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Why Do So Many Gamers Get Motion Sickness?

After 10 minutes of running around ‘Breath of the Wild,’ I was running to my bathroom to blow chunks

A few months ago, I finally pulled the trigger and bought a Nintendo Switch. It’s the first gaming system I’ve owned since the Nintendo 64 growing up, and I told myself it’d be a good way to wean myself away from social media whenever I have downtime.

And then I remembered why I hadn’t bought a system since the Nintendo 64: I get awful motion sickness from first-person POV games. After 10 minutes of running around the Great Plateau in Breath of the Wild (the most recent installment of the Zelda series), I was running to my bathroom to blow chunks.

Look at all this movement. Oh god. I’m going to be sick again.

Motion sickness kept me from playing GoldenEye 64 growing up, and now it’s keeping me from playing Nintendo’s fastest-selling console in history. Once again, I’m on the outside, feeling all dizzy and sweaty and gross, looking in.

It’s not an uncommon effect. John McCrae, 56, an Army veteran in Seattle, thought he’d cured his motion sickness riding around in M901 ITV armored vehicles in the early 1980s — dark spaces that made him feel like he was floating and smelled like “random diesel exhaust/fart/food/B.O.” Once he left the Army, though, he started playing 1990s-era video games, and the motion sickness came back. “I get really disoriented and get vertigo and then barfy,” he confesses. “Yuck.”

“It’s gotten to the point that if I ate already, I won’t play,” says Kandyse, a 25-year-old gamer in Pennsylvania. “I’ve lost too many dinners, lol — good stuff, too — all going to waste. Once I get [the vomiting] over with, I’m able to play. I’m playing Vermintide now, and I’ve been able to go 40, 45 minutes without really needing to hurl. But the sooner I go, the sooner it’s over.” Only after Kandyse pukes multiple times, she’s able to play for a few hours straight, she says.

What about VR? “Hard pass,” Kandyse says. “I guess that’s just something I won’t be able to participate in.”

Why do we puke-y gamers get sick in the first place? “The root cause of motion sickness in this circumstance is believed to result from a mismatch between the input from the visual system (what your eyes see) and the vestibular system,” says Dr. Ming Wang, an ophthalmologist in Memphis. The vestibular system is basically your center of balance — the fluid in your inner ear you’ve probably heard about.

The vestibular system, Wang explains, “responds to changes in motion and head position and helps us coordinate balance and orientation in space.” So when playing video games, “the input from the visual system tells the person they are moving, but the vestibular system tells them they are mostly sitting still.”

Wang adds that more people suffer motion sickness from video games than might be expected. In fact, he cites a 2012 study that investigated rates of motion sickness in children and adults “which found 67 percent of adults and by 56 percent of children were affected by at least mild motion sickness when playing video games.”

As to why the brain’s reaction to this sensory misalignment is nausea, we still don’t know. The leading theory, which Wang tells me was proposed by [Michel] Treisman in the 1970s, “supposes the mismatch between the systems may indicate the body to assume it has ingested something poisonous. Therefore, the evolutionary response is to induce nausea, which can lead to vomiting, which would cause the clearance of the poison.”

In other words, the brain believes it’s hallucinating and therefore has been poisoned, so it throws the nausea and vomit switches to expunge the toxins.

“This theory does seem to be consistent with what we understand to be the cause of motion sickness and why the body may react this way,” Wang tells MEL. “I am not familiar with any other theories that directly address why the result is nausea.”

For gamers with motion sickness, it’s hard to opt out. People want to play these games and participate in the culture, and they want to do it often. I spent $70 on Breath of the Wild, and goddammit I’m going to play it. Even if I’m puking the whole time.

So what can we do?

If you suffer from video game motion sickness as well, and don’t feel like taking prescription pills or puking before every gaming session, there are a few more solutions.

Horus L., a 30-year-old in Texas, is a medic by trade and knows a few tricks to keep his motion sickness at bay. “If I’m going for a long car/boat/plane ride that I’m sure I’ll have time to play games on, I’ll usually either get some ODT Zofran or transdermal scopolamine patches for the trip,” he says.The best thing to do is to look at your surroundings for a little bit” when you begin to feel nauseated.

Dr. Hallie Zwibel, director of NYIT’s Center for Sports Medicine and expert in eSports medicine, says the brain can get used to “misalignment” in senses. “The brain is very good at adapting to different environments and stimuli and creating a new equilibrium,” he says. “For example, if you are on a cruise ship, you might feel [nauseated] when you are on board the first day. Then your body adapts and you feel fine.” In other words, it takes time, and will probably suck for a while, but you can train your body and brain to eventually know it’s not being poisoned.

McCrae, the Army vet, tried to train himself to get used to video games by literally playing until he felt sick — then pushing himself a few minutes longer each session. The new batch of high-quality games with crisp, clear graphics made it easier, he says. But eventually he gave up; now he mainly sticks to strategy and card games.

Dr. Wang also advises making sure your eyesight is appropriately corrected. Wear your glasses or contacts while playing, he says, because “blurred vision can exacerbate the mismatch from the visual system and the vestibular system.”

And in line with Horus’ advice, Wang says taking breaks should help. “The 20-20-20 rule is a good rule to follow here. Every 20 minutes, take a 20-second break, and look at something 20 feet away. In this instance it is particularly helpful to look at something stationary far away, such as the horizon. This allows your eyes and vestibular system to catch up to each other.”

Wang also says to avoid playing in a completely dark room where the TV is the only source of light. “For … motion sickness, if you are getting all of your input from the moving screen (and none from a fully dark room around you), then you aren’t getting any visual input from stationary objects, such as the TV stand and the floor, which can make that misalignment between the systems much more pronounced,” he says.

Sitting farther away from the TV can help in a similar fashion, the doctor adds: “You are getting more the input from the stationary walls and floors to help your vestibular system get the input from non-moving sources.”

Finally, the ophthalmologist has personally found ginger to help with motion sickness — be it chewing ginger candy or drinking ginger tea or soda. But in severe cases, and in cases where someone’s brain just can’t adapt (looking at Kandyse, who pukes every time she plays), Dr. Wang says it’s best to look into prescription medication.