What does jet lag mean?

Technology helps us travel thousands of kilometers across time zones, in a matter of few hours. Due to the change in the time zones, long distance traveler may suffer from an inability to sleep or other sleep disorders during the first few hours/ days of their arrival at their destination.

Traveling jet lag results from rapid travel modes, such as the plane, across several time zones. For example - traveling from Saudi to US or vice versa (west or east).

What are the symptoms of jet lag?

Time alteration causes different symptoms to appear during the first or second day of traveling across several time zones.

Symptoms of Jet Lag:

People who travel for long distances may show symptoms like insomnia, sleep in wakening times, inactivity during the daytime, body pains, headache, bad moods, lack of appetite, stomach pains and acidity, gastrointestinal disorder, and an increase in night urination.

These symptoms occur as the time alteration causes acute alteration in the body’s circadian rhythm or biological clock as the person might have to remain awake while his body needs sleep or vice versa.

For example, the time difference between Riyadh and New York is about eight hours. If a person travels from Riyadh to New York and arrives there during the early morning, his biological clock will act as per noontime (from the Riyadh time zone). Now, if he is used to having a nap in the noontime, he will feel drowsy in New York during the early morning. Accordingly, when the time in New York is 3 pm, his biological clock will suggest bedtime.

How could we avoid these symptoms during travel?

Thanks to science, we can avail several therapies that can treat this issue permanently and effectively. However, there are some behavioral recommendations that could help one cope with jet lag and decrease the symptoms:

• Try to change your sleep and waking time two to three days prior to your travel to align with your destinations time zone. If travelling to the west, try to delay your sleep gradually, one hour at a time. Similarly, if you were to travel to the east, you should gradually try to advance your sleep time.
• While boarding the plane, adjust your watch as per your destination time. If possible, do it a few days prior to accelerate the adjustment with the new timing.
• You may even perform some stretching exercise before and while sitting to avoid muscle pain and stress.
• Try to move around the plane during the flight to exercise the muscles.
• Avoid stimulants such as tea, coffee, and alcohol during the flight.
• Drink plenty of water during the flight as the plane environment has a tendency to cause dryness.
• If you land at your destination during the daytime, get as much sleep as possible in the flight. If you are expected to reach your destination at night, stay awake and try to be active on the plane in order to be able to sleep on arrival.
• Avoid heavy meals that conflict with the destination time, until your body’s biological clock adjusts with your new timing. Studies suggest that, an inability to do so might lead to the secretion of a certain type of hormone that hampers insulin generation, and hence increase the glucose and fat rate of the body.
• Avoid heavy meals before sleep as it leads to poor sleep quality.
• Many travelers fall asleep soon after the arrival because of fatigue even if it is not their regular bedtime, especially during the daytime, this results in a difficulty to sleep at night. So unless necessary, avoid sleeping after arrival. Even if you do sleep, it should be limited to two hours so your might sleep does not get disturbed.
• Avoid strenuous exercises before bedtime.
• A warm shower might help restore your body’s energy and achieve regularity of sleep.
• The sunlight is a basic factor that helps organize our body's biological clock, so expose yourself to sunlight if possible, and avoid it during unsuitable times. The exposure timing to light depends on your travel direction. The elaboration for the same requires further details. However, it is recommended that:

- For people who travel west - spend time under sunlight in the afternoon as this leads to a delay in body's circadian rhythm

- For those who are to travel eastwards - sit under sunlight during sunrise for it leads to advancement in the body's circadian rhythm

• Sleeping Drugs:Some people also use sleeping drugs to help overcome time alteration during travel. Melatonin is one of these drugs, which is well known. Few studies show that the melatonin drug might help reduce jet lag symptoms. It has a substance that aids in hormone secretion by the pineal gland of the brain into the body, and helps in organizing the body's circadian rhythm. It prepares the body for sleeping by increasing the hormone secretion at night and decreasing it at the daytime. We can say that its effect is contrasting to the light therapy effect. The timing of ingesting melatonin is very important for the body's biological clock alteration.

- Taking melatonin at the evening helps in the advancement body's biological clock, and is recommended for who travel toward the east.

- Taking melatonin in the morning helps delay the body's biological clock and is recommended for who travel toward the west.

You should also note that the chemicals in most of the melatonin drugs available in the west are safe as they are authorized by the competent authority in the US viz. the FDA. It is also used as a food additive.

The long-term side effect of this drug is not yet known. A Mayo clinic study showed that there are gangues in some of melatonin drugs in the US. Thus, my recommendation for the reader is to consult their doctor prior to using any medication including melatonin.

• Finally, if you are traveling on a business trip, try to arrange the dates of important meetings so that they are at a time when your body is at the top of its activity.

Wishing you a happy travel!

Ahmed BaHammam, FACP, FCCP
Professor of Medicine
Director, University Sleep Disorders Center
College ofMedicine, King Saud University