Preventing motion sickness

DEAR DOCTOR K: I have a lot of travel coming up for work. The problem is that I get motion sickness in cars, trains, planes – basically everything that moves. I’d love some tips for relief.

DEAR READER: Motion sickness is caused by what’s known as a “neural mismatch.” Normally your eyes, muscles, joints and the balance mechanism in your inner ear send messages to your brain about your body’s movement in space.

The neural mismatch that causes motion sickness usually follows one of two patterns. The first is when your body experiences motion that your eyes can’t see. One example of this is being below deck on a rocking boat or ship. Everything in the room looks stationary to your eye. But your body can feel the motion of the boat.

The other type of neural mismatch occurs when your body is not actually moving, but your eyes tell it that it is. This can happen when you are watching a movie in a widescreen theater.

Here are some tips to help prevent it.

• Travel on an empty stomach.

• On an airplane, try to get an aisle seat toward the center of the cabin, where motion is the calmest. On a ship, request a lower-level cabin toward the middle of the vessel to minimize motion.

• Avoid odors such as perfume, smoke or cooking smells. Open a window for fresh air if possible. Turn on the air vent if you’re on an airplane.

• Don’t read or watch videos while traveling.

• During a bumpy car or boat ride, try keeping your gaze fixed on something stationary, like the horizon.

If these tips don’t help, consider medications. Over-the-counter drugs include dimenhydrinate (Dramamine) and meclizine (Bonine). Prescription medications include promethazine (Phenergan) and scopolamine (Transderm Scop), a patch worn behind the ear. Adding caffeine to these medicines (particularly promethazine) may provide additional relief.

A final word of caution: Most motion sickness medications tend to make people drowsy.