Health ConditionsMotion sickness is a common, unpleasant condition that occurs when an individual is exposed to real or perceived motion, resulting in symptoms such as nausea, vomiting, nonvertiginous dizziness, and malaise. It is generally considered a physiologic response rather than a disease state and reflects a mismatch between sensory inputs involved in motion perception.
The Greek physician Hippocrates observed over 2,000 years ago that "sailing on the sea proves that motion disorders the body," and the word "nausea" itself derives from the Greek root word naus, meaning "ship," from which "nautical" is also derived. In modern times, motion sickness can be provoked by a wider range of situations, including cars, buses, trains, aircraft, roller coasters, virtual reality, simulators, and even movement in outer space.
Although travel-related motion is the most common trigger, motion sickness may occur in a variety of settings and is described using different terms depending on the context, including seasickness, airsickness, space motion sickness, and visually induced motion sickness (cybersickness).
Presentation can be diverse and may include gastrointestinal, central nervous system, and autonomic symptoms. The main symptom of motion sickness is typically nausea. The full range of symptoms includes nausea and vomiting, cold sweating, pallor, headache, drowsiness, yawning, loss of appetite, and increased salivation.
This activation leads to the characteristic autonomic features of motion sickness, such as nausea, vomiting, pallor, diaphoresis, hypersalivation, and malaise. Neurobehavioral manifestations, including lethargy, irritability, and decreased alertness, may persist even after motion exposure ends.
The constellation of symptoms known as "sopite syndrome" refers to profound drowsiness and fatigue that can persist for hours to days following exposure. In severe cases, intractable retching and vomiting, postural instability, inability to walk, incapacitation, dehydration, and electrolyte imbalance may result.
The sensory conflict and neural mismatch theory is the most widely accepted theory for explaining motion sickness. It describes the conflict that occurs between the visual, vestibular, and somatosensory systems resulting from real or virtual motion. Afferents from the vestibular apparatus arrive at the vestibular nuclei of the brainstem, which also receives inputs from the visual and proprioceptive systems. Efferent projections then reach the temporoparietal cortex via the posterolateral thalamus, triggering autonomic reactions and the vomiting center.
Activity and structures that produce motion sickness include vestibular input through the semicircular canals, the otolith organs, and the velocity storage integrator in the vestibular nuclei. Motion sickness occurs only when the 8th cranial nerve and cerebellar vestibular tracts are intact; those lacking a functional vestibulo-cochlear system are immune to motion sickness.
Central nervous system components that mediate motion sickness include the vestibular system and brainstem nuclei, the hypothalamus, the nodulus and uvula of the cerebellum, and emetic pathways such as the medullary chemoreceptor trigger zone and vomiting center. There are also extensive projections from the vestibular nuclei to the autonomic system, both utilizing glutamatergic and serotonergic pathways.
Although much research remains to be done, it appears undeniable that the physiological expression of motion sickness is mediated by the autonomic nervous system, and when nausea is a predominant symptom, the stomach in general shuts down in a response characterized by decreased normal gastric myoelectrical activity and delayed gastric emptying.
Many of the physiologic changes in subjects with motion sickness result from altered activity of the autonomic nervous system, and increased secretion of pituitary and adrenal hormones. Gastric and colonic motility decrease, with a concomitant decrease in bowel sounds.
Motion sickness is a common response to unnatural motion that varies widely among individuals. A review of recent findings highlights the gut's active role, including its brain-body pathways potentially driving pathophysiology and hinting at a more complex model than previously thought.
Children aged 2–12 years are especially susceptible, but infants and toddlers are generally immune. Adults over 50 years are less susceptible to motion sickness. Infants and children younger than 2 years rarely exhibit symptoms. Susceptibility increases in early childhood, with the highest incidence reported among children aged 3–12 years.
Sex-related differences have been consistently reported, with females experiencing motion sickness more frequently and with greater severity than males. Pregnancy is associated with increased susceptibility. Pregnancy, menstruation, and taking hormone replacement therapy or oral contraceptives have also been identified as potential risk factors.
Ancestry may also play a role; there is some evidence that motion sickness occurs more frequently in individuals with Asian ancestry compared to European ancestry. Limited data suggest that ethnicity may influence susceptibility, with some studies reporting increased sensitivity among individuals of Chinese ancestry; however, these findings are based on small studies and require further validation.
Certain medical conditions are associated with increased susceptibility, including a history of migraine, vestibular disorders, and prior episodes of motion sickness. Enhanced motion intolerance is also a characteristic of vestibular migraine, suggesting that in vestibular migraine, there is a disruption of normal brain mechanisms that control central vestibular signals to minimize intravestibular sensory conflict.
Cross-sectional studies show increased susceptibility in persons with high levels of aerobic fitness; there have been suggestions that this is due to a more reactive autonomic system.
Sleep deprivation may contribute to motion sickness incidence and severity and may also degrade the capacity to compensate for perturbed motion. Motion sickness susceptibility is also influenced by personal characteristics including trait-anxiety, aerobic fitness, and hemodynamics, as well as age and sex.
One study showed that passengers without a view of the road ahead were about three times more likely to experience illness, and another report suggested that adopting a wider stance may reduce motion sickness. There is also evidence that diet and eating behavior influence risk.
Both Traditional Chinese Medicine (TCM) and Ayurveda have used ginger for over 3,000 years — not as a marginal folk remedy, but as a foundational therapeutic agent prescribed for dozens of conditions. In TCM, ginger (sheng jiang for fresh, gan jiang for dried) is classified as a warm, pungent herb that expels cold, warms the middle burner (digestive system), and transforms phlegm. Ginger is commonly used in TCM to address digestive issues such as nausea, bloating, and indigestion. Its warming properties help stimulate digestive enzymes and promote healthy gut function.
Traditionally used in Herbal Medicine, ginger has been applied to help relieve digestive upset including lack of appetite, nausea, digestive spasms, indigestion, dyspepsia, and flatulent colic. The Canadian Health Products monograph recognizes ginger as helping to prevent nausea and vomiting associated with motion sickness and/or seasickness.
The major classes of ginger compounds are gingerols, shogaols, zingiberene, and zingerone, as well as other less common compounds, including terpenes, vitamins, and minerals. Among them, gingerols are considered as the primary components, reported to possess several bioactivities.
Ginger and its bioactive secondary metabolites, especially gingerols and shogaols, interact with the 5-HT3 signalling pathway. Moreover, ginger is reported to show anticholinergic and antihistaminergic activities in vitro, which may further contribute to its antiemetic effect.
Ginger has been proposed to possess anticholinergic effects at both central and peripheral sites. Hence, the possibility that ginger exerts its antiemetic effects by acting on cholinergic-dependent pathways deserves further investigation. Ginger has also been shown to be a potent inhibitor of prostaglandin and leukotriene synthesis and has demonstrated anti-5-HT3 effects.
A notable human RCT investigated ginger's effects on gastric function specifically during motion sickness. Thirteen volunteers with a history of motion sickness underwent circular vection, during which nausea, electrogastrographic recordings, and plasma vasopressin levels were assessed with or without ginger pretreatment in a crossover-design, double-blind, randomized placebo-controlled study. Circular vection induced a maximal nausea score and increased tachygastric activity and plasma vasopressin. Pretreatment with ginger (1,000 and 2,000 mg) reduced the nausea, tachygastria, and plasma vasopressin. Ginger also prolonged the latency before nausea onset and shortened the recovery time after vection cessation.
A systematic review of randomised controlled trials (RCTs) and animal studies was conducted using PubMed, Web of Science, and DOAJ in accordance with PRISMA guidelines. Four RCTs (involving 469 participants) and only one animal study met the inclusion criteria. Despite its widespread historical use and apparent promise as a remedy for motion sickness, the available data are not without flaws. The included trials differed greatly in terms of follow-up time, dosage standardisation, and sample size. The majority of earlier research lacked long-term follow-up and had small sample sizes.
A broader systematic review of 12 RCTs found that eleven trials including 2,630 subjects showed that supplementation with dried ginger powder resulted in significant improvement of nausea or vomiting related to early pregnancy or motion sickness.
The NCCIH (NIH National Center for Complementary and Integrative Health) gives a balanced assessment: evidence from some laboratory and clinical studies has suggested that ginger might help with motion sickness, but other studies have not found a beneficial effect.
Ginger avoids the sedative and neurological side effects that are frequently connected to centrally acting antiemetics by acting directly on the gut. In some people, ginger can have mild side effects such as abdominal discomfort. Research has not definitively shown whether ginger interacts with medications, but concerns have been raised that it could interact with anticoagulants.
Evidence strength: Moderate, based on multiple RCTs and systematic reviews. Results are promising but mixed across studies, with heterogeneity in dosage, form, and study design noted as significant limitations.
Peppermint has a long history of use in various folk remedies across different cultures. It is often utilised for its soothing effects on the digestive system, particularly for alleviating nausea and motion sickness.
Certain micronutrients such as hesperidin, menthol, vitamin C, and gingerol were shown to have a positive impact on alleviating motion sickness. According to a comprehensive 2023 review published in Nutrients, the reduction in motion sickness levels from herbal formulations is attributed in part to bioactive compounds including menthol, which may exert effects by modulating histamine levels in brainstem regions and the hypothalamus.
Peppermint oil aromatherapy, especially when combined with other oils, effectively reduces postoperative nausea, though not significantly on its own compared to saline. The literature reveals a significant gap in research related to peppermint oil inhalation as a treatment specifically for motion sickness, indicating the need for additional research to assess its effectiveness.
Evidence strength: Preliminary. Evidence for menthol and peppermint aromatherapy is largely derived from postoperative nausea contexts; direct clinical evidence for motion sickness specifically is limited.
Hesperidin is a flavonoid found naturally in citrus fruits and has been used in traditional medicine systems as part of whole-fruit preparations, though it has not been isolated historically as a specific anti-motion sickness agent.
The NCCIH notes that although the evidence for the effectiveness of the bioactive plant compound hesperidin (found in citrus fruit) is very limited, one study has suggested benefit for motion sickness.
A laboratory study investigated hesperidin's mechanism: the sensory conflict theory proposes that histamine elevations are a primary reason for motion sickness, providing a path for effective pharmacotherapy. Researchers aimed to evaluate the anti-motion sickness effect of hesperidin by modulating histamine and histamine receptor H1 expression. The inhibitory effect of hesperidin on histamine release was studied in KU812 cells, while the in vivo anti-motion sickness effect was evaluated in mice.
Chinese herbal formulations of gingerol, hesperidin (found in citrus fruit), and menthol (from the mint family) exhibit antihistamine properties that may improve motion sickness symptoms.
Evidence strength: Preliminary and largely preclinical (cell and animal studies). Human clinical trial evidence for hesperidin specifically in motion sickness is very limited.
Although the evidence for effectiveness is limited, one study found that taking 500 mg of vitamin C can help improve seasickness, especially in young adults. Vitamin C is among the micronutrients shown to have a positive impact on alleviating motion sickness in the comprehensive 2023 Nutrients review. Nutritional supplements including vitamin C, ginger, menthol, and hesperidin may also lower symptoms by reducing histamine.
Evidence strength: Very limited. The existing evidence is based on a small number of studies, and further clinical research is needed before firm conclusions can be drawn.
Complementary approaches advocated for preventing or treating motion sickness include pyridoxine (vitamin B6). However, the NCCIH is explicit in its assessment: although the American Congress of Obstetrics and Gynecology recommends pyridoxine alone or in combination with doxylamine as a safe and effective treatment for nausea and vomiting associated with pregnancy, no evidence supports claims that pyridoxine prevents or alleviates motion sickness.
Vitamin B6 supplementation has demonstrated benefits for nausea and vomiting, particularly during pregnancy. The American College of Obstetricians and Gynecologists recommends it as a first-line treatment for nausea and vomiting during pregnancy, but it may not be as effective for more sudden forms of nausea or motion sickness because B6 needs to build up in the system over time.
Evidence strength: Weak specifically for motion sickness. While vitamin B6 has established evidence for pregnancy-related nausea, institutional sources confirm there is currently no direct clinical evidence for motion sickness specifically.
Based on traditional Chinese medicine, acupressure bands apply pressure to the P6 (Neiguan) point — two to three finger widths below the wrist crease between the two tendons on the inner wrist. This point has been used in TCM for centuries to manage nausea and digestive disturbance.
Several studies have shown that acupressure, acupuncture, and electroacupuncture on the P6 point (located on the anterior surface of the forearm, two inches proximal to the distal wrist crease and between the middle two tendons of the inside of the forearm) are effective in the treatment of motion sickness.
A 1995 published study concluded that P6 acupressure reduces the severity of symptoms of visually-induced motion sickness and gastric tachyarrhythmia.
However, the NCCIH offers an important caveat: research does not support the use of acupressure or magnets for motion sickness as a robust finding, and studies are conflicting on whether acupressure is helpful for motion sickness.
Regarding postoperative nausea more broadly, a Cochrane review analyzing multiple trials found that P6 acupressure significantly reduced postoperative nausea and vomiting compared to sham acupressure. It should be noted that this Cochrane evidence applies to postoperative nausea rather than specifically to travel-induced motion sickness.
Evidence strength: Mixed. Some positive results in controlled studies for motion sickness specifically; Cochrane-level evidence exists for postoperative nausea. Multiple studies conflict on effectiveness for travel-related motion sickness, and NCCIH concludes current evidence does not support acupressure for this indication.
Herbal dietary formulations such as Tianxian and Tamzin were shown to be as effective as medications. The 2023 Nutrients review hypothesizes that the observed reduction in motion sickness levels resulting from administration of these herbal formulations is attributed to the potential presence of bioactive compounds including hesperidin, menthol, and gingerol, which possess antihistamine properties. These compounds may exert their effects by modulating histamine levels in brainstem regions and the hypothalamus. However, further research is needed to confirm the effectiveness and safety of these herbal formulations for motion sickness treatment.
Evidence strength: Preliminary. Findings are from a limited number of trials; the proposed mechanisms are plausible but require confirmation in larger, well-designed RCTs.
Based on a review of the literature, the composition of pre-exposure meals appears to significantly impact the severity of motion sickness symptoms. While the effects of high-carbohydrate and high-protein meals have yielded varying results, the consumption of high-fat meals prior to exposure to motion sickness has been associated with a heightened risk of this syndrome.
High-fat meals prior to flight have been found to increase levels of air sickness. One study examined the effect of both low-fat meals and high-fat meals on participants who were exposed to drum rotation after the intake of meals.
Lifestyle changes, such as eating smaller, more frequent meals and opting for bland foods, can help manage symptoms. The 2023 Nutrients review reinforces these findings, noting that further research is necessary to elucidate the macronutrients or ingredients that most significantly influence motion sickness symptoms.
High-fat diets have been linked to higher motion sickness symptoms, possibly because of their negative impact on the availability of food components, including protein. Therefore, when investigating the relationship between protein and motion sickness, it is important to consider the impact of dietary composition, including macronutrient ratios and other factors that can modify amino acid absorption and availability.
Research has noted that alcohol consumption can worsen vestibular and sensory system function. The Communications Biology perspective on the gut-brain axis in motion sickness cites work on alcohol's influence on cybersickness, exploring the influence of alcohol on cybersickness, consistent with the broader understanding that substances altering vestibular or CNS function may modulate susceptibility.
Research suggests that activation of the parasympathetic nervous system using pleasant music and diaphragmatic breathing can help alleviate symptoms of motion sickness. These approaches aim to identify non-pharmacological strategies that can be employed to reduce or prevent motion sickness in both real and virtual environments, with research supporting the use of parasympathetic activation through pleasant music and diaphragmatic breathing.
Individuals with a history of motion sickness will have a high likelihood of recurrence in the presence of a provocative stimulus unless able to achieve habituation. Habituation — the process by which the nervous system adapts to repeated motion stimuli — is well documented as a protective factor. Protective factors for motion sickness in parabolic flight include prior zero-g flight experience (habituation) and antimotion sickness medication.
Herbal dietary formulations such as Tianxian and Tamzin were shown to be as effective as medications. Therefore, nutritional interventions along with behavioral countermeasures could be considered as inexpensive and simple approaches to mitigate motion sickness. Multidisciplinary interventions used for motion sickness include pharmacological approaches, nutritional interventions, and behavioral countermeasures. Nutritional interventions along with behavioral countermeasures could be considered as inexpensive and simple approaches to mitigate motion sickness.
5-HTP is the immediate serotonin precursor and is the bioactive constituent of Griffonia simplicifolia seeds. Research implicates depleted serotonergic activity in vestibulo-ocular disturbances underlying motion sickness. An open-label clinical study (Esposito et al., J Med Food 2015) in a pediatric population found that a Griffonia simplicifolia/magnesium complex providing 50 mg 5-HTP twice daily for three months significantly reduced motion sickness symptoms compared to an untreated control group.
Ginger (Zingiber officinale) has the strongest natural evidence base for motion sickness among herbal remedies. The European Medicines Agency's Committee on Herbal Medicinal Products classifies dried powdered ginger rhizome as a 'well-established use' for prevention of nausea and vomiting in motion sickness. Multiple RCTs, including a landmark 1982 Lancet trial and a 2003 study in the American Journal of Physiology, have demonstrated its ability to reduce gastric dysrhythmias and nausea symptoms induced by motion. A 2026 systematic review concluded ginger is a reasonably safe, well-tolerated, and effective treatment for motion sickness.
Hesperidin, a citrus flavanone, is explicitly cited by the NIH/NCCIH and CDC Yellow Book as a bioactive compound for which at least one study has suggested benefit in motion sickness. Preclinical research in mice (Neurochemical Research 2019) demonstrated hesperidin significantly reduced motion sickness symptoms by inhibiting histamine release and downregulating histamine H1 receptor expression, with an effect comparable to dimenhydrinate at 80 mg/kg.
Magnesium was used as a co-treatment with 5-HTP (Griffonia simplicifolia) in the Esposito et al. (J Med Food 2015) open-label pediatric trial, which showed significant motion sickness symptom reduction over three months. Magnesium's relevance is supported by evidence that serum Mg2+ levels are associated with vestibular migraine, a condition closely linked to motion sickness susceptibility. Its role may include modulating serotonergic and NMDA receptor activity in vestibular nuclei.
Chamomile (Matricaria chamomilla) has a centuries-old tradition in European herbal medicine for gastrointestinal complaints and nausea. A 2025 PMC review noted chamomile has been found beneficial for motion sickness, indigestion, and anorexia, attributing its antiemetic effect to COX-2 inhibition and reduced prostaglandin E2 levels. Clinical evidence is limited compared to ginger; most trials focus on post-operative nausea rather than motion sickness specifically.
Peppermint is a well-established traditional remedy for motion sickness, included in traditional herbal medicine references. Its antiemetic and antispasmodic properties support this use. Clinical trial evidence specifically for motion sickness is limited compared to its nausea evidence in other contexts.
Peppermint (Mentha × piperita) has a long history of traditional use for nausea and gastrointestinal complaints, and is included among complementary approaches for motion sickness-related nausea by authoritative sources including the CDC. Its active constituent menthol is noted in herbal formulations shown to exhibit antihistamine properties relevant to motion sickness. Clinical evidence for peppermint specifically in motion sickness is limited; most studies address post-operative or pregnancy-related nausea.
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