Can You Avoid the Drag of Jet Lag?

HYANNIS – It’s 1 a.m.

I’m awake.

I’m very, very awake.

I toss. I turn. I get a glass of milk. I toss and turn more. I plump my pillow, throw off the blanket, pull up the blanket, throw off the blanket. The dog sighs his irritation. Finally, I fall asleep, only to wake up the next morning feeling like I’ve partied like a teenager.

Alas, it’s only jet lag.

I am “bi-coastal,” as my son describes it, living on the East Coast while some of my children and grandchildren live in California and Nevada, three time zones away. While I’m lucky to be able to make a few trips a year, my body pays the price, especially flying home to the East. And, the older I get, the more likely it is to take me two or three days to bounce back from a three-hour time change.

Why is this happening to me and is there nothing that can be done?

“It has to do basically with your internal clock,” said Gary Tratt, MD, a Hyannis internist and world traveler. “We have these circadian rhythms in our brains; jet lag happens when this so-called body clock is disturbed.”

The body’s circadian rhythm of sleeping and eating is controlled by the hypothalamus, a gland in the brain behind the eyes that reacts to light. It sends signals to the pineal gland deep in the brain to control the release of the hormone melatonin. An increase in melatonin tells the body to go to sleep; while a decrease prompts it to wake up. So, if, like me, you leave the West Coast at noon Pacific time and land in Boston at 8:30 p.m. Eastern time, your body thinks it’s 5:30 p.m. and won’t secrete the necessary melatonin for sleep until it’s bedtime California time – at, say, 2 a.m. in Boston.

It’s All About Melatonin

The number of time zones you cross, the direction and timing of flights, your age and health, are all factors in jet lag, according to the National Institutes of Health (NIH). Going west to east seems to be worse for most people. Major League Baseball players traveling west to east before a game, for example, have more problems with hitting and fielding, according to 20 years of statistics studied at Northwestern University.

And, bad news for aging jet setters: Melatonin levels decline as we age, making sleep even more elusive and jet lag recovery more drawn out.

Of course, it’s not just travelers who suffer from problems with circadian rhythm. Night workers and the blind also have trouble adjusting their body clocks. And researchers have now identified social jet lag, a problem for people who have sleep, appetite, and health problems when they try to catch up on sleep in a short period of time, say on a weekend. Researchers blame social jet lag for bad moods, poorer health, higher rates of smoking, and increased sleepiness and fatigue.

For most of us, jet lag is a mere inconvenience. But it can put a damper on an important work meeting or that pricey six-day vacation in Paris.

“It usually takes about a day for every time zone that you cross,” Dr. Tratt said. “So, if you go to Europe, it takes about a week to get over it.”

The worse jet lag he’s ever experienced? Flying from Boston to Japan, a change of 13 hours.

“I’ve come back from India. I’ve come from Japan. I’ve come from Vietnam. It’s the second or third day that I’m crashing,” he said. “Because when you get back from a trip, you’ve got all this mail to do, all these papers, all this stuff that’s been waiting for you – and the unpacking, of course. So, there’s a lot of work. You’re very focused. But after about two days when it’s all done, that’s when you crash.”

What’s A Traveler To Do?

Research on sleep patterns suggests light therapy, like the ultraviolet light used to treat the mood disorders associated with the lack of sunlight in winter. Light may decrease the sleepiness caused by jet lag and resynchronize your body clock, according to the NIH. New research at Stanford University suggests that exposing people to short flashes of light while they’re asleep could prevent jet lag. That solution is still experimental, Dr. Tratt said, and while there are light visors and lamps, artificial light isn’t a very practical solution for most travelers.

In a 2016 study of circadian rhythm, scientists at the Salk Institute found that a protein called REV-ERB affects the strength, rather than the timing of circadian rhythm, and is an important factor in staying healthy. They believe it may someday lead to a pharmacological solution for body-clock issues. In the meantime, melatonin supplements are sometimes suggested. But Dr. Tratt and others do not recommend melatonin for jet lag because of the inconsistent potency of over-the-counter-products.

In a Canadian analysis of 31 melatonin supplements available at grocery stores and pharmacies in one Ontario town, the melatonin content ranged from 83 percent less than the concentration on the label to 478 percent more, according to the American Academy of Sleep Medicine (AASM). Several samples also contained “unlabeled but significant” doses of serotonin, a neurotransmitter that can be dangerous in large amounts. And guidelines published by the AASM in February, cautioned clinicians against using melatonin as a sleeping aid because of the weak evidence supporting its efficacy.

So, back to the question: What can a traveler do about jet lag? Here are recommendations from Dr. Tratt, the NIH, and the ASSM:

Plan ahead. Start adjusting before you go on your trip by going to bed earlier or staying up later. And if it’s nighttime at your destination, try to sleep on the plane.
Get out in the morning light. This seems to help adjusting to an earlier time zone, Dr. Tratt said. And, although he hasn’t tried it, he said some people recommend a high protein diet to avoid a carbohydrate crash.
Avoid caffeine and alcohol. A couple of drinks might knock you out, but then will disrupt your sleep patterns and make it hard to fall back to sleep.
Stay hydrated on the plane.
Pick your aircraft. The interior air pressure in most commercial flights is the equivalent of 6,500 to 8,000 feet (higher than Mt. Washington), which can cause headache, nausea, vomiting, anorexia, lassitude, and sleep disturbance, according to a study reported in the New England Journal of Medicine in 2007. Newer planes, such as the Boeing 787 Dreamliner and the Airbus A350 keep pressure as low as 6,000 feet, causing fewer side effects.
Exercise. “Some people feel that … exercise gets them back on schedule,” Tratt said. It’s also a commonly cited recommendation from airline personnel.
Try the “11 a.m. rule.” The BBC reports that some airline pilots and flight attendants use this. If they fly west to east and arrive before 11 a.m., they try to take a nap. If they arrive after 11 a.m., they try to stay awake until a reasonable bedtime.