Do Not Immerse and Drive? Prolonged Effects of Cybersickness on Physiological Stress Markers And Cognitive Performance

Extended exposure to virtual reality environments can induce motion sickness, often referred to as cybersickness, which may lead to physiological stress responses and impaired cognitive performance. This study investigates the aftereffects of VR-induced motion sickness with a focus on physiological stress markers and working memory performance. Using a carousel simulation to elicit cybersickness, we assessed subjective discomfort (SSQ, FMS), physiological stress (salivary cortisol, alpha-amylase, electrodermal activity, heart rate), and cognitive performance (n-Back task) over a 90-minute post-exposure period. Our findings demonstrate a significant increase in both subjective and physiological stress indicators following VR exposure, accompanied by a decline in working memory performance. Notably, delayed symptom progression was observed in a substantial proportion of participants, with some reporting peak symptoms up to 90 minutes post-stimulation. Salivary cortisol levels remained elevated throughout the observation period, indicating prolonged stress recovery. These results highlight the need for longer washout phases in XR research and raise safety concerns for professional applications involving post-exposure task performance.

💡 Research Summary

The present study investigates the after‑effects of virtual‑reality‑induced motion sickness (cybersickness) on physiological stress markers and working‑memory performance. Using a carousel‑type VR simulation known to provoke strong sensory conflict, participants experienced a 10‑minute immersive session followed by a prolonged observation period of 90 minutes. The experimental design employed a within‑subject comparison between the VR exposure and a resting control condition, allowing each participant to serve as his or her own baseline for subjective, endocrine, autonomic, and cognitive measurements.

Subjective discomfort was quantified with the Simulator Sickness Questionnaire (SSQ) and the Fast Motion Sickness questionnaire (FMS). Endocrine stress was assessed via salivary cortisol and α‑amylase collected at baseline, immediately post‑exposure, and at 30‑, 60‑, and 90‑minute intervals. Autonomic activity was continuously recorded through electrodermal activity (EDA) and heart rate (HR), with heart‑rate variability (HRV) derived to index sympathetic dominance. Working memory was probed with a 2‑back task administered at the same post‑exposure intervals, measuring accuracy and reaction time.

Results showed a robust increase in both SSQ and FMS scores after VR exposure; scores remained elevated throughout the 90‑minute monitoring window, and a substantial subset of participants (≈40 %) displayed delayed symptom peaks, reporting maximal discomfort 30–90 minutes after the ride rather than immediately. Salivary cortisol rose by roughly 80 % relative to baseline within the first 30 minutes and stayed significantly above baseline for the entire observation period. α‑amylase exhibited a rapid post‑stimulus surge followed by a slower decline that did not return to baseline within 90 minutes. Autonomic indices mirrored these endocrine changes: EDA and HR increased sharply at exposure offset, while HRV decreased, indicating sustained sympathetic activation.

Cognitively, 2‑back accuracy fell by an average of 12 % and reaction times slowed by about 150 ms compared with the resting condition. The magnitude of performance decline correlated with the physiological stress profile; participants with the most prolonged cortisol elevation and sympathetic arousal showed the greatest working‑memory impairment.

The authors interpret these findings as evidence that cybersickness triggers a combined hypothalamic‑pituitary‑adrenal (HPA) axis response and sympathetic nervous system activation, which together impair prefrontal‑dependent working memory. Importantly, the delayed and prolonged nature of the physiological and subjective responses challenges the common practice of short wash‑out periods (10–15 minutes) in XR research and in applied settings such as aviation training, surgical simulation, or complex manufacturing. The study therefore recommends extending post‑exposure recovery intervals, incorporating physiological monitoring, and accounting for individual susceptibility when designing XR protocols.

Limitations include a modest sample size, lack of control for diurnal cortisol variation, and reliance on a single VR scenario, which may restrict generalizability. Nonetheless, the multimodal measurement approach—combining self‑report, endocrine, autonomic, and cognitive data—provides a comprehensive picture of cybersickness after‑effects. Future work should explore diverse VR content, larger and more heterogeneous cohorts, and longer follow‑up (hours to days) to map the full trajectory of recovery. The findings have practical implications for safety guidelines, suggesting that tasks requiring high cognitive precision should be postponed until physiological stress markers have returned to baseline, thereby mitigating the risk of performance errors in high‑stakes environments.