Avoiding the drag of jet lag

Don’t let jet lag keep you from enjoying your business trip or holiday . . .

Traveling can be glamorous, but jet lag can get in the way of enjoying your vacation or business trip — if you let it. Symptoms of jet lag are not fun and may include drowsiness, irritability, difficulty concentrating, swelling, headaches, GI upset, and even fatigue and insomnia.

While these temporary issues are not life-threatening, they can interfere with your trip. When traveling across several time zones, you may risk the effects of jet lag. But with these preventive tips, you can make sure jet lag doesn’t hinder your time away from home!

Eastward travel is associated with difficulty falling asleep at the destination’s bedtime and difficulty arising in the morning. When traveling westward, it is common to have early evening sleepiness and pre-dawn awakening. Crossing more time zones and traveling east generally increases the time for adaptation.

Before traveling:
• Get plenty of rest, eat a healthy diet and exercise
• Try to reset your body’s internal clock slowly a few days prior to travel. Shift your bedtime 1-2 hours later if traveling westward and 1-2 hours earlier if traveling eastward
• Expose yourself to bright light in the evening if traveling westward; in the morning if traveling eastward

During travel:
• Break up a long trip with a stopover, if possible
• Avoid large meals, alcohol and caffeine
• Set your watch to the new time of the destination, then try to eat and sleep accordingly
• Keep well hydrated with water
• Consider taking a short-acting hypnotic like Ambien® or Lunesta® during a long flight

On arrival:
• Adapt to the local schedule as soon as possible
• Maximize sun exposure
• Drink plenty of water and avoid excess alcohol and caffeine
• Take short naps (20-30 minutes)

For more information, I asked Anne Marie O’Melia, MS, MD — medical director at the Harold C. Schott Eating Disorders Program and sleep expert at the Lindner Center of HOPE in Cincinnati — for her input on the following questions.

What is the role of short-acting sleep medications to treat jet lag?

Avoiding sleep deprivation is important. Using ear plugs and eye shades, avoiding alcohol use and trying to get sleep on the plane is recommended. Traditional hypnotics — such as the benzodiazepines like temazepam (Restoril) or newer nonbenzodiazepine GABA-A agonists like zolpidem (Ambien) and zaleplon (Sonata) — are sometimes used on the plane and for several nights after arrival in new time zone. When using these medications, shorter-acting agents are preferred with the intention of helping to induce sleep with fewer carry-over effects such as grogginess in morning. Typically, taking Ambien 10 mg, Sonata 5-10 mg or temazepam 7.5-15 mg just before one wants to be asleep will help induce sleep quickly with fewer morning or daytime side effects.

Does the use of melatonin prevent jet lag?

Melatonin is believed to be effective when crossing five or more time zones and is most effective when traveling east. Melatonin is considered to be a supplement, not a drug for the purposes of production and marketing. Doses for melatonin use seem to vary by an individual’s response and can range from 0.5 mg to 9 mg.

When traveling east, I recommend taking 3 mg in the early afternoon for several days before travel. After arrival, this dose can be continued at bedtime for three or four days to help establish a new sleep pattern. When traveling west, pre-treatment isn’t helpful, but taking 3 mg at bedtime in the new time zone is helpful for some people.

Does jet lag differ if traveling eastward or westward?

Our body rhythms seem to adapt more easily when the day is artificially lengthened, as is the case of westward travel. Most people find it easier to stay up late than to have to get up early. This may be different for so-called “morning people” or “early birds” who generally find eastward travel to be easier.

Susan Locke, MD, is Healthnetwork Foundation’s Medical Director.

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