Motion Sickness - A Doctor's Advice

As a doctor, I see patients suffering motion sickness caused by everyday reasons like driving, as well as others who avoid air travel because of the symptoms it causes. Not everybody is susceptible to motion sickness, but it can cause enormous problems and suffering for those who do.

Motion sickness occurs when the body receives conflicting information from the eyes, the vestibular centre (in the inner ear) and the body sensors (in the legs).

The brain expects the information it gets from these to be consistent but, in some situations (such as travelling by car, ship, train, plane or even on a swing!) the information through the eyes is of rapid movement while the body is moving in a different way.

The body responds to this mismatch with symptoms of motion sickness. These range from dizziness, excess salivation, pallor and nausea through to cold sweats, vomiting, fatigue and loss of concentration.

A suffering pumpkin [Image: Abbamouse under CC-BY-SA licence]

Episodes can also be triggered by poor ventilation or emotional factors like anxiety.

If you suffer with motion sickness then the good news is that with prolonged exposure your body adapts. But there are also specific steps I advise my patients that can help minimise the symptoms.

Prevention

1. On the road

Being the driver you are in control of the car, and this can lessen the effects of car sickness. If you have to be the passenger then ensure that you have a wide peripheral view of the surroundings – your senses can be confused by the sensation of travelling if you can't see the reason for it.

So looking down to read a book, for example, can often trigger sickness. If you do feel unwell then don't hold your head in your hands – it'll just make things worse. Try to look up and keep an eye on the road.

Make sure you have good ventilation in the car, as the smell of smoke or other strong smells can trigger and aggravate motion sickness.

Also, avoid a heavy meal or excess alcohol as this will aggravate the motion sickness.

2. On Water

Many people suffer from seasickness and often are not aware that there are specific steps you can take to reduce the symptoms.

Ideally go out on deck where you can give your senses a better chance of understanding what's going on.

Focus your eyes on the horizon and away from the waves or other moving objects, as this gives your eyes a fixed point to gauge the movement against. This should help your brain match up the sensations of movement that it's getting from your inner ear and what it sees through your eyes.

If you try to minimise your head movements this should also help. Being outside will also help you get plenty of fresh air, and this can also help. If you can position yourself as centrally as you can then you should minimise the amount of movement that you experience, which should also help.

If you must stay inside, then try to minimise the motion by sitting somewhere central. You will also find that being able to see the horizon is helpful, so try to find somewhere close to a window.

3. In the air

Motion sickness in flight also something that you can minimise with a little knowledge. For example, the sense of motion in a plane is at its least over the wing, so if you can secure a seat here then this should help.

You can also reduce the confusing signals about motion that your brain receives by maintaining a steady head position and by sitting upright.

Some patients come to me with anxiety about flying which compounds their motion sickness. I often find that the use of relaxation breathing techniques can help the minimise symptoms. You may also like to look at my advice on fears and phobias.

As with all types of motion sickness excess alcohol or eating a large meal can increase the chance of developing the symptoms, so avoid alcohol if possible and keep meals simple and light. On long trips eating and drinking little and often would be preferable to a single large intake of food and drink.

Treatment

Occasionally I prescribe medications for patients to use before a flight or on a ship if their motion sickness symptoms are disabling. There are a variety of drugs that can be useful, including stemetil diphenhydramine, cyclizine, promethazine and scopolamine.

These would be taken a little time before departure and can offer some people relief from motion sickness. If vomiting does occur, then there are anti sickness medications available, such as buccastem which dissolves under your upper lip and should stop the vomiting. All these drugs have side effects so if you are wondering about taking tablets with you on a trip then you should discuss it with your GP.

An alternative option is an acupressure band, which is an elasticated wrist device, which presses on a pressure point on your inner wrist. This simple device has been reported to help some people and can be bought at most pharmacies.

The good news is that your brain is adaptable. Just because it naturally gets confused by mixed sensory messages doesn't mean it can't learn to cope. So if you regularly expose your body to these situations, it should get start to become 'habituated' and the brain will begin to no longer find the signals confusing – and the symptoms of motion sickness should reduce.