Abstract
Background/Objectives: Motion sickness is a prevalent neuro-vestibular syndrome that affects individuals across various modes of transport and can significantly impact quality of life and travel safety. This study aimed to assess the prevalence, severity, and associated risk factors of severe dizziness related to motion sickness among adult residents in the Kingdom of Saudi Arabia (KSA), with particular focus on socio-demographic and behavioral determinants. Methods: A cross-sectional survey was conducted among 349 participants recruited primarily from the Riyadh region. A structured questionnaire captured demographic variables, personal health history, and experiences of dizziness and related symptoms during air or metro travel. Chi-square tests and multivariable logistic regression were applied to examine associations between dizziness and potential predictors, with p ≤ 0.05 considered significant. Results: Overall, (23.5%) of respondents reported experiencing severe dizziness during metro travel (82/349). Females were more affected than males (32.1% vs. 15.8%; χ(2)(1) = 12.06, p = 0.0005, Cramer's V = 0.186), although this association lost significance in the adjusted model. Height showed a borderline association (p = 0.053). In multivariable analysis, previous similar episodes were the strongest independent predictor of dizziness (aOR 15.63, 95% CI 6.40-38.16, p < 0.001). ANOVA revealed no difference in severity by sex or height (p > 0.7). Conclusions: Motion sickness affects nearly one-quarter of Saudi metro travelers (23.5%) and is predominantly influenced by a history of previous similar episodes rather than demographic factors. These findings underscore the need for targeted preventive strategies, ergonomic vehicle design, and public health education to mitigate the burden of motion sickness in the KSA's expanding transportation systems.