Airsickness

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Airsickness
Specialty Emergency medicine

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]

Contents

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:

Prevention

Travelers who are susceptible to motion sickness can minimize symptoms by:[ citation needed ]

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

Related Research Articles

<span class="mw-page-title-main">Motion sickness</span> Nausea caused by motion or perceived motion

Motion sickness occurs due to a difference between actual and expected motion. Symptoms commonly include nausea, vomiting, cold sweat, headache, dizziness, tiredness, loss of appetite, and increased salivation. Complications may rarely include dehydration, electrolyte problems, or a lower esophageal tear.

An antiemetic is a drug that is effective against vomiting and nausea. Antiemetics are typically used to treat motion sickness and the side effects of opioid analgesics, general anaesthetics, and chemotherapy directed against cancer. They may be used for severe cases of gastroenteritis, especially if the patient is dehydrated.

Morning sickness, also called nausea and vomiting of pregnancy (NVP), is a symptom of pregnancy that involves nausea or vomiting. Despite the name, nausea or vomiting can occur at any time during the day. Typically the symptoms occur between the 4th and 16th week of pregnancy. About 10% of women still have symptoms after the 20th week of pregnancy. A severe form of the condition is known as hyperemesis gravidarum and results in weight loss.

<span class="mw-page-title-main">Space adaptation syndrome</span> Condition caused by weightlessness

Space adaptation syndrome (SAS) or space sickness is a condition experienced by as many as half of all space travelers during their adaptation to weightlessness once in orbit. It is the opposite of terrestrial motion sickness since it occurs when the environment and the person appear visually to be in motion relative to one another even though there is no corresponding sensation of bodily movement originating from the vestibular system.

<span class="mw-page-title-main">Dimenhydrinate</span> Anti-emetic and antihistamine medication

Dimenhydrinate, sold under the brand name Dramamine, among others, is an over-the-counter medication used to treat motion sickness and nausea. Dimenhydrinate is a theoclate salt composed of diphenhydramine and 8-chlorotheophylline in a 1:1 ratio.

Postoperative nausea and vomiting (PONV) is the phenomenon of nausea, vomiting, or retching experienced by a patient in the post-anesthesia care unit (PACU) or within 24 hours following a surgical procedure. PONV affects about 10% of the population undergoing general anaesthesia each year. PONV can be unpleasant and lead to a delay in mobilization and food, fluid, and medication intake following surgery.

<span class="mw-page-title-main">Domperidone</span> Peripheral D2 receptor antagonist

Domperidone, sold under the brand name Motilium among others, is a dopamine antagonist medication which is used to treat nausea and vomiting and certain gastrointestinal problems like gastroparesis. It raises the level of prolactin in the human body and is used to induce and promote breast milk production off label. It may be taken by mouth or rectally.

Hyperemesis gravidarum (HG) is a pregnancy complication that is characterized by severe nausea, vomiting, weight loss, and possibly dehydration. Feeling faint may also occur. It is considered more severe than morning sickness. Symptoms often get better after the 20th week of pregnancy but may last the entire pregnancy duration.

<span class="mw-page-title-main">Cinnarizine</span> Antihistamine and calcium channel blocker medication

Cinnarizine is an antihistamine and calcium channel blocker of the diphenylmethylpiperazine group. It is prescribed for nausea and vomiting due to motion sickness or other sources such as chemotherapy, vertigo, or Ménière's disease.

<span class="mw-page-title-main">Rumination syndrome</span> Medical condition

Rumination syndrome, or merycism, is a chronic motility disorder characterized by effortless regurgitation of most meals following consumption, due to the involuntary contraction of the muscles around the abdomen. There is no retching, nausea, heartburn, odour, or abdominal pain associated with the regurgitation as there is with typical vomiting, and the regurgitated food is undigested. The disorder has been historically documented as affecting only infants, young children, and people with cognitive disabilities . It is increasingly being diagnosed in a greater number of otherwise healthy adolescents and adults, though there is a lack of awareness of the condition by doctors, patients, and the general public.

<span class="mw-page-title-main">Vomiting</span> Involuntary, forceful expulsion of stomach contents, typically via the mouth

Vomiting is the involuntary, forceful expulsion of the contents of one's stomach through the mouth and sometimes the nose.

5-HT<sub>3</sub> antagonist Anti-nausea group of medications

The 5-HT3 antagonists, informally known as "setrons", are a class of drugs that act as receptor antagonists at the 5-HT3 receptor, a subtype of serotonin receptor found in terminals of the vagus nerve and in certain areas of the brain. With the notable exceptions of alosetron and cilansetron, which are used in the treatment of irritable bowel syndrome, all 5-HT3 antagonists are antiemetics, used in the prevention and treatment of nausea and vomiting. They are particularly effective in controlling the nausea and vomiting produced by cancer chemotherapy and are considered the gold standard for this purpose.

The sopite syndrome is a neurological disorder that relates symptoms of fatigue, drowsiness, and mood changes to prolonged periods of motion. The sopite syndrome has been attributed to motion-induced drowsiness such as that experienced by a baby when rocked. Researchers Ashton Graybiel and James Knepton at the US Naval Aerospace Medical Research Laboratory first used the term "the sopite syndrome" in 1976, to refer to the sometimes sole manifestation of motion sickness, though other researchers have referred to it as "Sopite syndrome."

Retching is the reverse movement (retroperistalsis) of the stomach and esophagus without vomiting. It can be caused by bad smells or choking, or by withdrawal from certain medications, or after vomiting has completed. Retching can also occur as a result of an emotional response or from stress, which produces the same physical reaction. The function is thought to be mixing gastric contents with intestinal refluxate in order to buffer the former and give it momentum in preparation of vomiting. Treatments include medication and correction of the fluid and electrolyte balance.

<span class="mw-page-title-main">Gastroparesis</span> Medical condition

Gastroparesis, is a medical disorder consisting of weak muscular contractions (peristalsis) of the stomach, resulting in food and liquid remaining in the stomach for a prolonged period of time. Stomach contents thus exit more slowly into the duodenum of the digestive tract. This can result in irregular absorption of nutrients, inadequate nutrition, and poor glycemic control.

<span class="mw-page-title-main">Nausea</span> Medical symptom or condition

Nausea is a diffuse sensation of unease and discomfort, sometimes perceived as an urge to vomit. While not painful, it can be a debilitating symptom if prolonged and has been described as placing discomfort on the chest, abdomen, or back of the throat.

<span class="mw-page-title-main">Meclizine</span> Chemical compound

Meclizine, sold under the brand name Bonine, among others, is an antihistamine used to treat motion sickness and dizziness (vertigo). It is taken by mouth. Effects generally begin in an hour and last for up to a day.

Chemotherapy-induced nausea and vomiting (CINV) is a common side-effect of many cancer treatments. Nausea and vomiting are two of the most feared cancer treatment-related side effects for cancer patients and their families. In 1983, Coates et al. found that patients receiving chemotherapy ranked nausea and vomiting as the first and second most severe side effects, respectively. Up to 20% of patients receiving highly emetogenic agents in this era postponed, or even refused, potentially curative treatments. Since the 1990s, several novel classes of antiemetics have been developed and commercialized, becoming a nearly universal standard in chemotherapy regimens, and helping to better manage these symptoms in a large portion of patients. Efficient mediation of these unpleasant and sometimes debilitating symptoms results in increased quality of life for the patient, and better overall health of the patient, and, due to better patient tolerance, more effective treatment cycles.

<span class="mw-page-title-main">Cancer and nausea</span>

Cancer and nausea are associated in about fifty percent of people affected by cancer. This may be as a result of the cancer itself, or as an effect of the treatment such as chemotherapy, radiation therapy, or other medication such as opiates used for pain relief. About 70 to 80% of people undergoing chemotherapy experience nausea or vomiting. Nausea and vomiting may also occur in people not receiving treatment, often as a result of the disease involving the gastrointestinal tract, electrolyte imbalance, or as a result of anxiety. Nausea and vomiting may be experienced as the most unpleasant side effects of cytotoxic drugs and may result in patients delaying or refusing further radiotherapy or chemotherapy.

Virtual reality sickness occurs when exposure to a virtual environment causes symptoms that are similar to motion sickness symptoms. The most common symptoms are general discomfort, eye strain, headache, stomach awareness, nausea, vomiting, pallor, sweating, fatigue, drowsiness, disorientation, and apathy. Other symptoms include postural instability and retching. Common causes are low frame rate, input lag, and the vergence-accommodation-conflict.

References

  1. 1 2 3 4 5 6 7 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. 1 2 3 4 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". November 2010.
  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". Neuro-Otology. Handbook of Clinical Neurology. Vol. 137. pp. 371–390. doi:10.1016/B978-0-444-63437-5.00027-3. ISBN   9780444634375. ISSN   0072-9752. PMID   27638085.
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