Don’t travel on small planes, which tend to be worse than larger jets. If you are on a boat, keep towards the centre, where there is less movement. In a car, being the driver helps; the worst place to sit is in the back seat, because it is harder to see out the window. Unfortunately, this is where children typically sit – and people are most susceptible to travel sickness from the age of eight to about 12, says John Golding, a professor of applied psychology at the University of Westminster. Adults who suffer migraines are also more susceptible.
Keep your eyes on the horizon
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The best explanation for motion sickness is the sensory conflict theory, which puts it down to a mismatch between what your eyes see and the information on movement detected by your inner ear. “If you can get a view of the outside and a horizon reference, it’s helpful,” says Golding. “The fewer outside cues you have, the less you can resolve any conflict.” Don’t read or look at your phone. Try to keep your head still, advises Louisa Murdin, a consultant in audio vestibular medicine at Guy’s and St Thomas’ NHS trust. “It’s not always obvious to people, but having conversations doesn’t help, because when we have a conversation we almost always move our head as part of that. Listening to music is one thing that has been shown in studies to be helpful.” Nicotine tends to make motion sickness worse, as can having a big meal or drinking alcohol before travelling.
Explore medicinal measures
Over-the-counter medication containing hyoscine can be effective, as can antihistamines, but they can cause blurred vision and drowsiness, says Golding, which isn’t much good if you are supposed to be driving. The drug cinnarizine, found in other motion sickness medications, “has fewer side-effects”. Take it about two hours before travelling. Once you have started to feel sick, tablets are useless. “Even if you’re not actually sick, you get what’s called gastric stasis,” says Golding: your body will stop your stomach contents moving further into the gut, meaning medication won’t be absorbed properly. Patches are an alternative to oral medication, but usually have to be prescribed. “Some people recommend ginger, but that has weak evidence to support it,” says Murdin. Studies have shown no evidence for the efficacy of wristbands that claim to prevent motion sickness through acupressure.
Watch your breathing
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“Controlled breathing is about half as effective as a drug,” says Golding. An inhibitory reflex between respiration and vomiting stops you inhaling vomit. “The vomiting reflex turns off the respiratory impulse; if you’re concentrating on your breathing, that can inhibit vomiting.” Practise keeping your breathing regular and consistent beforehand, he adds.
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The most effective long-term strategy is one used by the military, says Murdin: the habituation approach. “They build up exposure in steps, taking someone on a journey that’s going to make them a little bit sick, then they stop, then they do it again, increasing the amount gradually. It helps the brain get used to the signals and reconcile them.” However, for the average individual, this is difficult to do – and you don’t want to oversensitise yourself, says Murdin. “It’s probably a good idea to get the help of a physiotherapist who is used to using those techniques,” she says. But Golding warns that habituation can be situation-specific: “If you’re used to sitting in the back of a car, so you don’t get car sickness any more, that doesn’t necessarily protect you against sea sickness.”