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Motion Sickness

(A newer version of this article is available.) How to prevent and treat kinetosis, or motion sickness, a common complaint of travelers on boats, planes, motor vehicles, and even while riding animals.Updated February 13, 2018: See the latest information on motion sickness here.Kinetosis — commonly known as motion sickness — is any disorder caused by motion, such as seasickness, airsickness or carsickness, as defined by Taber's Cyclopedic Medical Dictionary. It is a common complaint of travelers on boats or planes, in motor vehicles, and even while riding animals such as horses.

Most people, including experienced boaters and frequent air travelers, have experienced motion sickness at some time. All that is needed is a strong enough stimulus, which can vary widely from one person to another. Most people acclimate — or "get their sea legs" — with time, but the process can take up to two or three days.The most distressing symptoms of motion sickness are nausea and vomiting, generally caused by an overstimulation of your inner ear's vestibular balance organs and/or by a discrepancy between the sensory inputs from your eyes and inner ears. Other symptoms include excessive sweating, pallor (pale skin), a mild headache and malaise.

Motion sickness is not a serious medical problem, but it may lead to more significant health issues or incidents because affected individuals can develop an almost desperate inattentiveness and a reduced ability to perform simple tasks. Assume that any tasks assigned to those affected by motion sickness require supervision. Reassign critical tasks to others who are less impaired.It is best to plan ahead to reduce the risk of motion sickness. Prepare by being well rested, nourished and adequately hydrated. If you feel anxious or uneasy, avoid consuming food for two hours before you embark for a short sail, as you will likely be more comfortable with an empty stomach than with a full one. For boaters, stow and prepare your gear before the boat leaves the dock to limit the time spent below decks.

While under way, position yourself on the boat where the motion is least, such as midline on the boat, low and close to the waterline or on the stern (if minimal or no exhaust is present). Avoid areas where the vertical motion is more pronounced, such as the bow or upper decks. Closing your eyes or sitting where the rocking motion of a boat is clearly visible can help prevent motion sickness. Gazing at the horizon rather than at objects in your immediate vicinity is widely accepted as helpful. Staying away from areas with strong fumes, particularly fuel or exhaust, is also a good idea. Avoid reading, looking at electronic devices or moving your head continuously back and forth because this can worsen symptoms.Advertisements promote numerous medications, herbs, foods and devices to prevent or treat motion sickness. Although many of these aids have proved to be successful, none are known to be completely effective. Taking an over-the-counter antihistamine such as meclizine, dimenhydrinate or cyclizine before you feel sick can be helpful, but it may cause some degree of drowsiness. Antihistamines interact with many drugs, so if you have chronic health issues and are taking other medications, consult your physician before you travel so there is enough time to make any necessary adjustments. As always, it is wise to test new medications or supplements days to weeks before using them away from home. Motion-sickness medications typically are most effective when taken before symptoms begin and are less effective after symptom onset.

If necessary, motion sickness can be treated with either oral drugs or a transdermal patch, which delivers medication through the skin. On the rare occasion when nausea and vomiting are severe and not improving after several days and other problems begin to appear, the person may need to be returned to shore for medical attention.

Drugs used to prevent and treat motion sickness vary in their effectiveness and side effects from one individual to another, so it is not possible to make a generalized recommendation. Use such medications with caution during certain activities, as most of these drugs cause mild drowsiness and inhibit mucous secretions.

Motion sickness usually subsides as the body adapts or when the motion stops. Fortunately, the more frequently one travels, the easier it becomes to adjust to being in motion.

Whether you are planning an ocean crossing, a leisurely sail to the islands for a few weeks, or a day or two of deep-sea fishing, under certain circumstances motion sickness can be a potential hazard to recreational boaters.

Consider, for example, getting seasick while traveling offshore with your small children or your first bareboat charter vacation. In both cases, the severity of your symptoms could negatively affect your reaction times and your ability to concentrate. You may not be able to keep as close a watch on your kids' safety as you normally would. You may be too distracted to notice weather changes or objects lurking below the waterline. You may be unable to provide timely or appropriate assistance if someone falls overboard or gets injured. Many people with motion sickness will express that during the first few days of travel they experience apathy and a decreased attention to detail even if they never experience nausea or vomiting.

You cannot always anticipate the onset or severity of motion sickness, but with a bit of preparation you can develop a plan to help manage the situation in case it occurs. Your "Plan B" could be as simple as ensuring that someone else on board has the ability to take over or help when needed. If you are new to boating or if you are planning an expensive trip, consider taking a short, inexpensive day trip prior to your excursion, especially if it is one in which your best efforts are required for the safety of the trip. That way you have time to consider other options if you are susceptible to motion sickness.

The possibility of disordered sleep, watchstanding, inexperienced or rusty sailors, medications, and seasickness should require everyone to be vigilant and double check themselves and each other.Using Prescription Scopolamine for Motion Sickness

For many people, transdermal delivery of the prescription drug scopolamine can be effective. The patch, which goes by the brand name Transderm Scop®, contains 1.5 mg of scopolamine. When placed on the skin (typically just behind the ear), the patch delivers the drug at a constant rate for three days. Remove the patch after that period. Those who are still in an environment where motion sickness could be a problem can apply another patch. Wear only one patch at a time, even if you think one patch is depleted, to avoid too much medication entering the bloodstream and causing undesirable side effects.

Possible side effects of scopolamine include dry mouth, drowsiness and blurred vision. Disorientation, memory disturbances, dizziness and restlessness may occur but are less common. Scopolamine should be used with caution in patients with narrow-angle glaucoma, a pyloric obstruction or a urinary bladder neck obstruction (such as from an enlarged prostate). Rare side effects include hallucinations, confusion, difficulty urinating, skin rashes and eye pain.

It is impossible to know in advance who scopolamine will affect and how. Therefore, before using a patch to prevent motion sickness, it is recommended to wear one on dry land for at least 24 hours to test its effects. Once you open the foil wrapper, avoid touching the patch under the plastic strip. If some of the medication gets on your finger and inadvertently contaminates your eye, the drug will produce unilateral pupil dilation, which has caused confusion with a number of serious medical emergencies by those who are unaware of this association. Do not consume alcohol while wearing a scopolamine patch.

If side effects occur, remove the patch. If you experience severe allergic reactions, difficulty urinating, pain in the eyes or dilated pupils, seek immediate medical attention.

If a patch is worn for more than three days, withdrawal symptoms can occur after removal. These symptoms, which generally do not occur until 24 hours after removal, include dizziness, nausea, vomiting, headache and balance disturbances.

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