Motion Sickness- Are You Fit to Fly?

My first airplane ride was as a cadet at the Michigan Wing Encampment in 1974. It was also my first experience with airsickness! Since that time I have become familiar with those dreaded symptoms: warmth, pallor, burping, increased salivation and cold sweats followed by dizziness, nausea and thenÖ.. well you know what comes next.

Many a cadet on an orientation flight or a novice aircrew member flying a search grid has fought the same symptoms. Not only is this uncomfortable, but it decreases the effectiveness of that crew member, and may even cause the flight to return to base.

Another form of air sickness is the Sopite Syndrome. Instead of feeling queasy, the airman begins to feel fatigued, drowsy, headachy, starts yawning, and may become apathetic, detached from the environment and less attentive. Sometimes irritability increases. This may not even be recognized by the individual as a form of airsickness. Some people experience a mixture of stomach and sopite symptoms to some degree.

Doing visual tasks where your attention is focused inside the cabin of the aircraft such as reading charts, navigating, working radios, and keeping logs tends to increase motion sickness symptoms. Even visual search tasks outside the aircraft can create problems. Head movement may also increase susceptibility to nausea.

Motion sickness is caused by a sensory conflict. The brain receives conflicting information about body motion from visual and vestibular (inner ear) receptors.

For example, during a coordinated turn, our eyes see a tilted horizon while our vestibular sense says we are perfectly upright. If you add turbulence, it is even more disconcerting.

Studies have shown we can adapt or "get used to" this motion with repeated exposures. Then, gradually, symptoms improve or disappear. Adaptation can only occur if you keep flying and challenging your body to accommodate.

Start with gentle flights using smooth control movements, slow shallow turns, and very little maneuvering. This is best done before 1000 hours or after 1800 hours in the evening when there is less wind and turbulence. A stimulus that is gradual in onset (a smooth flight) generates fewer symptoms and allows for more rapid adaptation than one which is abrupt (yanking and banking). The brain comes to recognize the conflicting information as normal, so it no longer sees the conflict and the symptoms are eliminated. As you do well with gentle flights, gradually increase the amount of maneuvers, bank angles and turbulence to build your tolerance levels. Before you know it youíll do fine in those low, turbulent search grids, the ultimate test of tummy!

Once you are acclimatized, you also need to periodically go flying again (Cool!). By re-exposing yourself, you maintain the resistance to motion effects and wonít loose your adaptation. In one study, the adaptation was still good one month after the last exposure, but a year later, individuals again became ill if they hadnít flown during that time. So, fly long and fly often!

Some tricks to avoid or treat motion sickness include:

1. Eat a light carbohydrate meal no less than 2-3 hours before exposure.

2. Avoid dairy products and foods high in protein, calories or sodium before flying.

3. Avoid alcohol, smoking, and disagreeable odors.

4. Open the cabin vents to increase exposure to cool, fresh air.

5. Adjust the temperature inside so you are not overheated.

6. Focus on a stable horizon or external object.

7. Limit head movements (eg press head into headrest)

8. Try to keep "inside" tasks such as chartwork and logging to short periods at a time.

Avoid unnecessary reading.

9. Occasionally take breaks from maneuvering and fly straight and level for a time.

Non-medications used to treat motion sickness include ginger root in the form of candies, capsules or as a tea. Some also nibble on ginger cookies. Emetrol, a sweet syrup available over the counter, can also help nausea. Some recommend drinking apricot juice, carrot juice, or peppermint tea.

Some feel the acupressure "Sea Bands" help. A wristband is placed with the pressure button over the middle of the inner wrist in the soft area of the lower arm just off the wrist bones.

Slow deep breathing (inhale for 4-5 seconds then exhale for 4-5 seconds- for a total of 6-7 breaths per minute) stimulates the parasympathetic nervous system and settles the stomach. This is a very helpful technique.

The relief band is probably one of the most promising devices. The battery-powered watch-like device is worn on the inner wrist and gives a low grade electrical stimulation to the underlying nerve in an acupuncture point area. This provides relief of nausea not only for motion sickness, but in chemotherapy and post-anesthesia patients as well. Although it is expensive ($100-200), it does not cause drowsiness and is well tolerated. (

There are several effective medications for motion sickness, however, none of them are legal for pilots to use. This is because they may cause subtle drowsy effects and may affect judgment and performance. These can also decrease the performance of observers and scanners. Dimenhydrate (Original Dramamine) is used to prevent and treat motion sickness. However, it often causes significant drowsiness. Meclizine (Antivert, Bonnine, Dramamine II) seems to cause less drowsy effects than Dimenhydrate and is very effective. If needed, talk to your doctor about prescription Reglan or Trans-derm Scopolamine patches. However, Scopolamine does inhibit adaptation.

If you are feeling the least bit off, donít hesitate to get out the airsick bag, open it up and have it ready. Better not to need it than to be too late. If you are going to vomit, seal the bag over your mouth with both hands while leaving your nose exposed for fresh air. In this way, all fluids and odors will be contained and there is less chance of spillage.

I am happy to say, that with the help of my CAP-pilot husband, Rick, I have flown frequently and no longer have the problems I once had. So, if you are one of those "vestibularly challenged" individuals, get in the air every chance you can and hopefully your stomach wonít get in the way of your love for flying. If you need an excuse, tell them, "My doctor told me I have to fly!" Enjoy!


Dr. Kay L. L. McLaughlin, DO


Michigan Wing Vice Commander

1201 S. Swegles, St Johns, MI 48879