Motion Sickness — BIMC Hospital Bali

Motion Sickness

Posted on : July 15, 2009

Why are people more likely to get car sick in the back seat than in the front? Why are drivers less likely to get car sick than front seat passengers? Why do some people get sick in the car only when they read? On a bumpy flight, why are children more likely than adults to need an airsick bag (and not get to it in time!)?

motion2What is it?
Our bodies have wonderful mechanisms for sensing and making sense out of motion. There are several important motion sensing parts of the body. The semicircular canals of the inner ear are like miniature levels that orient the head in space. The eyes also constantly update the brain with information about motion. In addition, the nerves in our joints, especially the ankles, knees and spine, are motion detectors. Even the light touch sensors of the skin can detect our movement in the air.

Normally, these different sensors provide our brains with a coordinated, immediate sense of how our body is moving and how the brain should respond.

Motion sickness can result when there is a mismatch between these different systems. If the brain gets conflicting information from the ears and eyes or joints, the histamine receptors in the vomiting centres of the brain may be stimulated to slow down the movement of the GI tract. Even the sight of food can be unpleasant. The brain wants the body to take a break until it can figure things out.
When does it happen?
The word nausea is derived from the Greek word for ship – naus. Perhaps linguists connected the movement of the ship with sea sick. Actually many different types of motion can cause sickness including travel by sea, air, train, car, swing, space, camel, elephant, in fact virtually anything that moves. Other environmental stimuli that can cause motion sickness include exposure to artificial environments such as flight stimulators, amusement park rides and planetarium or IMAX theatres.
Who gets it?
Under the right circumstances, anyone can experience motion sickness. Some people are more susceptible to it than others. It tends to be worst on first boat trips or plane rides or space voyages, before the brain has a chance to get used to the new sensations. Sometimes a previous bad experience will trigger a new bout of motion sickness on an even gentler trip. Even anticipation of a ride can trigger symptoms. Either way, motion sickness tends to improve with age and eventually with experience.

Children in the back seat of the car are more susceptible when their height limits their view to seemingly stationary objects in the car. Reading also makes car sickness worse by focusing the attention on something that does not appear to be moving. The inner ears sense motion, but the rest of the body does not.

Some people get vertigo when standing over great heights because the visual cues of normal body swaying are lost over the great distances.

Some people get queasy, or at least a funny feeling in the stomach, when watching intense motion on a movie screen. The eyes suggest movement; the ears and joints and skin do not.

The most common places for motion sickness are cars, planes, boats, playground equipment and amusement park rides.
Many times the previous 24 hours are the reason for motion sickness not the journey itself. Hangovers, over tiredness, anxiety, minor illnesses all contribute to motion sickness. A heavy meal, full of fat and possibly over spiced, does not help either. Too many carbonated and or alcoholic drinks can unsettle your stomach, which will make you more sensitive to motion sickness during the journey. Therefore if you are not fit, rested and healthy you will probably suffer more motion sickness than you usually do.
What are the symptoms?
Mild motion sickness usually begins with a funny feeling in the stomach. If the mismatch in motion signals is not resolved to the brain’s satisfaction, the symptoms may progress to include sweating, yawning, crying (in babies), increased saliva, pallor, nausea and vomiting. Some people also breathe more quickly. Some have a headache. Some even faint.
Is it contagious?
Somewhat. The nausea centres of the brain are more sensitive when others are vomiting.
How long does it last?
The motion sickness lasts until soon after the motion has stopped, or until the brain has become comfortable with the motion.
How is it treated?
Either stop the motion, or do what you can to help the motion make sense to the brain.

Sometimes fresh air and focusing attention outside of the vehicle can provide enough additional information to the brain to break the cycle of motion sickness.

Sometimes, it is best to stop the car or merry-go-round and take a break. Frequent stops can make a big difference. Distraction (perhaps from a song) can also help.

Height vertigo can often be treated by sitting down and by focusing on a nearby object. Queasiness when watching a movie can be lessened by moving with the image.
Treatment for the nauseated children. Have your child lie down and keep a vomiting pan handy. Give him only sips of clear fluids until his/her stomach settles down. If your child goes to sleep, let him sleep. Usually, children don’t vomit more than once and all symptoms disappear in about 4 hours.
How can it be prevented?
Some antihistamines can block the chemical signals of motion sickness. If this is a frequent problem for your child, talk with your health care provider about how and when to use these medications.

Try arranging trips to reduce conflicting cues and take breaks early when symptoms do develop.

Other tips
• Avoid exposure to the causative situation as much as possible
• Stay in a central location on a boat or ship or in an aeroplane
• Sit in front seat of a car or central position in the rear seat, or drive rather than be a passenger
• Focus on a stable horizon or external object
• Avoid jerky, sudden movements when driving
• Eat a light meal then avoid food for three hours before departure
• Avoid heavy meals, dairy products and foods high in protein, calories or salt
• Avoid alcohol, smoking and strong smells
• Have access to cool, fresh air
• Avoid visual stimuli (e.g. reading, watching videos)
• Limit head movements (e.g. press head into the headrest)
• Lie in a supine position with eyes closed
• Have cognitive behavioural therapy with a psychologist
• Take medications for prevention and treatment
• Note that habituation or adaptation will occur with increasing length of exposure to the causative situation

• Dr. Greene’s webpage
• Medical Progress Journal

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