Airsickness: how to keep you and your passengers from getting it!

Have you or a passenger ever experienced nausea or vomiting during flight? If so, then you are not alone. While statistics for pilot airsickness during flight are hard to come by, the available figures are staggering. It is estimated that 40 to 50 per cent of pilots may experience motion sickness at some point during their training. In fact, some pilots (about five per cent) are repeatedly airsick during early stages of training and 0.5 to 1.5 per cent may have difficulty completing their training because of the airsickness. Airsickness usually subsides by the time a pilot achieves his or her certification, but reoccurring episodes later on during certain circumstances in flight are not uncommon.

Just what exactly causes airsickness is not entirely understood, but the factors that are likely to make an airsick-prone individual become airsick are well known. The first factor is activity; if the airsick-prone person is flying the aircraft, he or she is less likely to become airsick. Attention seems to be a critical factor for some people in promoting airsickness. The pilot flying is likely to be attending to flying the aircraft and will be less aware of their body’s motion cues. Likewise, the non-flying pilot or passenger may be sufficiently out of the control loop that aircraft motion is not anticipated. It is well known that we "prime" our bodies for anticipated motion by tensing certain muscles and preparing for inevitable vestibular cues. Failure to anticipate motion and properly compensate for it may lead to airsickness.

Another factor in airsickness is what you eat before flight, or what you don’t eat! It is safe to assume that any foods that upset your stomach are ones you should avoid prior to flight. These might be spicy, acidy, or gassy foods. In any event, each individual knows best what foods to avoid. Generally, research has shown that most people are better off with at least a small amount of food in their stomachs during flight. In addition, the pilot should be sure to have the proper fluids before flight (but not too much fluid unless you have a "range extender" on board).

Psychological factors are perhaps the most common factors that lead to airsickness, especially for less experienced pilots or passengers. The most obvious of the psychological factors is probably anxiety. Psychological stress, induced by anxiety, can trigger the central nervous system to try and defend itself. Nausea may be a symptom of the motion that created the anxiety but vomiting is the reaction of the central nervous system to try and fix itself. While I agree that this is not a very useful defence mechanism, remember that our bodies were not built with these types of motion in mind. In the case where a pilot vomits in response to flight anxieties (perhaps due to motion or other stressful events), he or she may be able to regain their composure soon after but a headache and mild nausea may persist. In general, an airsick pilot should be considered impaired and the non-flying pilot should immediately take over. In the case where you are the only pilot aboard, and you experience airsickness, it is advisable to land as soon as you are sure you can handle the demands of a landing.

Avoiding airsickness is a tricky task at best. For the pilot that gets sick regularly, and inner ear problems have been ruled out as a cause, a change in diet and fluid intake prior to flight might remedy the situation. There are also several over-the-counter motion sickness drugs available (Dramamine, Marazine, etc.) but these are not approved for flight duties because of the myriad of nasty side effects that may occur. As a passenger, you may use anything that works well for you. Pilots, who cannot find a solution to airsickness on their own, should work with their aeromedical doctor to solve the problem. This can be a long process so don’t expect an immediate cure.

A pilot who experiences continual airsickness during training will normally overcome the problem if their motivation to fly allows them to continue to put up with it for awhile. Why some people are more susceptible to airsickness than others is not well understood, but if you want to determine your susceptibility, there are simple tests that can be taken. In any event, there is little justification, other than an inner ear problem, for not continuing in flight training just because of frequent airsickness. After time the body naturally becomes accustomed to the stimuli that induces airsickness.

While in flight, an episode of impending airsickness can be staved off by following several simple rules:

1. Try to fly straight and level.

2. Find smooth air if possible.

3. Minimize head movements; motion while the head is oriented out of the aircraft’s plane of motion can also lead to spatial disorientation.

4. Open the air vents and point the vent at your face.

5. Try to establish a relaxed comfortable body position.

6. If in visual conditions, try to look outside and as far ahead as possible. The detection of motion is more difficult if the focus of attention is at a distance.

7. Focus attention on something other than how you feel.

These tips are also useful for passengers who experience airsickness.

If these tips fail you or your passenger, then be sure to have a "goodie bag" handy. These can be purchased at most stores that sell piloting supplies. Personally, I never fly without one. Fortunately, I have not had to use one yet. However, several students of mine have, and I was very grateful that they used it instead of my instrument panel or the cockpit floor.