A History of Space Sickness: How to Avoid Throwing Up When There is No ‘Up’
Expedition 42 astronauts on the ISS in 2014 - Credit: ESA

A History of Space Sickness: How to Avoid Throwing Up When There is No ‘Up’

15/12/2021Written by Dan Kendall

The unpleasant, gag-inducing history of space sickness.

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Around this time of year, it is easy to overdo it. In fact, many of us might suffer to the extent that we start to feel a bit bilious. A little nauseous. A little bit sick.

Even the thought of such a topic can be enough to turn a few stomachs. So, with ample warning to avoid this blog for those without a cast-iron belly, read on to discover the grim, gag-inducing history of space sickness.

Titov (left) with Nikita Khrushchev and Yuri Gagarin

Firstly, when people say ‘space sickness’, it doesn’t always mean actually becoming reacquainted with your breakfast… in space. Space sickness is shorthand for the rather more grand-sounding Space Adaptation Syndrome. Essentially, this is a sort of motion sickness that many astronauts suffer from… maybe. I say maybe, as space sickness is still a topic for debate amongst scientists trying to better understand the impact of space travel on the human body. More on that later.

On 6 August 1961, Gherman Titov sat aboard his Vostok 2 spacecraft ready to become the second person to orbit the Earth, and only the fourth to travel into space. A great adventure awaited, but so too did a sick bag.

After a few orbits, Titov started to feel a bit unwell. The Soviet cosmonaut became the first sufferer of space sickness. And, as I have detailed in a blog about going to the toilet in space, when fluids leave the body whilst in orbit things can get a little messy. Perhaps even dangerous if blobs of sick start to float into important equipment.

The crew of Gemini 12 demonstrate how small their spacecraft was - Credit: NASA

Such was the worry caused by Titov’s sudden déjà food, as the contents of his stomach left his body, that the Soviet Union stopped all human spaceflight for a year whilst it was investigated. These were the early days of spaceflight, so being sick in space was a big cause for concern. What if it was some sort of space bug? Or perhaps humans simply could not cope with spending longer periods in space? After all, Yuri Gagarin had only spent a short time completing his single orbit a few months earlier.

In time, Titov’s experience would be put down to Space Adaption Syndrome – no mystery space bugs involved. Over in America, astronauts flying aboard the Mercury and Gemini missions were not experiencing similar problems. Or if they were, they were keeping quiet about it. Perhaps individual astronauts worried that admitting to feeling queasy might prevent them from being selected for future missions. Others have suggested that the small size of Mercury and Gemini capsules limited how much ‘floating about’ the astronauts could do, preventing their movements from causing a motion sickness style illness. On top of this, not everybody suffers from space sickness. Just like how not everyone gets car sick, as I discovered on a trip to Cornwall as my eldest child pointed out, rather redundantly, that my youngest child had just pebble-dashed the back of my seat.

The anatomy of the inner ear - Credit: Blausen Medical Communications

So, what exactly causes space sickness? Scientists do not fully understand yet, but Dr Charles Oman of the Massachusetts Institute of Technology, a leading expert, believes that it is essentially motion sickness. However, Oman feels that it is laid on top of other problems from being in the weightless environment of space, such as headaches and a puffy face caused by how fluids move differently around the human body.

Here on Earth, our inner ear has a liquid-filled vestibular system, which is what tells the body which way up we are, as well as helping us keep our balance. This system is made up of a series of tubes, inside of which the liquid moves about triggering a response from a series of microscopic hairs that send signals to the brain. With the help of our other senses, such as sight, our brain can figure things out. It’s good like that. But in space, the liquid inside the system floats about and confuses the brain, which can disorientate and cause feelings of sickness. This is made worse by the fact that the eyes might be showing the brain all sorts of confusing information – such as a fellow astronaut floating upside down in front of you.

Wally Schirra preparing for his Apollo 7 flight - Credit: NASA

Gene Cernan and Jack Schmitt demonstrating the extra room aboard Apollo 17 - Credit: NASA

So that’s the basics when it comes to space sickness, but things get a little weird when you look at who gets sick. Remember, astronauts in the early days of American spaceflight were often all-American hero types with thousands of hours of ‘pulling Gs’ in jets. And yet, despite never so much as getting a single butterfly in the stomach, some of these hardy types went on to barf in space.

Frank Borman on the way to the Moon on Apollo 8 was sick but did not want Mission Control to know. Some experts believe the cold-like symptoms suffered by Wally Schirra on Apollo 7 were Space Adaption Syndrome symptoms too.

It might be, that on the Apollo missions, having more room to float about caused greater disorientation leading to space sickness. Certainly, by the time of Skylab and the Space Shuttle – both of which offered even more room – astronauts were getting sick more regularly. Fortunately, it normally only lasted a few days, but some estimates suggest around half of all space travellers feel ill in their first few days in space, as their bodies struggle to adapt. The advice these days is to keep your head still and on no account immediately start doing somersaults! Which is a shame.

Jake Garn holds up a colour swatch, used to document if space sickness changed his appearance - Credit: NASA

When it comes to the crowned champion of space sickness – and you doubt it is an award anyone wanted – there is only one winner, Jake Garn. Garn was an American politician, a sitting member of Congress, at the time of his one and only spaceflight in 1985. Flying aboard the Space Shuttle Discovery as a payload specialist, Garn was something of a medical guinea pig.

Part of Garn’s mission was to study Space Adaption Syndrome. And, fortunately for the study but maybe not for Garn, he was the perfect candidate. As soon as he got into space, the American politician-astronaut started to feel unwell. Very unwell. Garn was in fact so sick that he has gone down in astronaut folklore. To this day astronauts use the ‘Garn Scale’ to measure how bad they feel – with ‘1 Garn’ being as sick as an astronaut could possibly be.

Jake Garn undergoing medical tests as part of a Space Adaptation Study - Credit: NASA
Ed White carrying out the first American spacewalk. Fortunately, he didn't feel sick - Credit: NASA

Lack of reporting, as well as the relatively small number of people to have travelled into space, makes it hard to predict exactly how many of us would suffer from Space Adaption Syndrome. On top of that, there are astronauts who have flown in space and felt fine, who have then gone on to feel ill on their next spaceflight. Similarly, newly qualified astronauts that were fine during training aboard zero-g simulating aircraft flights, have then been poorly in space. Just because you feel ill on a rollercoaster, it does not follow that you will feel ill loop-the-looping around the Earth in a spacecraft.

All of this raises some important issues for anyone with aspirations of seeing the Earth from space. What about the future of space tourism? What measures might people need to take? There is medication that can help fight off space sickness, but some of the side effects can include drowsiness and can hamper performance. This means many astronauts chose to tough it out, knowing that for most people the symptoms of space sickness pass after a few days of getting used to being in orbit. For this reason, the first few days of an astronaut’s time in space are scheduled not to be too busy, with mission planners giving time for people to adapt. Spacewalks are never scheduled for the first few days of an astronaut’s time aboard the International Space Station. Even after those first few days, astronauts use patches affixed to their body to give them doses of medication before spacewalks – as an added safety mechanism. It is one thing to throw up in your spacecraft, but throwing up inside your spacesuit helmet could be fatal. With nowhere for it to go, the potential for blocking up the oxygen supply or stopping an astronaut from being able to see means that extra safety steps need to be taken.

Astronaut Suni Williams inside a mock-up of the SpaceX Crew Dragon spacecraft - Credit: NASA

The growing space tourism industry has seen more sub-orbital flights into space. These are flights where the spacecraft goes up and then comes straight back down again, spending only a short while in space. Even so, there is a risk that such flights could lead to a space tourist feeling sick. As spaceflight becomes more commonplace, and perhaps that should be ‘if’, more work needs to be done to assess Space Adaption Syndrome. Ticket prices are astronomically high, and I doubt anyone that can afford it would be pleased to spend their few moments in space being sick or feeling too sleepy to appreciate it because of anti-sickness drugs.

Feeling sick for a few days of your spaceflight is only one part of why adapting to life in space can be hard. As a species, as we begin to look towards long-duration deep space missions, much work is still to be done to better understand how the human body will adapt. Carrying inflight sick bags is not a long-term solution.

About the author: Dan Kendall is the Curator at the National Space Centre.