Airsickness

Airsickness is a specific form of motion sickness which is induced by air travel[1] and is considered a normal response in healthy individuals. Airsickness occurs when the central nervous system receives conflicting messages from the body (including the inner ear, eyes and muscles) affecting balance and equilibrium. Whereas commercial airline passengers may simply feel poorly, the effect of airsickness on military aircrew may lead to a decrement in performance and adversely affect the mission.[2]

Airsickness
SpecialtyEmergency medicine

The inner ear is particularly important in the maintenance of balance and equilibrium because it contains sensors for both angular (rotational) and linear motion. Airsickness is usually a combination of spatial disorientation, nausea and vomiting.[3]

Signs and symptoms

Common symptoms of airsickness include:

Nausea, vomiting, vertigo, loss of appetite, cold sweating, skin pallor, difficulty concentrating, confusion, drowsiness, headache, and increased fatigue.[1] Severe airsickness may cause a person to become completely incapacitated.[1][3]

Risk factors

The following factors increase some people's susceptibility to airsickness:

  • Fatigue, stress and anxiety are some factors that can increase susceptibility to motion sickness of any type.
  • The use of alcohol, drugs, and medications may also contribute to airsickness.
  • Additionally, airsickness is more common in women (especially during menstruation or pregnancy), young children, and individuals prone to other types of motion sickness.[4]
  • Although airsickness is uncommon among experienced pilots, it does occur with some frequency in student pilots.[3]

Prevention

Travelers who are susceptible to motion sickness can minimize symptoms by:

  • Choosing a window seat with a view of the ground or of lower clouds, such that motion can be detected. This will not work if the plane is flown in the clouds for a long duration.
  • Choosing seats with the smoothest ride in regards to pitch (the seats over the wings in an airplane). This may not be sufficient for sensitive individuals who need to see ground movement.[1]
  • Sitting facing forward while focusing on distant objects rather than trying to read or look at something inside the airplane.

Treatment

Medication

Medications that may alleviate the symptoms of airsickness[1] include:

Pilots who are susceptible to airsickness are usually advised not to take anti-motion sickness medications (prescription or over-the-counter).[1][3] These medications can make one drowsy or affect brain functions in other ways.

Non-medication based

A method to increase pilot resistance to airsickness consists of repetitive exposure to the flying conditions that initially resulted in airsickness. In other words, repeated exposure to the flight environment decreases an individual's susceptibility to subsequent airsickness.[1] The US Air Force and US Navy have an Air Sickness Management Program and use a device called a Barany chair to desensitize trainees over 3 days. This combined with progressive relaxation (diaphragmatic breathing and muscle tensing) yields a high success rate.[7][8] The Italian Air Force also uses a similar spinning chair and psychologic relaxation techniques which yields an 82% long-term success rate, over a 10-day training period.[9]

Several devices have been introduced that are intended to reduce motion sickness through stimulation of various body parts (usually the wrist).[10]

Alternative medicine

Alternative treatments include ginger and acupuncture, with variable effectiveness.[11][12][13][14]

See also

References
  1. Benson AJ (2002). "35". Motion Sickness. In: Medical Aspects of Harsh Environments. Vol. 2. Washington, DC: Borden Institute. Archived from the original on 2009-01-11. Retrieved 2008-05-09.
  2. Samuel, Orit; Tal, Dror (November 2015). "Airsickness: Etiology, Treatment, and Clinical Importance—A Review". Military Medicine. 180 (11): 1135–1139. doi:10.7205/MILMED-D-14-00315. ISSN 0026-4075. PMID 26540704.
  3. Antunano, Melchor J., M.D. Medical Facts for Pilots (pdf) Federal Aviation Administration, Civil Aerospace Medical Institute. Publication: AM-400-03/1.
  4. Hain, Timothy C., M.D. (2006) Motion Sickness.
  5. Weinstein SE, Stern RM (October 1997). "Comparison of marezine and dramamine in preventing symptoms of motion sickness". Aviat Space Environ Med. 68 (10): 890–4. PMID 9327113.
  6. Spinks, Anneliese; Wasiak, Jason (2011-06-15). "Scopolamine (hyoscine) for preventing and treating motion sickness". The Cochrane Database of Systematic Reviews. 2007 (6): CD002851. doi:10.1002/14651858.CD002851.pub4. hdl:10072/19480. ISSN 1469-493X. PMC 7138049. PMID 21678338.
  7. "Squadron aims to reduce use of air-sickness bags".
  8. "Motion Sickness Treatments Make Waves". Scientific American.
  9. Lucertini, M.; Bianca, E.; Marciano, E.; Pettorossi, V. E. (October 2019). "Analysis of the nystagmus evoked by cross-coupled acceleration (Coriolis phenomenon)". Acta Otorhinolaryngologica Italica. 39 (5): 341–346. doi:10.14639/0392-100x-2073. ISSN 1827-675X. PMC 6843578. PMID 30933174.
  10. Bertolucci LE, DiDario B (December 1995). "Efficacy of a portable acustimulation device in controlling seasickness". Aviat Space Environ Med. 66 (12): 1155–8. PMID 8747609.
  11. Brainard A, Gresham C (2014). "Prevention and treatment of motion sickness". Am Fam Physician. 90 (1): 41–6. PMID 25077501.
  12. Han-Chung, Lien; Wei Ming, Sun; Yen-Hsueh, Chen; Hyerang, Kim; William, Hasler; Chung, Owyang (11 March 2003). "Effects of ginger on motion sickness and gastric slow-wave dysrhythmias induced by circular vection". American Journal of Physiology. Gastrointestinal and Liver Physiology. 284 (3): 481–489. doi:10.1152/ajpgi.00164.2002. PMID 12576305.
  13. Stern, RM; Jokerst, MD; Muth, ER; Hollis, C (Jul–Aug 2001). "Acupressure relieves the symptoms of motion sickness and reduces abnormal gastric activity". Alternative Therapies in Health and Medicine. 7 (4): 91–94. PMID 11452572.
  14. Golding, J. F. (2016). "Motion sickness". Handbook of Clinical Neurology. 137: 371–390. doi:10.1016/B978-0-444-63437-5.00027-3. ISBN 9780444634375. ISSN 0072-9752. PMID 27638085.
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