Heart rate variability dynamics during virtual reality roller coaster experience: correlations with vestibular function and motion sickness susceptibility

Virtual reality (VR) increasingly causes motion sickness, yet physiological mechanisms and individual susceptibility factors remain unclear. Understanding autonomic nervous system responses and their relationship to vestibular function is crucial for developing safer VR applications. This study aimed to characterize autonomic responses to visually induced motion sickness (VIMS) exposure through heart rate variability (HRV) analysis and determine correlations between vestibular function and motion sickness susceptibility. Thirty participants underwent finger PPG monitoring during baseline, VR exposure, and recovery phases, and additionally completed motion sickness questionnaires and vestibular evoked myogenic potential (VEMP) testing. HRV parameters were analyzed using a mixed-design ANOVA, with Pearson correlations examining vestibular-autonomic relationships. VR exposure significantly increased heart rate (3.67%, [Formula: see text]) and HRV parameters (SDNN: + 41.12 ms, RMSSD: + 43.50 ms), followed by pronounced recovery decreases. High motion sickness susceptibility individuals showed the greatest autonomic reactivity. Associations emerged between VR symptoms and ocular VEMP amplitudes ([Formula: see text], [Formula: see text]), and between vestibular function and autonomic responses during VR ([Formula: see text], [Formula: see text]); these are interpreted as hypothesis-generating findings. VR exposure triggers measurable autonomic responses that correlate with individual motion sickness susceptibility and vestibular function. These findings support using HRV monitoring and vestibular assessment as candidate markers of VR-induced discomfort.