I often feel carsick while traveling. What are the best ways to prevent or treat motion sickness?
A. Historically associated with sailors reacting to the pitch, roll and yaw of ships, motion sickness now affects people in cars, trains, planes and even in space.
The symptoms can start within minutes of feeling movement and last for hours after it stops. Classic motion sickness often begins with feeling warm, sweaty and dizzy. You might also develop a headache or feel fatigued. As the condition worsens, nausea sets in and can lead to vomiting.
While motion sickness is generally temporary, it can hold you back from traveling and other activities you enjoy, sometimes in life-changing ways. James Phillips, a vestibular neurophysiologist at the University of Washington, said he had planned to be a marine biologist until he spent time on a research expedition vomiting over the side of the boat. “I just couldn’t tolerate it, so I abandoned that career ambition,” he said.
We asked experts what’s behind motion sickness and which of the products to treat or prevent it — from glasses and bracelets to medications — really work.
Why do people react this way to motion?
Scientists don’t know exactly what causes motion sickness, but one theory is that it’s the body’s reaction to conflict between different senses. If you’re reading in a car, for example, your eyes see a stationary page. But the parts of your inner ear that detect acceleration and rotational motion sense you’re moving, even if you’re not aware of it, said Paul DiZio, a cognitive neuroscientist at Brandeis University.
A newer theory among many researchers, DiZio said, is that motion sickness results from a mismatch between what your brain expects your senses to detect and what they do detect. Even before a motion occurs, “you build a little model in your brain of how it’s going to feel,” he said, and you get sick if what you sense doesn’t fit those predictions.
It’s unclear why some people react with motion sickness, but some scientists think the brain interprets inconsistency as resulting from a neurotoxin, and sets off vomiting in response.
Most people experience some motion sickness from extreme motion, but some also react to milder movements. Children are generally more susceptible than adults, possibly because they have not yet become habituated to such movements. Women are more at risk than men, most research suggests. One study estimated that genes account for 57% to 70% of a person’s susceptibility to motion sickness.
Dr. Kristen Steenerson, a vestibular neurologist at Stanford University School of Medicine, said you’re more likely to get motion sickness if you have migraines. In particular, people with vestibular migraines — who experience vertigo or dizziness, along with some migraine symptoms, sometimes without a headache — may get sick watching an action movie, unloading the dishwasher or even reading while sitting still, she said.
How can I prevent motion sickness?
Over-the-counter medications, including antihistamines like Dramamine and Bonine, are effective but they should be taken before motion starts, Steenerson says, and they can have side effects, like drowsiness.
Scopolamine, a patch worn behind the ear, helps some people but can also come with side effects such as dry mouth, and isn’t recommended for children or older adults. Last year, the Food and Drug Administration approved a new prescription drug, Nereus, that targets different receptors in the brain to prevent motion induced vomiting and may have fewer side effects, Phillips said.
There are also behavioral approaches that may help prevent motion sickness. If you’re in a car, driving may reduce symptoms because you’re in control of your environment. If you’re a passenger, Steenerson said, sitting toward the center of the car and keeping your eyes on the road can help. Dr. Erich Voigt, an otolaryngologist at NYU Langone Health, recommends staying toward the center of planes and above deck on boats, where you can see the horizon.
Controlled breathing and distractions like fresh air, pleasant music or scents like rose or lemon may help reduce symptoms, some experts said. But evidence to support the effectiveness of ginger or other supplements is mixed, and most studies suggest acupressure bracelets and motion sickness glasses help no more than a placebo.
If motion sickness is still holding you back, a physical therapist who specializes in neurology or vestibular rehabilitation can help you identify motions that set off symptoms and improve your tolerance over time. This kind of controlled habituation, Steenerson said, can be more effective than many other approaches. “It takes time and it’s unpleasant,” she said, but if you put the time in, it can work “really, really well.”
Paying attention to what sets off your symptoms can help you navigate them long-term. For example, Steenerson said she gets sick in cars but loves roller coasters. Phillips said he has a sailboat that doesn’t give him the same debilitating symptoms that the research vessel did. Though most people are able to manage motion sickness if they plan ahead, he said, “there’s some things that are just, you know, overwhelming for some people.”
This article originally appeared in The New York Times.
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