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Preventing and dealing with sea sickness

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What is the issue?
Anyone can get seasick and it is a totally unpleasant malady to succumb to.

Why address this?
Knowing what causes sea sickness and how to prevent or deal with it, should you or your crew suffer, can mean the difference between the ships party having the most miserable time humanly imaginable, or a great day’s sailing.

How to address this?
Seasickness can be addressed by a good understanding of its cause coupled with effective personal and vessel strategies. This will include preventatives which altogether should improve sailing for someone who suffers.

What Is Seasickness?

Seasickness is a form of motion sickness. It is caused when the senses that process spatial orientation, what enables us to function in our three dimensional world, send streams of conflicting information to the brain. These reporting receptors are four fold:
(i) Our eyes monitor our body relative to its surroundings and its relative bearing.
(ii) Our inner ears sensing three dimensional motion and motion direction.
(iii) Neural receptors distributed throughout our physic informing the brain of the bodies activity (i.e. are we standing still, turning, in motion and that motions relative direction).
(iv) Skin sensors in our feet and buttocks monitoring our physical orientation (e.g. are we seated, standing, laying face down our orientated to gravitational pull).

These work perfectly fine in the natural land based environment. However in a boat that is swaying, pitching and yawing, all four of the sensory inputs send a constant stream of conflicting information to the brain to process. Unable to marry these streams the brain begins to malfunction and sets off spatial orientation alarms. A lot of us then know how that feels.

I have been unable to find out why this results in nausea and vomiting. My personal guess is that the brain concludes that the sensory conflict has been caused by eating something hallucinogenic and bad. So it is programmed to take the safe route of expelling the stomach contents as a first step to address it. If a reader can enlighten us on this please comment below and I will add the edit to the text.

Looking on the bright side, we are a highly adaptive species and after some time the brain learns to process this conflicting sensory data. Typically within two to three days the sailor will grow a pair of ‘sea legs’. But these fabled ‘sea legs’ do not make you immune. If the sensory data dramatically changes, such as a sudden storm or a passage moving off a downwind sea leg and onto that of a more challenging upwind beat, the brain has to relearn that altered sensory pattern and it will send its alarms again, if perhaps not as severe. Furthermore ‘sea legs’ are all but completely lost in just about the same amount of time it took to acquire them once a foot is set down upon land. The more you sail the more quickly you will acclimatise to the conditions. Incidentally sometimes you may experience a ‘land sickness’ for some time after coming ashore. If you go into a tight confined room and pause you get a sensation that the room is moving. The mind is continuing to process the errors coming in. However, this is scarcely perceptible in most cases and once ashore or in tranquil waters the sensory data returns to normal and recovery from any motion sickness is thankfully rapid.

Susceptibility to seasickness varies from person to person. On a scale of 1 ‘Highly Susceptible’ to 10 ‘Scarcely Touched’ I would personally place myself at the median of 5. Research has shown that preteen children and females have a slightly higher rate of susceptibility and young toddlers are virtually unaffected.

Levels of Seasickness

Mention the word seasickness to most people and they immediately conjure up an image, or a memory, of a sad victim hanging over the edge physically vomiting. I believe that is too narrow a definition, causing skippers to inappropriately judge the capability of the crew and their own capability to make good decisions. I believe seasickness to be far less binary. Its hold should best be measured across degrees of affectation. It proceeds through the following general range of affects:

Feeling slightly tired
Concentration challenged
Warm flushes
Slight sweating
Excessive saliva
Pallid colour
Complete debilitation

The key observation here is an individual does not have to be vomiting to be seasick; its effects are in degrees. Just because a crewmember or guest is not throwing up does not mean they are untouched by seasickness and the boat is running to plan. You have to only go one third of the way down that list before things that should be attended to are not. We all know of very strange decisions being made on boats by very bright people. How many times have we all lethargically hoped that the wind would back off delaying that timely reef. Or found that we could not get our mind around a certain plot location or even which course to take?

People are more likely to be affected by early stages of motion sickness. We should vigilantly measure our own decision making and that of our crew based upon a broader perspective of seasickness for smooth vessel operations.

Addressing seasickness before boarding

Prevention is infinitely better than a cure. Anything that lowers your body's general sense of wellbeing, lowers its resistance to the stressful factors of the boat trip, increases the likelihood of seasickness. The key to avoiding seasickness is to step aboard in good physical condition.
1. Be rested before you go out on the water. Weariness and exhaustion can make you more susceptible to motion sickness. Have all your gear prepared and other business matters sorted well in advance and have a good nights sleep.
2. Don't consume an excessive amount of alcohol the night before departing or in the day before sailing.

This may present a challenge. Sailing is intensely sociable and once a crew gets together and go out on the town it is almost inevitable a party is going to break out. Alcohol causes seasickness in many individual and combined ways. Firstly, alcohol inhibits the deepest dream stage of sleep called REM (Rapid Eye Movement) where the brain derives most rest. You may feel tired the next day even just after having a few drinks the night before. Secondly alcohol dehydrates the body again lowering its resistance to the stresses and strains of the motion. Finally a full fledged alcohol hangover is practically a seasickness invitation on a boisterous boat ride. This is the case if the drinks were consumed the night before or in the hours preceding embarkation.
Of course we rarely plan to drink too much and social events tend to sweep us away in their own momentum. If caught up in a social session involving alcohol make a fast rule that every third glass you drink will be water. This will give you a chance to avoid the hangover and dramatically reduces dehydration.
2. Carefully avoid rich and spicy foods the day before sailing and greasy or acidic foods in the hours before setting sail.
If your digestive system is already stressed to digesting slow to break-down heavy acidic foods the motion sickness will leverage this weakness whilst rolling around on the sea. Substitute the hearty traditional ‘Full Fry Up’ for the ‘Continental Breakfast’s’ selection of breads, pastries, croissants, rolls, milk, cereals and grains. Equally avoid the traditional breakfast’s orange or grape fruit juice as they are very acidic. Exchange them for gentler low acidic alternatives derived from apple, cranberry, pear or melon.
Reduce the intake of coffee, and caffeinated drinks before leaving the dock. They are diuretic (increases urination) accelerating dehydration and are hard to cope with. This also lessens visits to the head (toilet) below decks which is positively the last place you should be as you are trying to acclimatise at the start of the journey.
3. But do have that ‘Continental’ breakfast, skipping eating before sailing is just as bad. Remember motion sickness tends to exploit any weakness or lowered resistance. If you are feeling hungry it will take hold of that. A good and gentle meal to digest and sense of well-being is the best defence.
4. Take lots of water and drink often before hand. Even feeling partially dehydrated lowers resistance increasing vulnerability.
5. I cannot vouch for this but reportedly having your ears cleaned before setting out on an extended cruise helps. Helping the inner ears mechanisms that sense three dimensional motions operate and acclimatise better has made the difference for many people.
6. Finally be calm, relax and enjoy the trip. Being anxious or fearful of succumbing to seasickness or any other aspects of the boating or life in general will not help.
I know that final point is a bit rich as you are only one third of the way through this extensive piece that is, I am sure, building upon your concerns. However this is all common sense and the art of strategy is knowing what not to do. Pick up a few tips implement them and go out and have a great time.
7. Finally avoid heavy conditions. There is just no valour in going out and taking it head on. If you are prone to seasickness, there is no point in going aboard when you know conditions are too rough. Life is short, make your apologies, and stay at home those days.

Addressing seasickness aboard

1. Avoid going down into the cabin. Keep in the open air where there is a nice breeze and a clear view out over the horizon. If you are prone to motion sickness being in the cabin is the worst possible place to go. In the cabin the four sensors are at their most conflicted. The eyes see nothing but the fixed lines of the cabin that are in dramatic contrast to the environment as sensed by all the other senses. Down below decks is the danger zone and you should only plan to be lying on your back if you are there.

2. Pick a nice spot between the centre and two thirds of the way back in the boat. Preferably as near to the centre line as possible. This is the calmest part of the boat, receiving the least of the changing horizontal and vertical motion caused by the bow rising and pitching into the waves. Stay off the upper decks as the higher you go, the more the pitching and rolling is amplified.

If night sailing and you have a choice of berths, again aim for the center of the boat and ideally if the vessel has one, the much sought after quarter-berth.
3. Avoid tasks that requires focus on near objects such as reading, chart plotting, or staring at close and moving objects such as the compass. Making intricate repairs below decks is the worst thing you can do particularly so on the engine for instance. If you are not feeling up to it, just say so. It is far better that you are available to attend to other tasks that are less inclined to aggravate seasickness than be totally debilitated.
4. Do keep busy above decks and get involved in the activity on the boat. Immersing yourself in what is going on, as opposed to thoughts of your wellbeing, will place you in a better psychological place to resist seasickness. Being involved in the running of the vessel keeps your mind alert and prevents the early stages of motion sickness taking hold.
5. Steer the boat if possible. Being at the helm keeps your mind active and your eyes focus on the horizon. Ever noticed how you can never feel car sick when you are doing the driving? This can really help if you feel like you are succumbing to seasickness.
6. Avoid boat positions where the engine exhaust is apparent and stay well clear of diesel or petrol fumes. The occasional and prolonged whiff of the exhaust or just a couple of drafts of fuel fumes will be enough to cause anyone to be overcome by sea sickness. Likewise avoid bilges or areas where any pungent odours exist.

7. If possible try finding some shade from direct sunlight. Feeling overheated and dehydrated will just make you uncomfortable and reduce motion sickness tolerance.
8. Avoid coffee and all caffeinated drinks, tea should be weak. Have water instead.
9. If one of the crew is starting to become sick move as far away as possible. In just a few minutes the smell, the sound, the sight of it, will overcome your resistance. This sounds less than friendly but you will not be able to help them if you succumb also and present a large problem aboard.

What to do if you have succumbed

There is a tipping point and if at all possible you must not let it literally tip as preventing sea sickness is easier than curing it. Once you have gone beyond the point of no return you will feel bad for quite some time, albeit marginally better than the moment before you cut loose. The key is to fight it and if you can do so you could overcome it and be less debilitated later.

1. If the early effects of seasickness are starting to become manifest, stay on deck in the fresh air initially and take slow deep breaths. Absolutely do not risk going below and do not over exert yourself. Once you have begun to feel sick, activity tends to make it worse.

2. If the sensation is persistent, stand up, and if safe to do so take a secure handhold. Look out over the horizon. Lethargy and feeling ill makes it tempting to lie down but this is more likely to make the ill feelings advance. You can still fight it at this point; again avoid passing the point of no return.
3. Nibble some ginger biscuits or Saltine crackers. They help calm stomachs reducing nausea and absorb acidity. Strangely whilst eating the nausea feeling backs off. Make certain to drink water.
3. Have a Cola. Yes this is caffeinated and a dehydrator but at this point the phosphoric acid in the cola helps reduce the likelihood of getting sick. It contains an element called Emetrol that is a vomiting controlling substance.

4. If you have done battle and you have passed the point of no return, let it go over the side. Just be careful you are on the leeward side of the boat and you are not in an unsafe position, if you can clip on. Once you start to vomit you have limited self control.

5. Most people recover somewhat once they get rid of it. If not keep going until you feel there is nothing more to go.

6. If you are completely debilitated afterwards and feel no signs of recovery don’t be afraid to ask for help. It is best to go to a berth down below to rest. The transition to the berth should be in one swift motion as any loitering down below in that condition is only going to aggravate the condition. Lie down on your back with your eyes closed. This will make things much better and the motion at this stage may even lull you off to sleep. Remember to replace the nutrients lost from your system when you recover.

What a skipper can do.

First and foremost if choosing a vessel to sail or buy, with motion sickness in mind, a traditional deep keeled cruiser that is ‘in the water and not on it’ with a centre cockpit is the best. This arrangement will offer the most sea kindly motion to the crew.

1. Keep the crew active and engaged whilst monitoring them for the early signs of seasickness. If anyone is looking off-key do not give them tasks that are critical or could aggravate their condition. If they look up to it offer them the helm.

2. Avoid sending the crew who are prone to seasickness to any task below decks.

3. Keep the boat under power at all times, by sail or motor. A stalled boat bopping about on the waves will dramatically accelerate crew seasickness.

4. Try having plain wholesome meals that contain ginger, a natural remedy as set out below.

5. If on a long passage let those crew members more susceptible to seasickness rest for the first days to help them acclimatise.

6. If enduring boisterous conditions be prepared to go hove to for a while at meal times. This allows crew respite from the conditions to get some good food and collect themselves before moving on. Anything that affects the general wellbeing of the crew reduces the likelihood that they will become seasick.

7. If someone is about to be sick, make certain they are not a danger to themselves. Immediately take off their glasses, dentures or anything they may loose overboard should they start to reach. Clip them on to be safe.

8. If they continue to be in a bad way, and have complete expelled themselves over the side for some time vent the cabin by opening the hatch. Set up lee cloths in the calmest berth and leave a plastic container to hand for their peace of mind. As stated above the move to the berth should be in one swift motion. Remove all heavy weather gear above decks so there is no final task to be administered to below decks before entering the berth. Leave a bottle of water to hand and a light fan will help if it is hot.

Non medication based preventatives

Unfortunately there is no panacea. What works for one will not work for others or at least with varying degrees of effectiveness. You may have to personally trial and experiment to find what will be your individual best defence. The benefit of
non medication based defences is they do not prohibited you from going to medicated alternatives should they fail to be effective.

1. Ginger is the most widely used and successful natural preventative. It seems to sooth stomachs and has no side effects whatsoever. It is available in tablets, capsules, powder, or as pickled ginger slices and it is recommend you take it 12-24 hours before hand. Between 1 to 4 grams per day of powdered ginger is all that is required. Ginger biscuits and ginger ale help but their limited content and purity means they are dramatically less effective. However no boat should depart without a good stock of ginger remedies.

2. Acupressure wrist band. Commonly sold as ‘travel bands’ they apply pressure to a particular point on your wrist which can prevent the feeling of nausea. I have never personally found this to work for me, largely due to the inability to keep them in position under oilskins. Many however do and would not go out sailing without it.

3. A peppermint accompanying ginger is said to help. Although to a dramatically lesser extent, mint has similar stomach calming qualities to ginger and can be used alongside ginger.

4. Place your feet in a basin of ice water. Reportedly it helps. As there are a lot of sensory receptors in the feet it makes sense that this would have an impact upon the condition.

5. ‘ReliefBand’’. This is a new electronic solution that many people find to be highly effective. The watch-like device is strapped to the underside of the wrist where it administers small pulses of electrical stimulation to the media nerve. This stimulus sends messages to the brain to settle the stomach and most people say it stops nausea cold. The electric pulses are variable so you may find a level you are copmfortable with.

Preventative Medications

Many people fear the side effects of seasickness drugs. However the side effects are nowhere near as bad as the illness they prevent. Recent studies present Ginger capsules as being almost as effective as some of the below medications without side effects but everyone is different. You have to find what works for you individually and here are the more popular over-the-counter and prescription medications. You will find most of these should be taken in advance and not on an empty stomach. Be sure to read the instructions as they nearly all have side effects.

1. Transderm Scop (transdermal scopolamine) is my choice and broadly accepted these days as the best defence sailors have for seasickness. If I know I am going to go out on a long passage after being ashore for season, or if I am caught out when there is a storm approaching, I will patch up. It is a prescriptive drug and comes in the form of a circular flat patch designed for continuous release after applying it to the skin behind the ear. Its side effects for me were the widely experienced slightly dry throat but apart from that nothing else. However when given to my father in law he had what almost seemed like a stroke! So everybody is different.

2. Cinnarizine (Stugeron®). This is the old British reliable and is an antihistamine drug that blocks histamine receptors in the body, including an area in the brain known as the vomiting centre. It works by preventing the brain from sending nerve messages to the stomach that would make it vomit. It appears to be effective but I found when I tried it made me so drowsy that I would prefer to run the gauntlet with seasickness to sail the vessel.

3. Dimenhydrinate (Dramamine®, Gravol®) Similar to the above this is an over-the-counter antihistamine. It is most effective when taken to prevent motion sickness rather than waiting to treat symptoms that have already started. It is not known exactly how it stops seasickness. It is thought to work by working on the inner ear. Again it has the drowsiness effect amongst others.

So that’s it as I know it. If anyone has any additional information or corrections that they can add to this please do place a comment below and I will be delighted to add it to the collective piece. Otherwise take as much from this as you can and go out and enjoy you and your friends sailing.

With thanks to:
Michael Harpur, Yacht Obsession.

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