very debilitating for some folks. For others it is not much more than an annoyance that must be tolerated and managed.

For most motion sickness patients, the symptoms cease shortly after the movement ends, but some people will experience them for several hours or even several days, in extreme cases, after the journey. There is a particular form of motion sickness called mal d’embarquement syndrome (embarkment or departure sickness) or mal de debarquement syndrome (disembarkment or arrival sickness). This form of the illness usually has symptoms that can last for days after travel, but these are rare conditions that are not the norm for motion sickness. Another rare form is sometimes called chronic motion sickness,and is something that has to be dealt with on a daily basis by individuals who are unfortunate enough to be afflicted with this ongoing variety. Chronic motion sickness is known by various names, including positional dizziness.

What Are the Causes of Motion Sickness?

Motion sickness is largely the result of abnormal operation of the body’s sense of balance and equilibrium. This function is officially called “spatial orientation,” and has to do with the brain’s ability to determine where the body is “in space.” Another way to put it is that our sense of balance and equilibrium helps the central nervous system to properly decipher movement of our body, movement of the environment around us, and what direction the body is pointing or oriented to (in other words, which way is up and which way is down). Much has been learned in recent decades regarding balance and equilibrium thanks to the space program and related studies in weightlessness and aeronautical medicine.

The mechanism that controls balance and equilibrium in the human body involves a complex relationship between several parts of the central nervous system:

  • The most critical aspect of balance and equilibrium, and the most important factor in motion sickness, is the inner ear. The vestibular system controls balance by, among other things, monitoring motions and determining their direction in relation to both the individual and his surroundings. The workings of the inner ear are able to differentiate between motions such as turning (spinning), side-to-side, up-and-down, and forward-backward. When operating properly, the labyrinth sends messages to other parts of the body telling it how to compensate for the various motions it is sensing. The inner ear might be correctly referred to as “balance central.”
  • The eyes also play a key role. They provide visual clues to the body to help it determine how it is oriented in space, such as upside-down or right side up, or leaning to the left or right, or to the front or back. They also provide data regarding whether the body is moving or standing still, and how the speed of that movement relates to the surrounding environment. There is a form of motion sickness called “pure optokinetic” that is solely caused by visual disturbances. It is linked to the eye’s inability to normally move appropriately in response to moving objects around it. It is often uncomfortable for folks with pure optokinetic motion sickness to view rotating or swaying images such as those on a movie screen.
  • Sensory receptors in the skin, especially in the feet and buttocks, convey information about which parts of the body are facing “down” or touching the ground.
  • Similar receptors in the muscles and joints supply data regarding movement of body parts.
  • All of this sensory input is gathered and analyzed by the brain and central nervous system in an attempt to make some sense of it all, and thereby make the necessary adjustments to keep the body balanced and stable.

When this marvelous navigational system is working properly, all systems are go, and we are able to make our way through the world around us with grace and agility (some of us with more of these qualities than others!).  However, when communication breaks down, the brain receives conflicting information from the senses that causes confusion and often results in motion sickness.  A good example would be a person who is in his cabin during a cruise when the ship hits some rough waters. The inner ear, skin, and musculo-skeletal sensors can sense the back- and-forth or side-to-side motions of the ship, but the eyes probably cannot. Therefore, the central nervous system becomes confused and cannot respond appropriately. This also occurs in people who have a damaged ear due to trauma or infection. Even if one ear is not reading the data correctly, the message received by the central nervous system may be flawed. Many researchers believe that a common result of the miscommunication is a mistakenly sent message to the “vomiting center” of the brain, which is thought to be the most likely explanation for the symptoms of motion sickness. However, the specifics are not fully understood at this point.

Certain factors, some that can be avoided or minimized, often increase a person’s risk of developing motion sickness:

  • Anxiety seems to be a clear trigger for motion sickness in some folks. Something like the fear of flying can make a person more prone to travel sickness, but it has also been observed that the fear of getting motion sickness can also be the source of anxiety for travelers who have experienced it in the past.
  • Diet is also important. If you have a propensity for motion sickness, you are better off to avoid eating a heavy meal, especially if it is also spicy, before a trip. Alcoholic beverages are also a no-no. Some people have a drink to help them relax, but this “therapy” usually backfires when it comes to travel sickness. Don’t overindulge before a trip either, as a hangover can make motion sickness even worse.
  • Getting plenty of fresh air is important too. Crack the window in the car, or turn the air vent towards your face if you are flying. Slow, deep breathing is also a helpful tip for fighting off motion sickness.
  • There is also some evidence that points to genetic predisposition when it comes to motion sickness. If it runs in your family, you are more likely to struggle with it yourself.

What Treatments Are Available for Motion Sickness?

There are various and sundry medicines that are used to treat motion sickness, and many of them are appropriate and helpful for many people. A number of antihistamines are often suggested, both prescription and over-the-counter (OTC). There are also skin patches available, and anti-seizure drugs such as klonopin are even prescribed in some extreme cases. I would be very careful of any of these medications. Even OTC antihistamines can have significant and dangerous consequences, especially for folks with respiratory problems, an enlarged prostate, or glaucoma.

There are a number of drug-free treatments that are very affective:

  • Wristbands that put pressure on the lower arm seem to work well at preventing motion sickness in many individuals.
  • Ginger has been used for thousands of years as a soothant for nausea and other stomach disorders. Try some ginger tea or capsules of ground ginger before or during your next trip. It also has a calming effect on the central nervous system.
  • Other preventative tips include:
    • Watch where you sit when traveling. In a car, either drive or sit in the front seat. On a ship, the least amount of motion is found in a middle cabin near the deck. The best spot on an airplane is on the front edge of a wing. Sit near the front on a train, preferably by a window. Never sit facing backwards.
    • Keep your eyes on the horizon, if possible. At sea, go on deck and focus on the horizon (but don’t watch the waves!).
    • Some people find it soothing to put their heads back or lie down with their eyes closed. Find what works best for you and plan ahead if possible.

Motion sickness can be very disruptive, especially if you travel a lot. The good news is that it is very preventable in most cases, and if you are prepared both before and during a trip, you can make life a lot easier for yourself. Also be encouraged that for many folks the effects seem to lessen the more they travel. Perhaps our bodies become used to it and stop over reacting. Above all, don’t let your self get anxious about it. Relax and enjoy the ride.

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