Holiday travel season is just around the corner, which means millions of people will experience motion sickness in a car, train, or plane. How can we manage this common discomfort to make the journey just as fun as the destination? Dr. Jason Fishel, MD, answers our biggest questions about motion sickness management.

Coronavirus Updates, Primary Care | one year ago

Don’t Rock the Boat: How to Manage Motion Sickness for Comfortable Travel

Holiday travel season is just around the corner, which means millions of people will experience motion sickness in a car, train, or plane. How can we manage this common discomfort to make the journey just as fun as the destination? Dr. Jason Fishel, MD, answers our biggest questions about motion sickness management.

It’s a sight that’s almost expected on cruises and long road trips — a person hunched over, pale in color, struggling with the onset of nausea. Though this scene has become a practical staple in comedies where nautical adventures are involved, experiencing motion sickness is no joke — and it’s also quite common. In fact, it affects around 1 in 3 people and nearly any person can experience it if they undergo particularly intense motions.

Various methods of travel and transportation can bring on motion sickness, and with the holiday travel season upon us, it’s a good time to discuss methods to mitigate the symptoms. Jason Fishel, MD, internal medicine physician at Atrium Health Mecklenburg Medical Group – Ballantyne, takes the time to answer some of our big questions about this condition and how to manage it for comfortable travel.

Question 1: What causes motion sickness?

Answer 1 | Dr. Fishel: There are three inputs from our body that tell our brain information about movement. The first is visual information from our eyes – actually seeing that we’re moving. There is also information about balance and acceleration that comes from our inner ear. Finally, the location of our arms and legs in space is sensed by our nervous system, a phenomenon called proprioception. If there is conflicting information coming from these systems, motion sickness can develop.

Q2: What kinds of travel often cause motion sickness, and why?

A2 | Dr. Fishel: Any form of travel can cause motion sickness due to a difference between your visual point of reference and the vestibular and proprioceptive movement information that is sent to your brain. If you’re sitting in the back seat of a car reading a book, you’re not visually seeing any movement, but your body still gets signals about acceleration and rotation that are not accounted for by what you are seeing. This then causes the release of chemicals in your brain that can trigger nausea. This happens more often with forms of transportation that involve movements you are not accustomed to or complex movements, like the rocking of a boat.

Q3: Are there any actions that promote motion sickness during travel?

A3 | Dr. Fishel: Any action that worsens the conflict in signaling between your systems can make motion sickness worse. In particular, reading or looking at a phone or tablet screen while in motion is very confusing to your nervous system and may increase the intensity of motion sickness.

There’s not any evidence that eating heavy meals or emotional stress cause motion sickness, but since both of these can contribute to nausea for other reasons, they may worsen the overall experience. Likewise, while pregnancy doesn’t cause abnormal function of the nervous system with respect to motion, the nausea of pregnancy can compound issues with motion sickness as well.

Q4: What are the best ways to battle motion sickness?

A4 | Dr. Fishel: The key is to focus on interventions to limit the mix-up in neurologic information in your body. Do everything you can to be in a position where you experience the least amount of motion possible — where your body is oriented in the direction of motion as much as possible. For example, when riding in a car, focus on the horizon in front of you instead of turning your body to the side or looking at the floor.

If you’re worried about getting motion sickness, there is some evidence that this worsens symptoms – call it a sort of ‘self-fulfilling prophecy’. If you know you’re going to be exposed to a situation where you can get motion sickness, try relaxation techniques such as breathing exercises to lower your stress.

Q5: Are there over-the-counter options you would recommend?

A5 | Dr. Fishel: Thankfully, there are quite a few over-the-counter treatments for motion sickness. Acupressure bands – bracelets with a small firm bead that puts pressure on the inside of your wrist – loosely adapt principles of traditional Chinese medicine to prevent nausea. They have been shown to have some benefit in motion sickness without any risk of side effects.

Ginger supplements are also an option. This can come as a capsule, gum, or chewable candy, but it is important to make sure your chosen delivery system contains real ginger – artificial flavoring won’t do the job.

If these don’t work for you, then the next medical recommendation would be over-the-counter medications called antihistamines. You specifically are looking for a medicine called meclizine or diphenhydramine. These can be taken about 30 minutes before travel to get maximum benefit. Both of them can make you drowsy, with meclizine a little less so than diphenhydramine. Before you take these, verify with your physician that they are right for you.

Q6: As people begin traveling more, are there any additional recommendations you have to stay healthy generally amid the pandemic?

A6 | Dr. Fishel: As travel picks up for the holidays, it’s reasonable to expect some possibly risky situations to pop up with respect to the COVID-19 pandemic. Things are improving in some parts of the country, but there are others where the pandemic is still in the earlier phases. By no means are we fully safe at this point.

Therefore, I would encourage you to not only follow your local ordinances in terms of social distancing and masking, but also to make yourself aware of the COVID-19 levels in your destination and any unique health recommendations or situations there. Carry hand sanitizer if possible. Sanitize or wash after contact with surfaces when you are in transit.

If you’re sick, even though this is understandably a difficult decision, please make the right call and stay home rather than exposing your loved ones and potentially hundreds of people in the airport or train station to the virus.

And finally, be kind to each other – following these regulations can make travel take longer. Try to leave plenty of time, be patient, and treat each other with respect. We’re all doing our best to keep as many people in our country as safe as we possibly can.

If you have any additional questions about motion sickness or are considering a treatment option, consult with your primary care provider. Need a provider? Search for one near you here.