Motion Sickness: Head It Off Before You Go

Key takeaways

Motion sickness is not a matter of having a weak stomach. According to NHS, the inner ear sends the brain signals that differ from what the eyes are seeing, and it is those conflicting messages that make people feel unwell — so everything useful happens BEFORE and DURING the journey.
According to CDC, medicine for motion sickness works best taken BEFORE exposure to motion: once symptoms have begun, a slowed stomach may mean an oral dose is not absorbed at all.
According to CDC the most effective approach is not a medicine — it is getting used to the motion gradually, and once that is complete it works better than any motion sickness drug currently available. According to CDC, do not use scopolamine patches in children: they can cause hallucinations and confusion.
If everyone in the vehicle develops a headache and feels unwell at the same time, think carbon monoxide rather than motion sickness — according to CDC the signs of carbon monoxide poisoning are often described as “flu-like”.
Still dizzy and unsteady after the vehicle has been stopped for hours is no longer motion sickness. Be seen.

Motion sickness is not a matter of having a weak stomach. According to NHS, the inner ear sends the brain signals that differ from what the eyes are seeing, and it is those conflicting messages that make people feel unwell. The most useful things to do happen before and during the journey.

Recognising it: is this really motion sickness

According to MedlinePlus, motion sickness often begins suddenly with a queasy feeling and a cold sweat. According to CDC the main signs are nausea and vomiting, along with drowsiness, increased saliva, feeling hot and a pale face.

According to CDC, children under 2 years old rarely get motion sickness; those most susceptible are around 7–12 years old. A baby fretting in the car usually has another reason.
According to CDC, people with a history of migraine or of inner-ear disorders are more susceptible. According to MedlinePlus it is more common in children and in pregnant women.

What it is easily confused with

Carbon monoxide poisoning — the signs overlap exactly with motion sickness. The distinguishing point: several people in the vehicle feel unwell at the same time, including people who have never had motion sickness. According to CDC, a small leak in the exhaust system is enough for carbon monoxide to build up inside a vehicle, and someone who is asleep or who has been drinking may die before they have any warning signs. Never leave anyone asleep alone in a closed vehicle with the engine running.
Dizziness that also appears when you are not travelling, and vomit containing blood or looking like coffee grounds, are different matters — each already has its own article on this site.

What to do now: preparing before you get in

According to NHS, do not eat a heavy or spicy meal or drink alcohol immediately before or during the journey. A completely empty stomach is not comfortable either — something light is enough. Get a full night's sleep beforehand.
Choose where you will sit while you are still at home. According to NHS, sit in the front of a car, or in the middle of a boat, to reduce the motion. According to CDC, avoid the places that move most, for example the bow of a ship.
Take a bag, tissues and water with you.

While the vehicle is moving

According to NHS, look straight ahead at a fixed point, such as the horizon. According to CDC this is somewhat protective on ships, buses and in cars.
According to CDC, keep head movement down: rest your head against the headrest or use a neck pillow.
According to NHS, breathe fresh air if you can, for example by opening a car window slightly; close your eyes and breathe slowly, concentrating on your breathing.
According to NHS, break up a long journey to get out for fresh air, a drink of water or a walk; with children, distract them by talking, listening to music or singing.

Things you must NOT do

Do NOT hand a child a phone or a tablet. According to NHS, do not read, do not watch films, do not use electronic devices, and do not look at moving objects such as passing vehicles or waves.
Do NOT drink alcohol and do not smoke. According to CDC, alcohol and nicotine should be avoided because they make motion sickness worse.
Do NOT let whoever is driving take motion sickness medicine: according to CDC the commonest side effect of this group is drowsiness; CDC also notes that the driver gets motion sickness less than the passengers.
Do NOT count on acupressure wristbands: according to CDC, trials found them no more effective than placebo.

Motion sickness medicine: the timing matters more than the brand

According to CDC, motion sickness medicine works best taken before exposure to motion, not after the signs have started — because, according to CDC, by then a slowed stomach may mean an oral dose is not absorbed.

The groups CDC names include antimuscarinics (scopolamine) and H1 antihistamines (dimenhydrinate, meclizine). Which one to use is for a doctor or pharmacist — according to NHS, a pharmacist will advise on the one best suited to you or to your child.
According to CDC, scopolamine must not be used by people with glaucoma or by those at risk of urinary retention from an enlarged prostate. Ask a pharmacist before buying a patch.
According to CDC the most effective approach is not a medicine but getting used to the motion gradually — and once that is complete it works better than any motion sickness drug.

When you must go to hospital

GO TO EMERGENCY CARE or call 115 (the emergency number in Vietnam) NOW if: several people in the vehicle develop a headache, dizziness, vomiting or confusion at the same time — that is the pattern of carbon monoxide poisoning: open all the doors, get everyone out into fresh air, then call for an ambulance; a sudden severe headache; confusion, drowsiness, hard to wake; seizures; loss of consciousness; weakness on one side, one side of the face drooping or difficulty speaking; chest pain, marked difficulty breathing; repeated vomiting after a blow to the head; unable to keep down a single mouthful of water. — BE SEEN WITHIN 24–72 HOURS if: you have rested for hours and are still dizzy and unsteady; a first-ever episode of motion sickness in an older person or in someone who has never had it; ringing in one ear or hearing loss on one side. Anyone with heart, kidney, liver disease or diabetes, or who is pregnant, should not wait to see whether it settles.

This is not an illness that calls for hospital admission. Where we can help is with medicines: Y Te Xanh (GreenCare) reviews the medicines you are already taking, points out where the same active ingredient is duplicated or an interaction is worth worrying about, and matches medicines you have brought from abroad against ones with the same active ingredient in Vietnam — we do not change or stop medicines on a prescribing doctor's behalf.

If you are not sure whether hospital is needed, ring for a remote consultation by video call first; a doctor can come to the house to examine you and say clearly which cases must be admitted. A remote consultation is not for anyone who is drowsy or having seizures — with a sign in the box above, go in first and ring afterwards. We do not take on maternity care.

This article passes on the recommendations of public health bodies — sources: the CDC Yellow Book chapter on motion sickness, the CDC page on carbon monoxide poisoning, the NHS page on motion sickness, and MedlinePlus. Citing CDC here does not imply that CDC endorses Y Te Xanh or our services.

Need personalised advice for your loved one? Call our hotline 094 368 81 15 (24/7) — calling to ask a question or to book costs nothing. GreenCare has doctors who come to examine, nurses who carry out doctor's orders (injections, infusions, dressing changes), remote consultation by video call, and a review of the medicines you are taking; an in-depth remote consultation, or any one after the first, is a paid service. For children we take examination and acute care only — not long-term care at home, and not newborns or expectant mothers. We confirm we have staff in your area and provide transparent pricing before we begin.

Sources

CDC — Motion Sickness
NHS — Motion sickness

Frequently asked questions

How long before travelling should motion sickness medicine be taken?

The exact timing is printed on the leaflet for each product and the pharmacist will tell you when you buy it — every active ingredient has its own timing. The general principle matters more: according to CDC the medicine works best taken before exposure to motion, not after the signs have appeared. A tablet reached for once you already feel unwell usually comes too late.

Which seat in a vehicle is best for avoiding motion sickness?

According to NHS, reduce the motion by sitting in the front of a car, or in the middle of a boat. According to MedlinePlus, the forward carriage of a train and a seat level with the wings on a plane usually give a smoother ride. According to CDC the principle is to avoid the places that move most — the bow of a ship, for example — and on a plane to sit near the wings. Wherever you sit, NHS advises looking straight ahead at a fixed point such as the horizon.

Does ginger work for motion sickness?

Two sources say different things, so this article gives both. According to NHS you can try ginger as a tablet, a biscuit or a tea — it is on their list of things you can do yourself. But according to CDC the evidence for the effectiveness of diets, supplements, vitamins and ginger is weak and inconsistent. So there is no harm in trying, but do not let the ginger displace the things that have been shown to work: choosing your seat, looking at the horizon, ventilation, and not looking at a screen in a moving vehicle.

Should I put a motion sickness patch on my child?

Not on your own initiative. According to CDC, scopolamine, including the patch form, can cause dangerous side effects such as hallucinations and confusion in children and should be avoided. According to NHS the patches can be used by adults and by children over 10, while for younger children a pharmacy has melt-in-the-mouth tablets; and according to NHS a pharmacist will advise on the one best suited to you or to your child. Tell the pharmacist the child's age and weight, and do not split an adult's medicine yourself.

Everyone in the car felt sick and had a headache — is that mass motion sickness?

That is the moment to think carbon monoxide poisoning rather than motion sickness. According to CDC the commonest signs of carbon monoxide poisoning are headache, dizziness, weakness, an upset stomach, vomiting, chest pain and confusion, and CDC says these signs are often described as “flu-like”. The distinguishing point is that several people feel unwell at the same time, including people who have never had motion sickness. Open all the doors, get everyone out into fresh air, call for an ambulance.

An adult has started getting motion sickness when they never used to — is that a worry?

It is worth being seen for, rather than just changing seats and leaving it. Motion sickness ought to settle once the travelling has stopped, so being dizzy and unsteady hours after resting means the cause lies elsewhere. According to CDC, people with a history of migraine or of inner-ear disorders are more susceptible to begin with, so a newly appearing pattern in an older person should be looked at by a doctor. With ringing in one ear or hearing loss on one side, be seen sooner still.