Motion Sickness: Symptoms, Causes & How to Prevent It

What Is Motion Sickness?

Motion sickness, also called kinetosis or travel sickness, is a condition where you experience nausea, dizziness, and sometimes vomiting when traveling by car, boat, plane, train, or even on amusement park rides. It happens when your brain receives mismatched signals from your eyes, inner ear, and body about whether you're moving.

Motion sickness is one of the most common travel-related health problems, affecting approximately 25-30% of travelers to some degree. The condition has been recognized since ancient times — the word "nausea" actually comes from the Greek word "naus" meaning ship, reflecting how common seasickness has always been among travelers.

The underlying mechanism of motion sickness involves a sensory conflict in your brain. Your vestibular system (the balance organs in your inner ear) is highly sensitive to motion and detects every acceleration, deceleration, and change in direction. Meanwhile, your eyes provide visual information about your surroundings. When these two systems send conflicting information — for example, when you're reading a book (eyes see a stationary page) while riding in a moving car (inner ear detects motion) — your brain becomes confused. This sensory mismatch triggers the symptoms of motion sickness.

Interestingly, the brain interprets this sensory conflict as potentially dangerous. One evolutionary theory suggests that sensory mismatch might indicate poisoning (since some toxins cause disorientation), which is why the body responds with nausea and vomiting — protective reflexes designed to expel potential toxins. While this explanation isn't proven, it helps explain why the symptoms can be so unpleasant.

Who Gets Motion Sickness?

Some people are more susceptible to motion sickness than others. Children between ages 2 and 12 are most commonly affected, with sensitivity typically decreasing during teenage years and adulthood. Infants under age 2 rarely experience motion sickness, possibly because their vestibular system hasn't fully developed yet.

Several factors increase your risk of motion sickness:

• Genetic predisposition: Motion sickness tends to run in families, suggesting a hereditary component
• History of migraines: People who suffer from migraines are significantly more likely to experience motion sickness
• Pregnancy: Hormonal changes during pregnancy can increase susceptibility
• Certain medications: Some drugs that affect the inner ear or central nervous system can worsen symptoms
• Inner ear conditions: Pre-existing vestibular disorders may increase sensitivity
• Female sex: Women appear to be slightly more susceptible than men, possibly due to hormonal factors

What Are the Symptoms of Motion Sickness?

Motion sickness symptoms typically begin with early warning signs like yawning, fatigue, and pallor (pale skin), followed by nausea, cold sweats, increased salivation, and potentially vomiting. Symptoms usually start 15-30 minutes after travel begins and can range from mild discomfort to severe incapacitation.

Motion sickness symptoms develop progressively, often following a predictable pattern. Recognizing the early warning signs allows you to take preventive action before symptoms become severe. The progression typically follows this pattern:

Early Warning Signs

The first symptoms of motion sickness are often subtle and easy to miss. Watch for these early indicators:

• Frequent yawning and sighing, even when not tired
• Drowsiness and fatigue that comes on suddenly
• Pallor — the skin becomes noticeably pale, especially around the face
• Mild discomfort or a general feeling of unease
• Increased salivation and swallowing

Progressive Symptoms

If travel continues or no preventive action is taken, symptoms typically worsen:

• Nausea — the hallmark symptom, ranging from mild queasiness to severe sickness
• Cold sweats — clammy skin, often with visible perspiration
• Dizziness and a sense of unsteadiness
• Headache — often a dull, throbbing sensation
• Stomach awareness — uncomfortable sensations in the abdomen
• Loss of appetite — food becomes unappealing

Severe Symptoms

In more severe cases, motion sickness can cause:

• Vomiting — which may or may not provide temporary relief
• Difficulty concentrating and mental fog
• Rapid breathing or hyperventilation
• Extreme fatigue and weakness
• Feeling faint or lightheaded

One important characteristic of motion sickness is that symptoms typically resolve relatively quickly once the motion stops. Most people feel significantly better within 15-30 minutes after leaving the moving vehicle, though severe cases may take several hours to fully recover. This is in contrast to other causes of nausea and vomiting, which may persist regardless of movement.

What Causes Motion Sickness?

Motion sickness is caused by a sensory conflict between your visual system (eyes) and vestibular system (inner ear balance organs). When your inner ear detects movement but your eyes see something stationary — or vice versa — the brain receives conflicting signals that trigger nausea and other symptoms.

To understand why motion sickness occurs, it helps to understand how your body normally perceives movement. Three main systems work together to keep you oriented in space:

The Vestibular System

Located in your inner ear, the vestibular system contains specialized organs that detect motion and head position. The semicircular canals detect rotational movements (turning your head), while the otolith organs (utricle and saccule) detect linear acceleration and the pull of gravity. These organs send continuous signals to your brain about every movement you make.

The Visual System

Your eyes provide visual information about your position and movement relative to your surroundings. When you walk, your brain expects to see the environment moving past you. When you're stationary, your brain expects to see a stable visual field. This visual information normally matches the signals from your vestibular system.

Proprioception

Sensors in your muscles, joints, and skin (called proprioceptors) provide information about body position and movement. These sensors tell your brain whether you're sitting, standing, or moving, and help confirm the signals from your eyes and inner ear.

Motion sickness occurs when these three systems send conflicting information to your brain. The most common scenario is:

• Reading in a moving car: Your inner ear detects the car's motion, but your eyes are focused on a stationary book. The brain receives conflicting signals — "we're moving" from the vestibular system and "we're stationary" from the visual system
• Below deck on a ship: The vestibular system detects the ship's rolling motion, but without windows, the eyes see only a stationary cabin
• Virtual reality: The eyes see movement on a screen, but the vestibular system detects no motion — the opposite mismatch

When the brain can't reconcile these conflicting signals, it triggers the autonomic nervous system response that causes motion sickness symptoms. The exact neurological pathway involves the vestibular nuclei in the brainstem, which communicate with the vomiting center (area postrema) and trigger the characteristic symptoms.

Why Are Some People More Susceptible?

Individual differences in motion sickness susceptibility likely relate to how sensitive a person's vestibular system is and how their brain processes sensory conflicts. Research suggests that:

• Genetic factors play a significant role — twins studies show high heritability
• Prior adaptation matters — sailors and frequent travelers often develop tolerance
• Migraine association — shared neural pathways may explain why migraine sufferers are more susceptible
• Age-related changes — the vestibular system becomes less sensitive with age, possibly explaining why adults are less affected

How Can You Prevent Motion Sickness?

Motion sickness can be prevented by choosing optimal seating positions (front seat in cars, middle of boats), focusing on the horizon or road ahead, avoiding reading or screens, ensuring good ventilation, eating light meals before travel, and taking over-the-counter medications 30-60 minutes before departure if needed.

Prevention is the most effective approach to motion sickness, as it's much easier to prevent symptoms than to treat them once they've started. The following strategies have proven highly effective for most people:

Optimize Your Seating Position

Where you sit can dramatically affect your likelihood of getting motion sick:

• In cars: Sit in the front seat where you can see the road ahead. Being the driver almost eliminates motion sickness because you're anticipating movements and your eyes see what your vestibular system feels
• On boats: Stay in the middle of the vessel where rocking motion is minimal. Being on deck where you can see the horizon is much better than being below deck
• On planes: Choose a window seat over the wings, which is the most stable part of the aircraft
• On trains: Sit facing the direction of travel and choose a seat near the center of the carriage

Visual Strategies

What you look at during travel significantly impacts motion sickness:

• Focus on the horizon: Looking at a stable, distant point helps your brain match visual and vestibular signals
• Avoid reading or screens: Looking at stationary objects while moving is one of the most common triggers
• Close your eyes: If you can't look outside, closing your eyes eliminates the visual conflict (though this doesn't work for everyone)
• Look out the window: Watching the scenery pass by helps your brain make sense of the motion

Physical and Environmental Factors

• Fresh air: Open windows or use air vents directed at your face. Good ventilation helps reduce symptoms
• Avoid strong odors: Gasoline, food smells, and perfumes can worsen nausea
• Stay cool: Heat and stuffiness worsen symptoms; keep the temperature comfortable
• Recline slightly: A semi-reclined position can help, as can keeping your head still against a headrest

Dietary Recommendations

• Eat light: Have a small, bland meal before traveling — neither a full stomach nor an empty stomach is ideal
• Avoid alcohol: Alcohol affects the vestibular system and increases susceptibility
• Stay hydrated: Drink water, but avoid large amounts of liquid at once
• Ginger: Some studies suggest ginger (as tea, candies, or supplements) may help prevent mild symptoms
• Snack during travel: Eating small amounts frequently can be better than not eating at all

Rest and Preparation

• Get adequate sleep: Fatigue increases susceptibility to motion sickness
• Avoid reading before travel: If you're prone to motion sickness, start focusing on the horizon before the journey begins
• Take breaks: On long trips, stop regularly to get out and walk around

How Is Motion Sickness Treated?

Motion sickness is treated with over-the-counter antihistamines like dimenhydrinate (Dramamine) or meclizine (Bonine), taken 30-60 minutes before travel. For severe cases, prescription scopolamine patches can be applied behind the ear 4-8 hours before travel. Behavioral interventions like focusing on the horizon and getting fresh air also help manage symptoms.

When prevention isn't enough or symptoms have already started, several treatment options can help:

Over-the-Counter Medications

The most commonly used medications for motion sickness are antihistamines, which work by blocking signals in the brain that trigger nausea and vomiting:

• Dimenhydrinate (Dramamine, Gravol): One of the most widely used motion sickness medications. Take 30-60 minutes before travel. Available in regular and non-drowsy formulations. Causes drowsiness in most people, which can be a benefit for sleeping through long trips but a problem for drivers
• Meclizine (Antivert, Bonine): Longer-acting than dimenhydrinate, with less sedation for most people. Take 1 hour before travel. Often preferred for day trips where alertness is important
• Diphenhydramine (Benadryl): Primarily an allergy medication but has anti-nausea effects. Causes significant drowsiness

Prescription Medications

For severe motion sickness or when over-the-counter options aren't effective, prescription medications may help:

• Scopolamine (Transderm Scop): Available as a patch placed behind the ear, scopolamine is highly effective for preventing motion sickness. Apply 4-8 hours before travel; one patch works for up to 72 hours. Side effects can include dry mouth, blurred vision, and drowsiness. Requires a prescription in most countries
• Promethazine (Phenergan): A prescription antihistamine used for severe nausea. Causes significant sedation
• Ondansetron (Zofran): An anti-nausea medication originally developed for chemotherapy patients. May help some people but isn't specifically designed for motion sickness

Non-Medication Treatments

Several non-drug approaches can help manage symptoms:

• Acupressure wristbands: Bands that apply pressure to the P6 (Nei-Kuan) point on the inner wrist. Some studies show modest benefit, though results are mixed. They have no side effects and may be worth trying
• Ginger: Available as ginger ale, ginger candies, ginger tea, or supplements. Some research supports mild effectiveness, particularly for mild symptoms
• Controlled breathing: Slow, deep breathing can help reduce nausea and anxiety associated with motion sickness
• Distraction techniques: Listening to music or audiobooks (not reading) can help take focus away from symptoms

What to Do If Symptoms Start

If you feel motion sickness symptoms beginning despite preventive measures:

1. Stop reading or looking at screens immediately — this is often the trigger
2. Focus on the horizon or a distant stable point
3. Get fresh air — open a window or go outside if possible
4. Lie down or recline if the situation allows
5. Take a break from travel — stop the car and walk around
6. Close your eyes and rest — sleeping can help symptoms pass
7. Apply a cool cloth to your forehead
8. Sip water slowly — avoid gulping

When Should You See a Doctor for Motion Sickness?

See a doctor if over-the-counter medications don't help, if you experience motion sickness symptoms when not traveling, if symptoms are severe enough to significantly affect your quality of life, or if you develop new motion sickness as an adult without previous history. These may indicate underlying vestibular disorders requiring evaluation.

For most people, motion sickness is a temporary inconvenience that responds well to prevention strategies and over-the-counter medications. However, you should consult a healthcare provider if:

• Symptoms persist after travel: Motion sickness should resolve once movement stops. Persistent dizziness or nausea may indicate another condition
• Over-the-counter treatments don't work: A doctor can prescribe stronger medications or investigate other causes
• Symptoms occur without travel: If you feel "motion sick" while stationary, this could indicate an inner ear problem
• New onset in adulthood: Developing severe motion sickness as an adult without previous history warrants investigation
• Associated neurological symptoms: Hearing loss, tinnitus (ringing in ears), severe headaches, or vision changes accompanying motion sickness require medical evaluation
• Motion sickness significantly impacts your life: If motion sickness prevents you from necessary travel or affects your quality of life, seek professional help

A healthcare provider may refer you to an otolaryngologist (ENT specialist) or a neurologist specializing in vestibular disorders if they suspect an underlying condition. Tests might include hearing evaluations, balance testing (vestibular function tests), and in some cases, imaging studies.

Special Considerations

Pregnant women, children, people with migraine disorders, and those with certain medical conditions require special consideration when managing motion sickness. Some medications should be avoided during pregnancy, and children need age-appropriate dosing. People who need to stay alert should choose less sedating options.

Motion Sickness During Pregnancy

Pregnancy can increase susceptibility to motion sickness due to hormonal changes, particularly during the first trimester when morning sickness is common. However, pregnant women should be cautious about medications:

• Consult your healthcare provider before taking any motion sickness medication during pregnancy
• Ginger is generally considered safe and may help with both morning sickness and motion sickness
• Acupressure wristbands are a safe non-drug option to try
• Some antihistamines may be acceptable during pregnancy, but only under medical guidance
• Scopolamine patches are generally not recommended during pregnancy

Motion Sickness in Children

Children are highly susceptible to motion sickness, but many medications aren't approved for young children:

• Prevention is key: Focus on behavioral strategies first — proper seating, looking out windows, avoiding screens
• Age restrictions: Check medication labels carefully for age restrictions. Dimenhydrinate is typically not recommended for children under 2 years
• Dosing: Children require lower doses based on their age and weight. Never give adult doses to children
• Formulations: Chewable tablets and liquid formulations are available for children who can't swallow pills
• Most children improve: Reassure parents that most children grow out of severe motion sickness by their teenage years

People Who Need to Stay Alert

Drivers, pilots, boat operators, and others who need to remain alert face a challenge, as most motion sickness medications cause drowsiness:

• Non-drowsy formulations: Look for these options, though they may be less effective
• Meclizine: Tends to be less sedating than dimenhydrinate for many people
• Focus on prevention: Behavioral strategies don't impair alertness
• Note: Being the driver actually helps prevent motion sickness because you anticipate movements

Chronic Motion Sickness

Some people experience motion sickness so frequently or severely that it significantly impacts their lives. Options for chronic sufferers include:

• Habituation training: Gradual, repeated exposure to motion can help the brain adapt
• Vestibular rehabilitation: A specialized form of physical therapy that can help reduce sensitivity
• Prescription medications: For frequent travelers, a prescription for scopolamine patches may be appropriate
• Cognitive behavioral therapy: May help if anxiety about motion sickness worsens symptoms