Space Adaptation Sickness
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Space adaptation syndrome (SAS) or space sickness is a condition experienced by as many as half of all space travelers during their adaptation to
weightlessness Weightlessness is the complete or near-complete absence of the sensation of weight, i.e., zero apparent weight. It is also termed zero g-force, or zero-g (named after the g-force) or, incorrectly, zero gravity. Weight is a measurement of the fo ...
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 ...
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 motor coordination, movement with balance. Together with the cochlea, a part of the auditory sys ...
.


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 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-nuclea ...
and inadequate hydration in space can lead to the formation of
kidney stones Kidney stone disease (known as nephrolithiasis, renal calculus disease, or urolithiasis) is a crystallopathy and occurs when there are too many minerals in the urine and not enough liquid or hydration. This imbalance causes tiny pieces of cr ...
, 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 In vertebrates, the circulatory system is a system of organs that includes the heart, blood vessels, and blood which is circulated throughout the body. It includes the cardiovascular system, or vascular system, that consists of the heart a ...
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 ...
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 is the physiological basis of visual perception (the ability to perception, detect and process light). The system detects, phototransduction, transduces and interprets information concerning light within the visible range to ...
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. It can be a debilitating symptom if prolonged and has been described as placing discomfort on the chest, abdomen, or back of the throat. Over 30 d ...
and other symptoms of
disorientation Orientation is a function of the mind involving awareness of three dimensions: time, place and person. Problems with orientation lead to ''dis''orientation, and can be due to various conditions. It ranges from an inability to coherently understand ...
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 ...
. 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 The limbic system, also known as the paleomammalian cortex, is a set of brain structures located on both sides of the thalamus, immediately beneath the medial temporal lobe of the cerebrum primarily in the forebrain.Schacter, Daniel L. 2012. ''P ...
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 g-force or gravitational force equivalent is a Specific force, mass-specific force (force per unit mass), expressed in Unit of measurement, units of standard gravity (symbol ''g'' or ''g''0, not to be confused with "g", the symbol for ...
s compromise one's
spatial orientation In geometry, the orientation, attitude, bearing, direction, or angular position 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 t ...
. According to ''
Science Daily ''ScienceDaily'' 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!. History The site was f ...
'', "
Gravity In physics, gravity (), also known as gravitation or a gravitational interaction, is a fundamental interaction, a mutual attraction between all massive particles. On Earth, gravity takes a slightly different meaning: the observed force b ...
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 (medicine), chronic ...
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 ointm ...
dimenhydrinate Dimenhydrinate, also known as diphenhydramine/8-chlorotheophylline salt and sold under the brand names Dramamine and Gravol, among others, is an over-the-counter medication used to treat motion sickness and nausea. Dimenhydrinate is a theocl ...
anti-nausea patches are typically used whenever
space suits A space suit (or spacesuit) is an environmental suit used for protection from the harsh environment of outer space, mainly from its vacuum as a highly specialized pressure suit, but also its temperature extremes, as well as radiation and ...
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 (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 from the U.S. state of Utah. A member of the Republican Party (United States), Republican Party, he served as a member of the United States Senate from 1974 to 1993. Garn ...
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 NA ...
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 astronaut ...
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 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, Edwar ...
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 (; 11 September 1935 – 20 September 2000) was a Soviet and Russian cosmonaut who, on 6 August 1961, became the second human to orbit the Earth, aboard Vostok 2, preceded by Yuri Gagarin on Vostok 1. He was the fou ...
became the first human to experience space sickness on
Vostok 2 Vostok 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 human body. Titov orbited the Earth over 17 t ...
; 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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References

{{Authority control Human spaceflight Motion sickness Space medicine Syndromes