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

TL;DR

This study demonstrates that VR-induced cybersickness triggers sustained physiological stress responses, including elevated salivary cortisol and adrenergic markers, and impairs working memory for at least $30$ minutes post-exposure, with some participants showing peak symptoms up to $90$ minutes later. Using a within-subject design with a passive control, the authors track subjective sickness (SSQ, FMS), endocrine (cortisol, alpha-amylase), autonomic (HR, HRV, EDA), and cognitive (n-Back) measures across a 2-hour session, revealing dose- and time-dependent effects and notable interindividual variability. The findings highlight delayed post-exposure symptoms and a protracted cortisol recovery, underscoring the need for longer washout periods in XR research and for safety guidelines in real-world VR use where post-exposure cognitive demands are present. Together, the results advance understanding of cybersickness as a multisystem stressor with meaningful implications for safety, design, and scheduling of VR-based training and operational tasks.

Abstract

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.

Figures (7)

• Figure 1: Egocentric view for the participants in the movement condition sitting in one of the Cybersicker carts.
• Figure 2: Schematic representation of the study procedure. The experiment followed a sequence-balanced within-subject design with control and study sessions conducted on separate days.
• Figure 3: Simulator sickness responses measured during the experiment. (A) Total SSQ score assessed at each measurement time point for both the study (motion) and control sessions. (B) SSQ subscales: Nausea (SSQ-N), Oculomotor Discomfort (SSQ-O), and Disorientation (SSQ-D), shown across all measurement time points for both sessions. (C) FMS ratings collected every 30 seconds during the VR motion exposure only (study session). The inset shows the temporal progression of FMS scores on a scale from 0 (no sickness) to 10 (severe sickness) during the up-to-eight-minute stimulation period. Bars represent mean $\pm$ SE.
• Figure 4: Salivary cortisol and alpha amylase in response to motion in VR. Bars represent mean $+/-$ SE
• Figure 5: HR, HRV, and EDA averaged for baseline, motion, and recovery phases of the study condition. Bars represent mean $+/-$ SE