Investigation of Heart Rate Variability Indices in Motion Sickness

Motion sickness (MS), or kinetosis, is a condition experienced by some individuals in response to rhythmic or irregular body motion. Multiple studies have explored its neurobiological mechanisms and countermeasures, with the sensory-conflict hypothesis remaining the most accepted explanation. Heart-rate variability (HRV) and electrocardiography provide complementary autonomic nervous system perspectives that may support MS assessments. From an applied viewpoint, reliable HRV markers could enable the early detection and continuous monitoring of MS in real-world contexts, such as autonomous vehicles, where passenger comfort and safety are critical, motivating contact-free cardiac sensing for unobtrusive monitoring. This systematic review examines the value of HRV indices in MS, conducted under PRISMA guidelines across PubMed, Scopus, and the Web of Science. The included studies were grouped into four categories based on the methods used to induce MS: mechanical stimulus, real trip, visual stimulus, and virtual reality. Aggregated findings indicate that frequency-domain metrics, particularly the low frequency (LF)/high frequency (HF) ratio, HF power, and mean heart rate (mHR), are most frequently reported in relation to MS. Overall, autonomic dysregulation likely contributes to MS susceptibility, but standardized protocols are needed to validate HRV as a reliable marker.