Travel Health Part 2: Jet Lag

Travelers can feel exhausted and disoriented after a long day of flying thousands of miles, with long airport layovers.  Difficulty sleeping can weaken your immune system, leaving you vulnerable to catching a cold or other illness. Here are my tips for avoiding some of this discomfort, and dealing with the part you can’t avoid.

I am not a doctor – you should discuss anything I suggest with your own physician, and seek his/her advice on these suggestions. 

On this page, I’ll talk about the following:

  • What is Jet Lag?
  • Falling Asleep on the Road
  • Time Zone Adjustments
  • Dehydration

What is Jet Lag?

There are different definitions for jet lag, but most people agree it’s the physical discomfort that follows traveling long distances via airplane.  I find I’m most vulnerable to it if I’m on flights that take 5 hours or more.

Originally, the term “jet lag” was used to refer to the body’s difficulty adapting to travel crossing multiple time zones.  Today, we realize that there are other issues with long-distance travel that also affect well being, even if the trip covers a north/south direction with no time zone changes at all.

Issues can include sleeplessness, time zone adjustment, dehydration, and lack of exercise.

Falling Asleep

Even if we travel a short distance and stay within the same time zone, it can be difficult to fall asleep while on the road. In hotel rooms, we often deal with unfamiliar beds, dry air, difficulty regulating room temperature, unfamiliar noises indoors and out, and light pollution.

With a little preparation, we can make it a little easier to sleep in a strange place.

Food and Drink

Some foods, such as turkey, encourage the body to sleep. (Turkey contains tryptophan.) When available, these can help become drowsy. Another option is to eat carbohydrates such as pasta for supper, which can encourage drowsiness.

I sometimes take an immersion heater with me, along with teabags of herbal tea containing chamomile, mint, or valerian. These herbs gently encourage sleep. I enjoy a cup of this at bedtime.

Hot milk can also promote sleepiness if you consume it at bedtime, but it can be hard to obtain in some destinations.

I avoid consuming alcohol and caffeine in transit, and in the evening when I arrive, because they can cause difficulty sleeping.  I also try to avoid them the first two days I’m at my destination.

Unfamiliar Noises

When you’re home, you probably know how to ignore the many sounds outside your door or window. However, when you’re traveling, the unfamiliar sounds can keep you awake. It can be hard to tune out the sound of birds chirping, cars honking, people in the corridor, and more.

I like loading my phone with soothing sound effects such as a thunderstorm or cracking fire, and taking along a small bluetooth speaking to play it.

Another option could be to wear noise-canceling earphones, particularly if trying to sleep sitting upright on an airplane.  They could also help if sleeping on your back in a hotel room. Some require batteries, so be sure to pack enough batteries to carry you through your journey.

Some of my friends like to wear earplugs to reduce the impact of ambient noise. I personally find earplugs too annoying, but you could give them a try to see if they work for you.

Other Sleep Aids

I like to take a hot bath or shower before I go to bed. The heat helps ease tension in my muscles from a long day of travel. If a bathtub is available, I’ll add bath salts with relaxing scents, such as lavender, and soak in it until the water starts to cool, about an hour. This also helps my skin rehydrate from the dry air of airplane travel.

I try to avoid doing anything that requires too much thinking at bedtime. I don’t study my guide book to plan my next day’s adventure, or try to refresh my memory on how to speak the local language. Instead, I try to read something relaxing, such as a novel with a simple story line.

Some hotel rooms have too much light to fall asleep easily. Either the curtains don’t block enough outdoor light, or light comes in under the door, or the appliances in the room all have lights to show that they’re active. In these cases, I use an eye mask to block it all out.

What About Sleeping Pills?

I personally try to avoid them.  If you feel you need them, you can ask your health care provider for suggestions.  Here’s why I avoid them:

  • They can make the symptoms of dehydration worse, and leave me feeling groggy the next day.
  • They increase the risk of deep vein thrombosis (blood clots) because they suppress the natural movement of the limbs during sleep.
  • They can result in adverse side effects. Specific side effects vary according to which pill is used, but can include diarrhea, constipation, headache, heartburn, dizziness, and more.

Time Zone Adjustments

Time zone shifts can make it harder to sleep.  I find that I personally sleep fine if I travel 1-2 time zones away from home. However, I find that traveling 3 or more time zones is likely to disrupt my sleep. Here are my tips for easing the adjustment.

Using Melatonin

Many people find that taking over-the-counter supplements of the hormone melatonin helps them adjust to time zone shifts. Melatonin is the hormone our bodies use to regulate our response to light and dark.  Many people, including me, believe it is useful for helping our bodies adjust to east/west travel over multiple time zones.  However, studies have suggested it’s not useful for traveling north/south, staying in the same time zone.

Doctors disagree on the details of using melatonin, such as dosage size, frequency of using it, etc.  My personal approach is based on a study that was published in the 1990’s.  It has proven effective for me:

  • Several days before leaving home, I figure out what time of day in my home city matches bedtime at my destination.
  • Two days before I am scheduled to leave on my trip, I take about 1-2 milligrams of melatonin (about 1/4 or 1/2 pill, depending on the dosage size you buy) at what would be bedtime in my destination city.
  • The next day, I take a similar dose at the same time.
  • On the day of travel itself, I take another dose. If my flight is many hours in length, I may need to take one more on the airplane.
  • Upon arrival, I take a final dose at bedtime.

The below chart illustrates how this would apply to somebody based in North America who is planning to travel to Egypt:

Your Home Time Zone (in North America) For a 10:00 p.m. Bedtime in Egypt For an 11:00 p.m. Bedtime in Egypt For a Midnight Bedtime in Egypt
Eastern Time Take melatonin at 3:00 p.m. (15:00) Take melatonin at 4:00 p.m. (16:00) Take melatonin at 5:00 p.m. (17:00)
Central Time Take melatonin at 2:00 p.m. (14:00) Take melatonin at 3:00 p.m.(15:00) Take melatonin at 4:00 p.m. (16:00)
Mountain Time Take melatonin at 1:00 p.m. (13:00) Take melatonin at 2:00 p.m. (14:00) Take melatonin at 3:00 p.m. (15:00)
Pacific Time Take melatonin at noon Take melatonin at 1:00 p.m. (13:00) Take melatonin at 2:00 p.m. (14:00)

Some experts suggest adjusting mealtime 2-3 days before departure so that you’re moving your appetite to match up with mealtimes at your destination. . I’ve personally never tried this because using melatonin as described above meets my needs. However, you might want to try it even though I don’t do it. If I were going to do this for a trip to Egypt, I would eat a high-protein meal about midnight in North American Central time (1:00 a.m. Eastern time) to coincide with 8:00 a.m. breakfast in Cairo. I would eat a high-carbohydrate meal about an hour or two before my melatonin dose to coincide with suppertime in Egypt.

After arriving at my destination, I take 4-5 milligrams of melatonin at bedtime the first and second nights I am there.

Sunlight

Sunlight helps me adapt to my new time zone. If I arrive at my destination during daylight, I try to spend some time outdoors to expose myself to natural rays. It can be satisfying to go for a walk to explore the neighborhood around the hotel.

Bicycle rider with bread
A bread vendor rides his bicycle on the street in downtown Cairo.

As I’m enjoying the ethnic sights and sounds at my destination, the natural sunlight helps my body reset itself to the new location. I often purchase a few items at neighborhood shops during my walk, such as snacks or bottled water.

It can be tempting to take a nap, but if I can persuade my body to spend time outdoors in the sunlight, it helps me adapt. Exercise also helps stay awake until bedtime.

After Arrival

Eat a high-carbohydrate meal in the evening. Eat high-protein meals for breakfast and during the day such as meat, cheese, yogurt, high-protein vegetables, etc.

Dehydration

Long airplane flights can cause you to feel dehydrated, due to the air quality on the aircraft.

If you are feeling these symptoms, it could be a sign of dehydration:

  • Dizziness
  • Fatigue
  • Muscle weakness or cramps
  • Wrinkly skin
  • Headache
  • Dried mucous membranes in the nose and mouth. When this happens, they are unable to perform their function of preventing germs from entering your body, and you become more vulnerable to catching a cold from that sneezing passenger two rows away.

When I went to Egypt in 2004, one of the women in our group told me over dinner the first night that she wasn’t feeling well. She suffered from a bad headache, dizziness, and fatigue. I asked how much water she’d drunk in the past 24 hours, and it wasn’t much. So right there at supper I urged her to drink plenty of it. An hour and a half later, as we finished our meal, she happily told me she felt so much better. The headache was gone and she felt a bit stronger. She had been dehydrated, and simple water was sufficient to solve her problem.

How it Happens

Many aspects of airplane travel contribute to dehydration. Airlines try to save money by serving a minimal amount of beverages on flights. Passengers often don’t realize they should purchase bottled water to bring on the airplane with them.

Coffee, sodas, and cocktails that we enjoy on the airplane may lead us to believe we are consuming enough fluid. However, caffeine and alcohol make dehydration worse.

In airports, both heating and air conditioning cause the air in waiting areas to be very dry. Air quality on airplanes is very dry. It sucks the moisture out of the skin, mouths, and nasal membranes.

Preventing Dehydration

I take several bottles of water on board the airplane. I try to drink at least the equivalent of one 8-ounce glass of water per hour of flight time. I avoid alcoholic beverages and caffeine-containing drinks  such as soda, coffee, and tea.

I put drops of salt water solution (which can be purchased in drugstores) in my nose to keep the mucous membranes lubricated.

Dry Eyes

Eye Care Items

Dehydration can irritate the eyes. Years ago, I left my contact lenses in for a 5-hour flight. When I arrived at my destination, I had severe pain, and was unable to wear my lenses for 48 hours. I consulted an ophthamologist, who said it was because my eyes dried out too much on that flight.

Because of that experience, I now recommend:

  • Remove the contact lenses for any flights longer than 3 hours.
  • Remove the contact lenses if planning to sleep on the airplane. When eyes are closed for sleeping, they don’t lubricate the eyes with blinking.
  • Turn off the air vent above the airplane seat, especially if it blows directly on the eyes.

I’ll also usually put a few drops of saline in my eyes approximately once per hour during the flight.  I also usually turn off the vent above my seat, because the air from it can be very drying.

Skin

On long flights, I sometimes soak a washcloth in hot water and lay it over my face for a few minutes to bring moisture to my skin and nasal membranes. I bring a plastic bag to store the washcloth in between uses.

If I don’t have a washcloth, I’ll use my hands rinse my face with water periodically during a long flight, once every hour or two.

My lips become very dry on airplanes. I take lip balm to soothe them and use it as often as necessary for comfort.

Above, I suggested taking a hot bath or shower to help relax muscles for sleep. Another benefit of the bath is that it rehydrates the skin and breathing passages.  After finishing the bath, leave the water in the tub so it will evaporate and add some humidity to the hotel room’s dry air.

Muscle Stiffness, Backache, and Circulation

Long trips place a large amount of stress on the body. It’s very unpleasant, and can even be life-threatening.

Airplane travel often requires sitting still for hours at a time, both in airport lounges and on board the airplane.  Airplane seats are usually very cramped, preventing even simple shifting of leg positions. Blood can pool in the feet, causing them to swell.  More serious is the risk of deep vein thrombosis or stroke, in which blood clots form and block circulation. This can be deadly.

There are a number of strategies for avoiding these serious health risks. The best is to get up and walk around a little at least once per hour, if possible. A trip to the restroom can encourage circulation and release muscle tension.  Walking up and down the aisle a couple of times just for the sake of movement can hep. While standing in the aisle, move the back around into various positions to release muscle tension, and circle the shoulders a bit.

If a layover is long enough to allow some waiting time, use that time to walk back and forth between gates.  Upon arrival at the destination, take some time to exercise. Walk outdoors the explore the neighborhood near the hotel, or use the hotel’s swimming pool.

What to Pack

  • For falling asleep – if you hope to sleep on the airplane, you may want to include some of these items in your carry-on luggage.
    • High-carbohydrate snacks for bedtime such as dried fruit
    • Immersion heater
    • Tea bags of sleep-supporting herbal teas
    • Noise-canceling headphones
    • Soothing sound effects MP3 files on your phone
    • Ear plugs
    • Lavender scent aromatherapy spray for pillow
    • Lavender or other relaxing scent bath salts for pre-bedtime hot bath in hotel
    • Eye shades to block light
  • Melatonin to adjust to a new time zone
  • To minimize health problems tied to dehydration, take these items along:
    • Bottles of water to drink on the airplane.
    • A washcloth to moisten and place over the face, with a plastic bag to keep it in after use
    • Sterile salt solution for eye drops and nose
    • Lip balm to protect against chapping
    • Glasses to wear on the airplane (if you normally wear contact lenses)
    • Skin moisturizer
  • To help with circulation, muscle stiffness, and backache, these items can be helpful:
    • Exercise clothing and/or swimwear
    • Exercise props (such as yoga mat)