General principle	Tactics
Minimize vestibular motion	Avoid particularly noxious types of motions Complex (multiple and off-axis) motions are worse than simple (one-axis) motions Low-frequency motions are worse than high-frequency motions Rotary motion is worse than linear motion Vertical motions are worse than horizontal motions Avoid travel in difficult conditions and locations Avoid air travel in storms and turbulent conditions Avoid terrain with many turns, accelerations, and ups and downs Avoid travel on water in storms and large waves Avoid travel through fog, clouds, and other conditions with poor visibility Choose location within the vehicle that minimizes motion Airplanes: over the wing Automobiles: driver's or front passenger seat, facing forward^3,4 Boats: facing toward the waves, away from the rocking bow, near the surface of the water² Buses: near the front, at the lowest level, facing forward³ Trains: at the lowest level, facing forward















Habituate to motion	Gradually increase amount of motion stimuli Start travel in calm conditions and slowly increase the amount of motion exposure If symptomatic, attempt to reduce, but not eliminate, motion stimuli


Synchronize the visual system with the motion	View the true visual horizon^2–5 Avoid close work (e.g., reading, looking at computer screens, photography) Avoid spaces where the horizon cannot be seen Focus on a distant point on the horizon Look toward the motion or direction of travel Maintain a wide view of the horizon If unable to view the true visual horizon Close eyes and hold head still Wear sunglasses








Actively synchronize the body with the motion	Perform active movements if possible Actively tilt head into turns⁶ Pilot the vehicle or connect with steering device⁷ Stand with legs bent, and anticipate the motion by moving entire body Actively swim if in water Walk around the vehicle if possiblePerform active movements if possible If unable to perform active movements Brace body and head to avoid additional motion⁸ Lay supine or recline head to 30 degrees








Reduce other sources of physical, mental, and emotional discomfort	Treat and prevent gastritis² Avoid alcoholic drinks Eat before traveling, and avoid an empty stomach Eat light, soft, bland, low-fat, and low-acid food Stay or get comfortable² Attempt to sleep Avoid dehydration, hunger, and fatigue Stay dry Avoid or reduce other unpleasant stimuli Assure adequate ventilation Avoid discussing motion sickness Avoid noxious stimuli (e.g., exhaust fumes, smell of emesis) Avoid unpleasant thoughts⁹ Listen to music¹⁰ Maintain a positive attitude^11,12 Use cognitive behavior therapy² Practice mindful breathing¹³