I AM AT - Inte rna tional Ass ociation for Medical Assis ta nce to Tra velle rs
1
HOW TO… Better Manage Jet Lag
info@iamat.org
www.iamat.org
IAMATHealth
@IAMAT_Travel
Image courtesy of Stock.XCHNG.
As travellers, many of us have
experienced jet lag. Some of us have our
own tried and true coping mechanisms,
while the rest of us can't shake off jet lag
for days or weeks. The key to preventing
jet lag is to understand how light and
travel direction
–
east or west
–
affects
your internal clock.
There are many over-the-counter
drugs
and
diets purporting to prevent jet lag, and
unfortunately there are few controlled scientific
studies done on jet lag and travellers. For this
article, we found the advice of
Dr. Stephen
Bezruchka
, senior lecturer at the University of
Washington, School of Public Health, helpful.
When several time zones are crossed rapidly
your sleep-wake pattern gets out of sync with
your circadian rhythm (a 24 hour internal cycle)
which is primarily regulated by daylight. Air travel
does not give your body enough time to cope
with the disruption and adjust to the new daylight
/ darkness cycle of your destination, temporarily
affecting your health.
The most common symptoms of jet lag
include:
fatigue, insomnia
poor concentration, disorientation
irritability, depression, exacerbation of
psychiatric disorders
headaches, muscle aches, fluctuating body
temperature
indigestion, irregular bowels
The more severe implications of jet lag
include increased vulnerability to infections,
judgement and performance errors as well
as reduced physical and mental
functionality. Chronic jet lag can affect the
central nervous system and cognitive
behaviour.
Travel stress too, can intensify jet lag symptoms.
Dr. Bezruchka points out that persons who suffer
from chronic stress or those who cannot afford
first class travel may be more affected by jet lag
than travellers who have access to airport
lounges, concierge services, and wellness and
relaxation perks (such as massages or nap
suites) during transit and at their destination.
What we know so far…
..
Almost all travellers are affected by jet lag
and most are affected by eastward travel
Symptoms intensify the more time zones are
crossed. They usually start after a two-hour
time difference and persist for one week or
more. Typically, it takes one day to recover
from one time zone change
Frequent travellers experience less jet lag
symptoms over time.
Older persons and those with pre-existing
sleep disorders are at higher risk of being
affected by jet lag.
Exercise, healthy meals, and hydration can
help reduce jet lag symptoms.
Travel stress can intensify jet lag.
What about prevention?
Although jet lag can't be avoided when travelling
across different time zones, you can minimize its
impact by taking a multi-pronged approach
which can make it more bearable.
Adjust your sleeping schedule
You've probably heard that one way to prevent
jet lag is adjusting your sleep schedule prior to
departure. If you're travelling from west to east,
you'll want to go to sleep one hour earlier each
night at least three days prior to departure to
mimic the time at your destination as close as
possible. The same method is used if you're
travelling from east to west, you'll want to stay
up one hour past your bedtime pushing your
awake time by at least three hours by the time
you leave. This method, however, may not be
realistic for many travellers.
I AM AT - Inte rna tional Ass ociation for Medical Assis ta nce to Tra velle rs
2
HOW TO… Better Manage Jet Lag
info@iamat.org
www.iamat.org
IAMATHealth
@IAMAT_Travel
Exposure to light
Another anti jet lag measure is maximizing
exposure to bright light (preferably natural light)
during the right time of day. If you travel east,
you'll want to get as much light as possible at
sunrise continuing early in the morning to get in
sync with the local time. The opposite is true
when travelling west; you'll want to delay getting
bright light exposure until late afternoon and
early evening. Doing this for a minimum of five
hours a day for a period of three to four days will
help readjust your circadian rhythm. The idea is
to limit exposure to light when not appropriate by
shielding windows, staying indoors, and wearing
sunglasses or visors and maximizing access
when needed. The table below explains how to
adjust your behaviour.
Travel
Direction
External
Clock
Circadian
Clock
Light
Exposure
Behaviour
West to
East
Turn watch
forward
Turn back
circadian
clock
Bright light
during early
morning
Early
bedtime,
early
awakening
East to
West
Turn watch
backwards
Advance
circadian
clock
Bright light
during the
afternoon
Later
bedtime,
later
awakening
Adapted from S. Bezruchka, in Jong E.C., Sanford C.A. (eds.), The
Travel and Tropical Medicine Manual - 4th Edition, Philadelphia,
Saunders/Elsevier, 2008, p.136.
Melatonin
Melatonin is a hormone produced by our pineal
gland when we sleep and helps regulate our
circadian rhythms with the help of exposure to
light. Supplements are usually taken 1 day prior
to your departure and continue 3 days after
arrival or taken at bedtime when you arrive at
your destination and continue up to a week after.
Talk to your healthcare provider before taking
melatonin, and if it's safe for you (it's not
recommended for persons with cardiovascular or
blood clotting conditions) get a prescription.
Over-the-counter melatonin may not provide the
adequate dosage, reducing its effectiveness.
Also, the use of melatonin is unregulated in
many countries, including in the USA. Note that
the effectiveness of melatonin varies among
individuals and there are currently no studies
analyzing the long-term safety of taking
melatonin, including during pregnancy.
Sleep Inducing Medication
Common sleep inducing medications belonging
to non-benzodiazepine class (ie. zolpidem,
zaleplon, zopiclone, and eszopiclone) offer
short-term relief from insomnia, but do not
readjust circadian rhythms. Check with your
doctor if these types of medications are right for
you and if they should be taken in conjunction
with melatonin. Side effects may include
memory loss, excitability, and depression. Do
not drink alcohol or take anti-histamines when
taking these types of drugs. Due to the
psychoactive properties of both non-
benzodiazepine and benzodiazepine drugs,
some countries have banned their importation.
Check the
INCB (International Narcotics Control
Board) website
to see if your destination country
is on the list. Note that the list is still incomplete
and you may want to contact your nearest
consulate for more information.
Quick tips to better manage jet lag
In flight:
Set your watch or mobile to the time at your
destination. This will train your brain to
adjust to local time quicker.
Wear an eye shield and use noise cancelling
earplugs when you need to sleep on the
plane to mimic the time at your destination.
For example, if you're going from Toronto to
Rome and your flight leaves at 9pm, you'll
want to sleep in the plane as much as
possible since it is 3am at your destination.
You may want to pass on the inflight meal
since it further disrupts your routine.
Stay well hydrated. Refrain from drinking
alcohol even though it may be sleep
inducing. Alcohol consumption disrupts your
sleep patterns.
Do small exercises to keep your blood
flowing (ie. ankle circles, knee lifts, neck
rolls, walk up and down the aisles)
At your destination:
Adopt daily cues to the local time. To adapt
more quickly, try to stay awake as much as
possible until local bedtime.
Avoid renting a vehicle at the airport and
take public transportation, a taxi, or the
airport shuttle to your accommodation.
Driving tired and being disoriented in a new
city with different road rules increases your
chances of getting into an accident, or worse
injured.
Take time to acclimatize to your new time
zone and environment. Avoid important