A vacation can be the most beautiful time of the year. Yet many people are afraid of traveling because they cannot tolerate trips by ship, plane, bus, or car. They suffer from motion sickness, which is also known as kinetosis. Typical symptoms include nausea, vomiting, dizziness, fatigue, headache, sweating, paleness, and more. The type and severity of symptoms vary from person to person. Fortunately, doctors have ways to support their patients.

How Common Is It?

Studies examining the incidence of kinetosis have provided a heterogeneous picture. In the general population, approximately 20%-30% of people are susceptible to such complaints during travel under normal conditions. In extreme situations, such as heavy seas on a small boat, ≥ 90% of people experience motion sickness. On cruises, the prevalence ranges from 3%-60%, depending on the study, route, and sea conditions.

Adolescents are more susceptible to motion sickness than adults. Estimates suggest that ≤ 50% of children aged 2-12 years have problems during normal travels. Women, on the other hand, appear to be more sensitive than men, especially during pregnancy or after menopause.

Potential Genetic Factors

Genetic factors may play a role in susceptibility to kinetosis. Scientists have found 35 single nucleotide polymorphisms (SNPs) in the genome associated with a significantly higher risk for motion sickness.

Many of these SNPs are near genes involved in balance and eye, ear, and skull development. Other SNPs may affect motion sickness through adjacent genes involved in the nervous system, glucose homeostasis, or hypoxia. Several of these SNPs have a gender-specific effect that can be as much as three times stronger in women.

Effects on the Body

Our brain assesses body movement with vestibular, visual, and proprioceptive receptors. Motion sickness occurs, according to common belief, when stimuli detected by receptors appear to conflict.

The balance organ in the inner ear and proprioceptive receptors in the muscles, tendons, and joints continuously send signals about body movements and positions to the brain. If they do not match the visual information perceived by the eye (eg, if the cabin of a ship moves but the horizon appears still), a sensory mismatch can occur. The brain receives conflicting information, and motion sickness occurs.

Behavioral Strategies

In mild cases, the following behavioral tips can alleviate symptoms or prevent motion sickness:

• Patients who slowly adapt to motion stimuli often experience less severe symptoms. Before a sea journey, they should spend as much time as possible on the ship in a port before heading out to sea.
• Patients should try to stay near the ship’s centerline, ideally close to the floor or waterline. Positions below deck and high in the ship are less favorable. Supporting the head to minimize additional head movements and reduce neck strain can reduce vestibular and proprioceptive stimuli.
• Focusing on the horizon can help with seasickness. An outside cabin with a window or balcony is better suited than an inside cabin without a view.
• Lying face down with closed eyes can help reduce symptoms to a tolerable level.
• Patients are better off avoiding alcohol or nicotine.

Patients often read online that acupuncture or acupressure can alleviate both motion sickness and nausea. Several products are available on the market. In high-quality studies, none of these devices have proven to be effective compared with placebos or sham interventions.

Pharmacological Interventions

If patients suffer severely from motion sickness or experience such symptoms on every trip, medication is recommended.

Most often, antihistamines (eg, cinnarizine and dimenhydrinate) are recommended for motion sickness. They are available over the counter and suitable for prevention rather than treatment. They should be taken 1 hour before the journey begins. With appropriate dose adjustments, children aged 6-12 years can also take the preparations.

The drugs’ effectiveness likely results from central antihistaminic and central anticholinergic properties. Common side effects may include dry mouth, nose, or throat; drowsiness; and sensitivity to bright light. Those taking the preparations should not drive.

Antiemetics are recommended for relieving nausea. However, researchers have not proven their ability to prevent motion sickness.

Scopolamine, a prescription anticholinergic drug, is suitable for preventing and treating motion sickness. Its effectiveness is likely due to central anticholinergic properties.

To achieve optimal protection, a transdermal patch should be applied approximately 5-6 hours before the journey begins to a dry, hairless area behind the ear. It provides protection against motion sickness for approximately 72 hours. Children aged < 10 years should not receive scopolamine patches due to insufficient data. Driving may be impaired while using this medication.

Common side effects include drowsiness, dizziness, visual accommodation disturbances, and skin irritations.

Products containing ginger are often recommended. Studies provide hints of possible effects. Standardization of extracts and the comparability of different preparations are problematic, however.

This story was translated from the Medscape German edition using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.