Motion sickness is the stomach’s expression of confusion. The brain likes the signals it receives to complement each other and, when they don’t, nausea and vomiting ensue. Motion sickness occurs when the signals arriving in the brain from the eyes are at odds with the input from the balance organs in the inner ear.
Blocking out one input can help suppress the problem. Motion sickness medications effectively sedate the part of the brain dealing with motion detection, thereby stopping the conflict of signals by suppressing detection of movement by the organs of the inner ear.
Am I susceptible?
Individuals vary greatly in their susceptibilities, but almost everyone feels unwell in extreme environments – such as on very rough seas (the Antarctic Ocean is a classic example). Motion sickness is rare in children under the age of two but very common in older children. The peak age for pukiness is between three and 12 years; thereafter many youngsters grow out of it.
Women suffer almost twice as much as men, in the ratio of 1.7 to 1. People can experience motion sickness if they are not moving but perceive that they are – as in a flight simulator or even at the cinema, although fortunately the usual response is passing queasiness rather than vomiting.
Some adults are especially sensitive to motion but there is also a lot of psychological conditioning: if you vomited on a previous journey and encounter a smell or sensation that reminds you of that experience – such as the odour of airline meals – then nausea can start even before you have moved anywhere. This scenario is perhaps most likely to respond to positive conditioning or telling your stomach it is acting unreasonably. People do develop ‘sea legs’ but most journeys are too short, and holiday time too valuable to wait for that to happen.
Those who experience bouts of nausea and even vomiting driven by migraine or Ménière's disease should be aware that their remedies work in different ways and may not help motion sickness even though symptoms can feel similar.
30 days before departure
Start strategising. On a cruise, book a cabin amidships on a middle deck. If you have suffered badly in the past, make an appointment to see your GP and ask if Scopoderm patches (hyoscine hydrobromide) might be appropriate for you. Each takes about six hours to start working and lasts 72 hours. If you believe your motion sickness has a suggestible or learned element to it – that is, just thinking about travel makes you feel a bit queasy – then hypnosis might be worth trying. Others opt for learning acupressure techniques.
1 week before departure
Head to the pharmacy – there are several good over-the-counter medicines. Some are rapid-onset and short-acting, such as hyoscine (Joy Rides or Kwells); these are good if you take the wait-and-see approach to using tablets. There are also longer acting antihistamines such as cinnarizine (Stugeron), which is best taken well before the start of the journey and can be taken every eight hours; this is best for long voyages. Some people find acupressure wrist bands (eg Sea-Bands) helpful.
5 hours before departure
Check the weather forecast. Take your first dose of cinnarizine if you’ve decided to use an antihistamine. Stick to light, readily digestible food and don’t fill your stomach with fluids. The more that’s in there, the more it splashes around and the more can come up. If you are using wrist bands, make sure these are accessible and not packed in your hold luggage.
Put on your Sea-Bands. On an aircraft the best place to sit is in the centre, between the wings. A central position is also best on a ship. If feeling queasy, fresh air on deck is great – and look at the horizon. On an aircraft, try to lie back and close your eyes; listen to some music to provide a distraction. Keep away from the galley to minimise exposure to food smells. You’ll feel calmer in an aisle seat so you can readily get out for a chunder if necessary.
Start of journey
If you suddenly realise you should have taken a pill (yawning is an early sign) and now need one, hyoscine (preferably a melt-in-the-mouth form) is your best bet. Some airlines and ships have them on offer, but don’t rely on this. Once the nausea has started most preparations are ineffective. Even if you feel fine, resist eating everything and anything just because it’s free. Choose high carbohydrate foods and sip at sugary drinks, but don’t take in a big volume. Watching a film is an excellent distraction but reading can bring on nausea. If you start feeling queasy, try to focus on a distant view.
Middle of journey
The sea is starting to swell. You feel a little queasy. It is best to get some fresh air. Certainly try to get away from folk who are vomiting. Nibbling on a ginger biscuit can help settle the stomach. If you are sick, this will probably make you feel better in the short term. Don’t then eat a proper meal. If you feel hungry, go for light, minimal nibbles. If you vomit more than once, try taking sips of a drink containing sugar, but avoid anything containing milk. Ribena and apple juice are best because they are sugary, so quickly absorbed from the stomach. Lying down, eyes closed, listening to some favourite music, is often the best therapy.
End of journey
Symptoms almost always subside as soon as you get off the boat or plane but don’t then rush to gobble down a big meal. Start with plain light food. You should be fit to drive but use common sense: if you have been ill or are dehydrated, allow some rehydration and recovery time. If you’re facing a return journey that you expect to be just as traumatic, try to get hold of some scopolamine patches – for example, they are available over the counter without prescription in the US. Identify a source of palatable ginger to nibble on; crystallised ginger is a delicious remedy for nausea. Image: Woman experiencing motion sickness. Photo from Shutterstock.