Joseph R. Anticaglia, MD
Medical Advisory Board
I was speaking with a friend who told me, “Several months ago my wife and I boarded a plane bound for London from JFK. The flight left New York in the early evening and landed at Heathrow around 7:29 a.m. London time. We gathered our luggage at the baggage claim, flagged a cab and were driven to our hotel foolishly expecting to get to our rooms, wash up and relax.
The man at the front desk of the hotel politely informed us, “The hotel is filled to capacity. I apologize for the inconvenience but the room you booked will not be available for several hours. You may leave the luggage with us in the hotel if you wish to do so?
My friend continued, “I felt totally exhausted and could barely keep my eyelids open We made our way to a nearby park and I literally “fell” asleep on a park bench. My wife, thank goodness, was much more alert and dealt with jet lag and the situation much better than I did.”
“Boy that was something.” He interrupted before I could say another word and said, “The problem was I didn’t figure out what to do before the flight, during the flight or after we arrived in London.” As an afterthought he wondered, “How do pilots or athletes handle jet lag when they fly London to Tokyo or others from JFK to Sidney, Australian?”
Symptoms
The most common complaints from jet lag passengers are daytime sleepiness and nighttime wakefulness. Being tired and irritable during the day, unable to sleep at night, experiencing loss of appetite, feeling lightheaded and/or unable to concentrate crushes you mentally and physically. It’s not the best way to begin a vacation, to compete in an athletic event, pilot an airplane or to present a proposal to a prospective client at work.
Located in the brain is a 24 hour biological clock that regulates the time we get up in the morning and the time we go to sleep at night. It’s referred to as the circadian sleep/wake cycle.
When we travel rapidly in an airplane across two or more time zones, for example, from New York to London, our biological clock needs time to adjust to the new time zone. How quickly and how many time zones the passenger crosses will determine to a significant degree how much time is needed to adjust to the new time zone. It’s been said that for each time zone you cross, the body clock needs one day to adjust. Other considerations to be aware of are whether you’re travelling east or west and that some people are more susceptible to jet lag than others.
Performance
Jet lag can diminish peak performance in the sports area and in the cockpit. The United States Olympic Committee (USOC) has issued strategies and countermeasures to reduce jet lag’s detrimental effect on performance. Some of the adverse effects of jet lag on performance according to the USOC include:
- Decreased alertness
- Decreased concentration
- Cognitive slowing – lessons ability to reason
- Prolonged reaction time
- Increased accident and injury rates
Other studies suggest because of jet lag people are less inclined to interact socially and there’s a reduction in motivation and resolve.
Jet pilots and others caution that every traveller is unique when it comes to jet lag. Although there is not a “magic bullet” for jet lag, the prevention tips of pilots and the USOC might reduce the days of jet lag and make your next flight less stressful.
Tips While at Home
- Reduce stress: eat well, sleep well, Avoid last minute packing and errands
- Exercise: Fit the exercise to the trip.
- Make reservations for a flight that arrives in the late afternoon or early evening.
- Plan to arrive a day or two earlier if you have an important event or business meeting. .
- While at home, figure out how to shift your biological clock (sleep and wake times) so that they’ll be in sync with the new time zones when you arrive
- Travelling eastward, try getting up one or two hours earlier for a few days. Also, try going to sleep earlier to prepare for the new time zone. If you’re travelling westward, go to sleep later and get up later.
Tips During the Flight
- Drink enough water to avoid becoming dehydrated. Greatly limit or avoid alcohol and caffeinated drinks.
- Move around on a long trip–get up and stretch every hour or two. Exercise while seated.
- Use earplugs and eye masks to help you sleep on the plane.
- Try to sleep if it’s actually night time where you’re going or stay awake if it’s daytime.
- Relax and make yourself comfortable during stopovers.
- Set your watch to the new time zone
Tips Upon Arrival
- Take a nap for no longer than 20 or 30 minutes if bedtime is many hours away.
- Eat customary meals according to your new time zone
- Exposure to light influences the body’s circadian rhythm (awake/sleep cycle). Light cues your body to be awake. Travelling westward, in general, your internal clock needs to adjust to going to sleep a few hours later. Light exposure in the evening theoretically, keeps you awake and helps you adjust to this westward later than usual time zone.
- Travelling eastward, try to get exposed to the morning sunlight as soon as you reach your destination. It can help you adapt to an earlier than usual time zone.
- Use earplugs and eye masks to minimize sleep distractions.
- For short trips try to eat and sleep at your usual times.
- Melatonin taken1/2 to 1 hour before going to sleep may help you get a good night sleep.
The symptoms of jet lag are temporary and there’s no magic cure for this type of sleep deprivation. But if you are a frequent flyer and are plagued by jet lag, you may benefit by seeing a sleep specialist
References Andrew M. Vosko et al; Jet Lag Syndrome: Circadian Organization. Pathophysiology and Management Strategies; Nat Sci Sleep; Aug 19, 2010
Martha Merrow et al; The Circadian Cycle; Daily Rhythms from Behavior to Genes; Embro Rep Oct 6, 2005
Jet Lag; Countermeasures and Travel Strategies; Report available from the USOC
Berry RB &Wagner MH; Patients with Jet Lag in Sleep Medicine Pearls; Elsevier Saunders, Philadelphia Pa 2015
This article is intended solely as a learning experience. Please consult your physician for diagnostic and treatment options.