by Thomas M Penders
Many otherwise active adults will avoid boating because of past experiences with sea sickness. The ancient Greeks, a seafaring people, provided us with the words nautical and nausea, an indication of the long held association between the sea and ill feeling. The French call it “mal de mer”. An anonymous sufferer once expressed his reaction to the experience: “At first you are afraid you’ll die, then you’re afraid you won’t.” A single bad experience with this condition can make one sour on ever approaching a boat again. This is regretable as there is much that can be done to limit the likelihood of a ruined day on the water.
Please note that content provided here is for general informational purposes only. It should not be taken as specific medical advise. Readers should seek specific recommendations to suit their individual circumstances from their personal physicians.
Causes
The reaction known as sea sickness is a response, pre-programmed into the human brain, to movements that confuse and disorient. Akin to vertigo, the reaction varies from mild queasiness and weakness to violent eruptions of vomiting that can lead to dehydration. 
Anyone who has intentionally spun themselves around as a child has produced a form of the reaction. The inner ear is the organ of balance. Made up of three circular tubes designed to detect movement of the head in any dimension (semi-circular canals), this apparatus sends messages to the brain about one’s position, direction and velocity of movement. Other messages, provided separately by sensors in muscles and joints, also provide the brain with information about position and movement of the body. Finally, what we see with our eyes tells the brain where we are in space, where we are going, and how fast.
Inner ear showing semicircular canals, the organ of balance
Image courtesy National Institutes of Deafness and Communication Disorders, NIH.
The sea sickness reaction, considered by the US Navy as a process of adaptation, occurs when the brain receives messages from these three senses that seem contradictory and confusing. This occurs, most commonly, when motion, such as the rocking motion of waves, is felt by one unaccustomed to it. The fatigue and immobility experienced by a sufferer is nature’s way of saying stop and be still. Sea sickness is a form of motion sickness . It has been variously nicknamed air sickness, car sickness, amusement ride sickness and even video game sickness. Special simulators used in research and training are able to predictably cause the symptoms.
Vulnerability
NASA has said that fifty percent of astronauts have had significant impairment as a result of motion sickness. Operators of whale watching trips report that 100% of their passengers will be sick in heavy seas. Women are more susceptible to this reaction, young more than old and; strangely, the more physically fit are more prone than the couch potato.
Children under three seem to be totally immune. Dogs and cats can also become sick on the water. Fatigue, lack of sleep and emotional tension have all been identified as contributors to vulnerability. There is a clear connection between dietary indiscretion and likelihood of falling victim to motion sickness. Heavy, especially fatty meals the day before or the day of embarkation are a set up for developing sea sickness. Certain medications, head colds and nasal allergies also predispose. Finally, it is clear, that excess use of alcohol can be a strong contributor to having an unpleasant time at sea. Experienced sailors become adapted to wave motion and are relatively resistant, though not totally immune, from sea sickness.
Symptoms of Sea Sickness
The early signs of sea sickness may be subtle. Yawning and a mild degree of sleepiness with a sense of anxiety may be the first hint of trouble. More troubling symptoms appear as the condition progresses. As one succumbs to mal de mer they progress through stages of symptom severity shown here.
- Mild symptoms consist of tiredness, mild queasiness, weakness and cold sweats.
- Nausea, lethargy and pallor occur as the condition progresses.
- Vomiting, retching, sleepiness and a desire to withdraw from surroundings follow as advanced signs.
What to Expect
If the trip is more than a day, most people with have a spontaneous resolution of symptoms in 48 to 72 hours. Experienced boaters call this “getting your sea legs under you”. Sometimes a nap can help the adaptation process.
What to Do if Someone is Affected
There are two recommended, but different, approaches to take if someone becomes sea sick while boating with you.
- Remain Active – To limit the likelihood that mal de mer will progress, the best approach is to keep the victim active. Assign a task such as steering the boat. This requires that the sufferer keep their eyes fixed on the horizon. Avoid close, focused work such as chart reading or reading text. Position the victim as close to the midd of the craftle as possible to minimize the rolling and pitching effects that they experience. Encourage drinking water or juices. Avoid alcohol.
Or
- Give up and go below – Some individuals will be so distressed that they insist on withdrawing and closing their eyes. In this case there is a greater likelihood that the condition will progress. Lie the victim with back and head supported to avoid aspiration. Provide with a container such as a sea sickness bag. Ventilate the area well, minimizing odors. Try a chewable seasickness pill as this individual is not likely to keep down a pill. Allow sleep to come. They will be better when awake.
Medicinal Remedies
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Antihistamines – Dramamine, Meclazine – Bonine - These over-the-counter medications have been repeated shown to be helpful in preventing and shortening the duration of seasickness. They both have the side effects of drowsiness and dry mouth. Individuals with any medical condition you should check with their doctor before using these.
- Scopalamine Patch - This is a prescription product that is placed behind the ear (where the drug is absorbed into the inner ear). It is more powerful in it’s anti-motion sickness effect. It is available only by prescription because it has the potential
for more serious side effects on the heart, urinary and gastrointestinal system. It should put in place three to six hours before casting off to be effective. The patch can be left on for 72 hours and replaced if needed.
- Herbal remedies – Ginger has been used for hundreds of years by seafarers in Europe and Asia. Studies have shown it to be effective and safe in preventing and reducing motion sickness symptoms.
Non-medicinal approaches
Pressure Band - Based on a principle derived from acupuncture, the Acupressure Band worn on the wrist has also been found to reduce symptoms of seasickness. There is no discomfort with wearing one or two bands. A pea-sized nodule of plastic serves to
maintain pressure on the inner wrist, a pressure point that reduces GI distress.Various training techniques including one directed at reducing morning sickness in pregnant women have been found to be helpful. These techniques include relaxation training and biofeedback.
Seven point program for prevention
The most effective way to prevent the development in seasickness, even among those who have been previous sufferers is to follow a series of recommendations. Each of these suggestions has been found to be helpful individually. The following seven point program will make your trip to the water world less troubled by illness. Chances of becoming ill can be reduced by as much as eighty percent using these guidelines.
- Rest well on the night before.
- Eat a light, low fat meal the evening before.
- Party prudently. Limit alcohol before and during the trip.
- Consult with your physician about the best medicinal or herbal remedy for you. Take or apply it at least three hours before you set out. Consider need for treatment of upper respiratory conditions or allergies.
- Stay hydrated. Drink water or juices, particularly if in direct sun. Avoid alcohol.
- Ask the captain to position you near the center of the boat where rocking motions are less.
- Assume a job on board that involves keeping your eyes on the horizon and away from tasks requiring reading or close focus.
It should be remembered that conditions that bring on sea sickness are sometimes those that bring on other dangers at sea, such as high seas and heavy weather. Vomiting and dehydration in someone who is not in the best of health can lead to serious medical complications.
If you, or someone with you, become severely ill for more than three hours, don’t be a hero. Ask to be taken ashore.
