Jet Lag

Jet lag occurs when the traveller’s “internal clock” doesn’t match the “real time” at the destination or upon returning home. It is more likely after crossing 3 time zones or more and when travelling from west to east (shorter day). Severity depends on the number of time zones crossed. There is a physiological as well as psychological component. Common problems include fatigue, disorientation, sleep difficulties, poor concentration, anxiety, poor appetite and impaired physical performance.

• Start the journey “rested”. Allow plenty of time to get to the airport.
• Consider a stopover if your destination is more than 12 hours flying. Choose a daytime flight where possible.
• Avoid excess alcohol or caffeine. Maintain hydration with at least 2 glasses of water per sector.
• Maximise appropriate exposure to light in the new time zone as soon as possible. Light stimulates the optic nerve to communicate with the pineal gland and this helps the body recognise the time shift. This approach seems to work best with afternoon and evening light with westward travel. Morning light seems to work best when travelling East. Sunglasses may be used to modify light when not indicated.
• For a few days prior to travel consider changing your time for bed and wakeup according to your proposed direction of travel. Earlier for eastward and later for westward.
• Avoid putting yourself in a position of important decision making in the first 24 to 36 hours. Judgement may be impaired.
• Protein rich meals at breakfast and lunch and carbohydrate rich ones at night have been suggested to restore the sleep-wake cycle.
• Short acting sleeping tablets such as Temazepam are useful for a few days at the destination or upon returning home. They help the “early morning waking”. Medication should be avoided while travelling as the sleep position is unnatural in most situations.

• Melatonin is a chemical naturally produced in the pineal gland of the brain. It is thought to be secreted in response to light/dark changes thus controlling the Circadian rhythm and day-night functioning of the body. Darkness stimulates production and release into the blood.
• The chemical has been synthesized and is available in some countries as a health supplement. The main therapeutic application is in modifying disturbed circadian rhythms. It is mildly sedating and helps improve the quality of sleep after crossing multiple time zones. The individual response is variable, and it seems to help with eastward flight more than westward.  Side effects are low but include drowsiness, headache and nausea. Allergy is possible. It should not be used by pregnant or breast-feeding women, or by those taking other sedatives, psychiatric medication or warfarin. It should also be avoided by those with epilepsy and auto-immune diseases. The dose suggested is 3-5 mg at local bedtime for the 5 nights after arrival.