June 21, 2018

Jet lag: a GP’s tips

By dryeongs

Photo by Quin Stevenson on Unsplash

This is a reader’s request, or, more specifically, my younger sister complaining about jet lag after returning from her holiday to the US, back to London. I know. I’m jealous too.

Anyway, she asked me what she should do about jet lag.

What is jet lag?

Our bodies are very good at routine. The light/dark pattern of day and night allows our bodies’ wake-sleep cycles to sync up appropriately, allowing us to sleep at night, and feel refreshed and awake in the day time (well, most of the time!). When we travel into a different time zone,  our bodies need to adjust our wake-sleep cycles, also known as our Circadian rhythms. This results in us feeling sleepy at the time our bodies are used to, which may not match up with the current time zone we are in.

How do we treat jet lag?

When I was doing night shifts in the hospital, I would work 7 nights in a row, and would have a similar jet lag experience as I adjusted to staying awake at night and sleeping in the day. When the week ended, sometimes I would only have 2 days before having to go back to working day shifts. So what I would do was ignore my body and pay attention to the clock. That is, I would sleep when the clock told me to, not when my body told me to.

On the plane

Usually on international flights, the airline staff will turn the lights on/off and serve meals (mostly) according to the destination time zone. If you can, try to eat and sleep as close to the destination time as possible. Eating can also acts as a signal for your Circadian rhythms.

When you arrive

If it is daytime in your destination country and your body feels like it is nighttime in your home country, try and stay awake until it is at least early evening in the destination country. If you really can’t stay awake, then you can have a nap, but it shouldn’t be for more than 2 hours.
For the next few days. It will take awhile for your body to adjust, but keep sleeping and waking according to the time on the clock. The circadian adjustment tends to be a little more delayed the older you are, so be gentle on yourself. Give yourself plenty of time in your destination to adapt to the time zone (don’t schedule too many walking tours in the first few days!).

What about medications? 

There are a number of prescription and non prescription medications that can assist with these adjustments.

Prescription. Often patients will come in asking for Temaze or Valium to help them sleep at the right time on the clock. These medications are of the class known as benzodiazepines, and should really be taken as a last resort. These medications are addictive, with the potential for long term side effects on the brain, and the potential for dependence. If you take them once in awhile, they are unlikely to cause problems, but I generally try to dissuade patients away from these. Remember, if your doctor does prescribe it for you, only take it if you absolutely have to, and never mix with alcohol.

A preferable prescription medicine might be melatonin. This is a synthetic version of a natural hormone released by the pituitary gland in your brain to make you sleepy and signal to your body that it’s bedtime. Taking melatonin at the right clock time for sleeping can help your body adjust to your timezone. The main side effect of melatonin is sometimes you can still feel drowsy the next day.

Non-prescription. This includes antihistamines such as Phenergan. These are easy to buy over the counter, and basically work to make you drowsy and help you sleep. Some people find they get a severe “hangover” effect the next day and feel even more drowsy, so be aware of this side effect and don’t drive the next day if that’s the case.

Always see a doctor before taking medications for sleep to ensure they are safe for you. Never take prescription medicines that you have been given by someone else. 

If you would like to see me for a travel consultation, including yellow fever vaccination please click here.