Spacesickness
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Space adaptation syndrome (SAS) or space sickness is a condition experienced by as many as half of all
space traveler This is a list of space travellers by first flight. The table is listed in chronological order from the date of first flight. The table adheres to the international definition of a space traveller; the Fédération Aéronautique Internationa ...
s during their adaptation to
weightlessness Weightlessness is the complete or near-complete absence of the sensation of weight. It is also termed zero gravity, zero G-force, or zero-G. Weight is a measurement of the force on an object at rest in a relatively strong gravitational fi ...
once in orbit. It is the opposite of terrestrial
motion sickness Motion sickness occurs due to a difference between actual and expected motion. Symptoms commonly include nausea, vomiting, cold sweat, headache, dizziness, tiredness, loss of appetite, and increased salivation. Complications may rarely include d ...
since it occurs when the environment and the person appear visually to be in motion relative to one another even though there is no corresponding sensation of bodily movement originating from the
vestibular system The vestibular system, in vertebrates, is a sensory system that creates the sense of balance and spatial orientation for the purpose of coordinating movement with balance. Together with the cochlea, a part of the auditory system, it constitutes ...
.


Presentation

Space motion sickness can lead to degraded astronaut performance. SMS threatens operational requirements, reduces situational awareness, and threatens the safety of those exposed to micro-g environments. Lost muscle mass leads to difficulty with movement, especially when astronauts return to earth. This can pose a safety issue if the need for emergency egress were to arise.
Loss of muscle Muscle atrophy is the loss of skeletal muscle mass. It can be caused by immobility, aging, malnutrition, medications, or a wide range of injuries or diseases that impact the musculoskeletal or nervous system. Muscle atrophy leads to muscle weakness ...
power makes it extremely difficult, if not impossible, for astronauts to climb through emergency egress hatches or create unconventional exit spaces in the case of a crash upon landing. Additionally,
bone resorption Bone resorption is resorption of bone tissue, that is, the process by which osteoclasts break down the tissue in bones and release the minerals, resulting in a transfer of calcium from bone tissue to the blood. The osteoclasts are multi-nucleated ...
and inadequate hydration in space can lead to the formation of
kidney stones Kidney stone disease, also known as nephrolithiasis or urolithiasis, is a crystallopathy where a solid piece of material (kidney stone) develops in the urinary tract. Kidney stones typically form in the kidney and leave the body in the urine s ...
, and subsequent sudden incapacitation due to pain. If this were to occur during critical phases of flight, a capsule crash leading to worker injury and/or death could result. Short-term and long-term health effects have been seen in the
cardiovascular system The blood circulatory system is a system of organs that includes the heart, blood vessels, and blood which is circulated throughout the entire body of a human or other vertebrate. It includes the cardiovascular system, or vascular system, tha ...
from exposure to the micro-g environment that would limit those exposed after they return to Earth or a regular gravity environment. Steps need to be taken to ensure proper precautions are taken into consideration when dealing a micro-g environment for worker safety.
Orthostatic intolerance Orthostatic intolerance (OI) is the development of symptoms when standing upright that are relieved when reclining. There are many types of orthostatic intolerance. OI can be a subcategory of dysautonomia, a disorder of the autonomic nervous sys ...
can lead to temporary loss of consciousness due to the lack of pressure and stroke volume. This loss of consciousness inhibits and endangers those affected and can lead to deadly consequences.


Cause

When the vestibular system and the
visual system The visual system comprises the sensory organ (the eye) and parts of the central nervous system (the retina containing photoreceptor cells, the optic nerve, the optic tract and the visual cortex) which gives organisms the sense of sight (the a ...
report incongruous states of motion, the result is often
nausea Nausea is a diffuse sensation of unease and discomfort, sometimes perceived as an urge to vomit. While not painful, it can be a debilitating symptom if prolonged and has been described as placing discomfort on the chest, abdomen, or back of the ...
and other symptoms of
disorientation Orientation is a function of the mind involving awareness of three dimensions: time, Location (geography), place and person. Problems with orientation lead to ''dis''orientation, and can be due to various conditions, from delirium to Substance int ...
known as
motion sickness Motion sickness occurs due to a difference between actual and expected motion. Symptoms commonly include nausea, vomiting, cold sweat, headache, dizziness, tiredness, loss of appetite, and increased salivation. Complications may rarely include d ...
. According to contemporary sensory conflict theory, such conditions happen when the vestibular system and the visual system do not present a synchronized and unified representation of one's body and surroundings. This theory is also known as neural mismatch, implying a mismatch occurring between ongoing sensory experience and long-term memory rather than between components of the vestibular and visual systems, emphasizing "the limbic system in integration of sensory information and long-term memory, in the expression of the symptoms of motion sickness, and the impact of anti-motion-sickness drugs and stress hormones on limbic system function. The limbic system may be the neural mismatch center of the brain." At present a "fully adequate theory of motion sickness is not presently available" but at present the sensory conflict theory, referring to "a discontinuity between either visual, proprioceptive, and somatosensory input, or semicircular canal and otolith input", may be the best available. Space adaptation syndrome or space sickness is a kind of motion sickness that can occur when one's surroundings visually appear to be in motion, but without a corresponding sense of bodily motion. This incongruous condition can occur during space travel when changes in
g-force The gravitational force equivalent, or, more commonly, g-force, is a measurement of the type of force per unit mass – typically acceleration – that causes a perception of weight, with a g-force of 1 g (not gram in mass measure ...
s compromise one's
spatial orientation In geometry, the orientation, angular position, attitude, bearing, or direction of an object such as a line, plane or rigid body is part of the description of how it is placed in the space it occupies. More specifically, it refers to the imagin ...
. According to ''
Science Daily ''Science Daily'' is an American website launched in 1995 that aggregates press releases and publishes lightly edited press releases (a practice called churnalism) about science, similar to Phys.org and EurekAlert!. The site was founded by mar ...
'', "
Gravity In physics, gravity () is a fundamental interaction which causes mutual attraction between all things with mass or energy. Gravity is, by far, the weakest of the four fundamental interactions, approximately 1038 times weaker than the stro ...
plays a major role in our spatial orientation. Changes in gravitational forces, such as the transition to weightlessness during a space voyage, influence our spatial orientation and require adaptation by many of the physiological processes in which our balance system plays a part. As long as this adaptation is incomplete, this can be coupled to nausea, visual illusions, and disorientation."
Sleep deprivation Sleep deprivation, also known as sleep insufficiency or sleeplessness, is the condition of not having adequate duration and/or quality of sleep to support decent alertness, performance, and health. It can be either chronic or acute and may vary ...
can also increase susceptibility to space sickness, making symptoms worse and longer-lasting. According to the sensory conflict hypothesis, space sickness is the opposite of the kinds of motion-related disorientation that occur in the presence of gravity, known as terrestrial motion sickness, such as becoming carsick, seasick, or airsick. In such cases, and in contrast to space sickness, one's surroundings seem visually immobile (such as inside a car or airplane or a cabin below decks) while one's body feels itself to be in motion. Contemporary motion sickness medications can counter various forms of motion disorientation including space sickness by temporarily suppressing the vestibular system, but are rarely used for space travel because it is considered better to allow space travelers to adapt naturally over the first one to seven days rather than to suffer the drowsiness and other side effects of medication taken over a longer period. However,
transdermal Transdermal is a route of administration wherein active ingredients are delivered across the skin for systemic distribution. Examples include transdermal patches used for medicine delivery. The drug is administered in the form of a patch or ointme ...
dimenhydrinate Dimenhydrinate, sold under the brand name Dramamine, among others, is an over-the-counter drug used to treat motion sickness and nausea. Dimenhydrinate is a theoclate salt composed of diphenhydramine, an ethanolamine derivative, and 8-chloroth ...
anti-nausea patches are typically used whenever
space suits A space suit or spacesuit is a garment worn to keep a human alive in the harsh environment of outer space, vacuum and temperature extremes. Space suits are often worn inside spacecraft as a safety precaution in case of loss of cabin pressure, ...
are worn because vomiting into a space suit could be fatal by obscuring vision or blocking airflow. Space suits are generally worn during launch and landing by NASA crew members and always for
extra-vehicular activities Extravehicular activity (EVA) is any activity done by an astronaut in outer space outside a spacecraft. In the absence of a breathable atmosphere of Earth, Earthlike atmosphere, the astronaut is completely reliant on a space suit for environmen ...
(EVAs). EVAs are consequently not usually scheduled for the first days of a mission to allow the crew to adapt, and transdermal dimenhydrinate patches are typically used as an additional backup measure.


Management

Just as space sickness has the opposite cause compared to terrestrial motion sickness, the two conditions have opposite non-medicinal remedies. The idea of sensory conflict implies that the most direct remedy for motion sickness in general is to resolve the conflict by re-synchronizing what one sees and what one feels. For most (but not all) kinds of terrestrial motion sickness, that can be achieved by viewing one's surroundings from a window or (in the case of seasickness) going up on deck to observe the seas. For space sickness, relief is available via the opposite move of restricting one's vision to a small area such as a book or a small screen, disregarding the overall surroundings until the adaptation process is complete, or simply to close one's eyes until the nauseated feeling is reduced in intensity during the adjustment period. Some research indicates that blindness itself does not provide relief; "Motion sickness can occur during exposure to physical motion, visual motion, and virtual motion, and only those without a functioning vestibular system are fully immune. As with sea sickness and car sickness, space motion sickness symptoms can vary from mild nausea and disorientation to vomiting and intense discomfort; headaches and nausea are often reported in varying degrees. The most extreme reaction yet recorded was that felt by Senator
Jake Garn Edwin Jacob "Jake" Garn (born October 12, 1932) is an American politician and member of the Republican Party who served as a United States senator representing Utah from 1974 to 1993. Garn became the first sitting member of Congress to fly in s ...
in 1985 on space shuttle flight
STS-51-D STS-51-D was the 16th flight of NASA's Space Shuttle program, and the fourth flight of Space Shuttle ''Discovery''. The launch of STS-51-D from Kennedy Space Center (KSC), Florida, on April 12, 1985, was delayed by 55 minutes, after a boat st ...
. NASA later jokingly began using the informal "Garn scale" to measure reactions to space sickness. In most cases, symptoms last from 2–4 days. When asked about the origins of "Garn", Robert E. Stevenson said: Garn's purpose on the mission was in part to subject him to experiments on space motion sickness. Predicting whether someone will experience space sickness is not possible. Someone who suffers from car sickness may not suffer from space sickness, and vice versa. In excellent physical condition, Garn did not become sick on the
vomit comet A reduced-gravity aircraft is a type of fixed-wing aircraft that provides brief near-weightless environments for training astronauts, conducting research and making gravity-free movie shots. Versions of such airplanes were operated by the NAS ...
before STS-51-D. All three astronauts on
Skylab 3 Skylab 3 (also SL-3 and SLM-2) was the second crewed mission to the first American space station, Skylab. The mission began on July 28, 1973, with the launch of NASA astronauts Alan Bean, Owen Garriott, and Jack Lousma in the Apollo command ...
suffered from nausea, although the three on
Skylab 2 Skylab 2 (also SL-2 and SLM-1) was the first crewed mission to Skylab, the first American orbital space station. The mission was launched on an Apollo command and service module by a Saturn IB rocket on May 25, 1973, and carried NASA astronau ...
had not; the illness affected their work during the first few days, worrying NASA doctors. Experienced aviators and space travelers can suffer from space sickness. Garn began piloting at the age of 16 and piloted a variety of military aircraft for 17,000 hours—more than any NASA astronaut—before STS-51-D.
Charles D. Walker Charles David "Charlie" Walker (born August 29, 1948) is an American engineer and astronaut who flew on three Space Shuttle missions in 1984 and 1985 as a Payload Specialist for the McDonnell Douglas Corporation. Personal Born in Bedford, In ...
became ill on the same flight despite having flown on the shuttle before. While the Skylab 3 crew quickly recovered—whether by eating six smaller meals instead of three larger ones, or just by becoming used to space—one of the
Skylab 4 Skylab 4 (also SL-4 and SLM-3) was the third crewed Skylab mission and placed the third and final human spaceflight, crew aboard the first American space station. The mission began on November 16, 1973, with the launch of Gerald P. Carr, Edward ...
crew became sick despite anti-nausea medication. Steven Smith estimated that on four shuttle flights he threw up 100 times. Space sickness that occurs during space flight can also continue for days after landing, until the vestibular system has again adapted to gravity.


History

In August 1961, Soviet cosmonaut
Gherman Titov Gherman Stepanovich Titov (russian: Герман Степанович Титов; 11 September 1935 – 20 September 2000) was a Soviet cosmonaut who, on 6 August 1961, became the second human to orbit the Earth, aboard Vostok 2, preceded by Y ...
became the first human to experience space sickness on
Vostok 2 Vostok 2 (russian: Восток-2, ''Orient 2'' or ''East 2'') was a Soviet space mission which carried cosmonaut Gherman Titov into orbit for a full day on August 6, 1961, to study the effects of a more prolonged period of weightlessness on the ...
; he was the first person to vomit in space. Apart from that record, space motion sickness was effectively unknown during the earliest spaceflights (Mercury, Gemini series) probably because these missions were undertaken in spacecraft providing very cramped conditions and permitting very little room for head movements; space sickness seems to be aggravated by being able to freely move around, especially in regard to head movement, and so is more common in larger spacecraft.


See also

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Airsickness Airsickness is a specific form of motion sickness which is induced by air travel and is considered a normal response in healthy individuals. Airsickness occurs when the central nervous system receives conflicting messages from the body (including ...
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Effect of spaceflight on the human body Venturing into the environment of space can have negative effects on the human body. Significant adverse effects of long-term weightlessness include muscle atrophy and deterioration of the skeleton (spaceflight osteopenia). Other significant e ...
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Human spaceflight Human spaceflight (also referred to as manned spaceflight or crewed spaceflight) is spaceflight with a crew or passengers aboard a spacecraft, often with the spacecraft being operated directly by the onboard human crew. Spacecraft can also be ...
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Micro-g environment The term micro-g environment (also μg, often referred to by the term microgravity) is more or less synonymous with the terms ''weightlessness'' and ''zero-g'', but emphasising that g-forces are never exactly zero—just very small (on the I ...
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Space medicine Space medicine is the practice of medicine on astronauts in outer space whereas astronautical hygiene is the application of science and technology to the prevention or control of exposure to the hazards that may cause astronaut ill health. Both ...


References

{{Spaceflight Human spaceflight Motion sickness Space medicine Syndromes