Prevention and treatment of motion sickness

It is better and easier to prevent motion sickness than to treat it after it has started. For this reason, it is important to learn what situations are likely to give you motion sickness and avoid them if possible. If you cannot avoid them, there are other things you can do that may help to prevent or reduce the symptoms.

Many things can make motion sickness worse, including:

• more severe and unpredictable motion: riding in a car on a bumpy, twisty road is usually worse than riding on a train, and being on a boat is worse in rough weather
• reading, looking at your phone, and other tasks that involve focusing your gaze on something close to you
• not being able to see the horizon, for example if there is fog or if you are not near a window
• an empty stomach
• unpleasant smells

Reduce the motion as much as possible

Avoid unpleasant types of motion as much as you can. For example:

• Do not fly if storms or turbulence are likely
• Try not to take routes with many turns and ups and downs
• Do not travel on water during storms or if there are large waves

Sit where the movement is smallest

Try to sit in the place that has the least vertical (up-and-down) and rotational (twisting or swaying) motion:

• In a car, drive or sit in the front passenger seat; if you need to be in the back seat, lie down
• In an airplane, sit over the wing
• In a boat, sit near the surface of the water and face toward the waves; do not sit at the front (bow) of the boat, which is often the bumpiest part
• In a bus, sit near the front, facing forward, on the lowest level
• In a train, sit facing forward, on the lowest level

Get used to the motion gradually

If you are going on a long trip, it may help to take shorter trips with breaks to help you get adjusted. For example, you could spend a few hours on board a boat and see how you feel before you set off on a cruise.

Move in sync with the motion

Moving your body actively can help with motion sickness. If possible, try the following:

• Tilt your head into turns
• Drive or imitate the driver’s actions
• Stand with your legs bent and move with the action of the vehicle or boat; do not try to stand too stiffly
• If possible, walk around

If it is not possible to move around, brace your body and head to avoid extra movement. If you can, lie as flat as possible.

Make sure you have a view

Watching the horizon can help with motion sickness:

• Avoid spaces without windows or where you cannot see the horizon
• Do not read, look at your phone or do anything else that keeps your eyes focused close to you
• Look forward, towards the direction you are travelling
• Focus on a distant point on the horizon and keep a wide view

If you cannot see the horizon, close your eyes or wear sunglasses.

Make yourself as comfortable as possible

Physical, mental and emotional discomfort can make motion sickness worse. Do everything you can to get as comfortable as possible and have a positive attitude:

• Do not drink alcohol
• Drink enough water to stay hydrated
• Eat frequent light, bland meals and snacks that are low in fat and acid, such as bananas, crackers, applesauce or toast
• If you have gastritis or stomach problems, get treatment for them if you can
• Try to be well rested before you start your trip
• Try to sleep
• Stay dry
• Make sure the space you are in is well ventilated and does not smell bad
• Try not to think or talk about motion sickness
• Distract yourself with music, breathing exercises or other relaxation techniques
• Cognitive behavioural therapy can also be helpful

Vestibular rehabilitation

Vestibular rehabilitation is a type of exercise-based therapy. It can be helpful for people with vestibular disorders who have motion sickness. Its goal is to help your brain get used to signals that trigger motion sickness. This is done through repeated, controlled exercises to reduce visual dependency for balance (sensory reweighting). A vestibular therapist can help you set treatment goals and design an appropriate program.

Vestibular rehabilitation for motion sickness may include:

• Habituation training
• Optokinetic exercises

Medication and other treatments

Some medications can help prevent or treat motion sickness. They work best if you take them before you start to have symptoms. The most common medications for motion sickness are:

• Transdermal scopolamine patches (Transderm-V^®): Apply the patch behind one ear at least 4 hours before you are going to travel. Each patch lasts for 72 hours (3 days). This medication is available from pharmacists in Canada. It can cause drowsiness in some people.
• Over-the-counter anti-nausea medications such as dimenhydrinate (Gravol^®): These are available in various forms, including capsules, chewable tablets and suppositories. Check the dosage instructions for the product you are taking. These medications can cause drowsiness, so you should not drive or operate heavy machinery if you take them.

If these products do not help your symptoms, talk to your doctor. Certain prescription medications may help with severe motion sickness.

Check with your pharmacist if you are taking any other medications or if you have any health conditions, especially glaucoma. If you have not used a motion sickness medication before, it is a good idea to try taking it at home so that you can see how it affects you before you need to travel.

If you smoke, temporarily stopping may reduce motion sickness.

Some people find that alternative therapies such as acupressure wristbands are helpful, although the evidence is limited. SEETROËN^® and other brands of anti-motion sickness glasses may be helpful, but more research is needed to test their effectiveness.