Overcoming Jet Lag

You've booked your flight, reserved your hotel and packed your bags. So don't let jet lag, keep you from enjoying all the wonders on your itinerary. In this episode, you'll learn how to phase shift your circadian rhythm. So you can make memories that last forever. 

It's kind of fascinating to think about jetting around the globe. We can hop on a plane and be on the other side of the world by tomorrow. Or is it today? What time is it again?  The problem is that our internal clocks. can't keep up. And it knocks the circadian rhythm for a loop. When your internal clock gets out of sync, it causes jet lag. Which can make us sleepy when we're supposed to be awake and enjoying our wonderful vacation or lying awake when it's bedtime in our dream destination. Either way, there are things you can do to lessen the effects.  

Jet lag causes insomnia by the de synchronization of the circadian rhythm. Well, that was enough 25 cent words to cut into your vacation budget, but don't worry. We'll go to mini medical school in a bit and learn more. But jet lag causes more than insomnia during the night and drowsiness during the day. It also causes GI upset, brain fog., bad mood and just feeling ick, in general.  And even if you don't change time zones, it's hard enough to sleep in an unfamiliar place where there's light noise to contend with. And it can be made worse if the pillow is too flat or too thick. 

On the other end of the spectrum is daytime sleepiness. You've planned all those amazing excursions. And now you're struggling to stay awake and actually enjoy your trip. Jeez. And don't forget GI upset.  Mostly it's decreased appetite and constipation due to eating at times you're normally sleeping, but some people get diarrhea and that's never a good travel companion. On top of that brain fog sets in which can make you and everyone around you and a bad mood. Decisions about where to go and what to eat, seem harder. And emotions get the best of you and sabotage your trip.  

So let the adventures begin.  Whether you've personally experienced jet lag, have an upcoming trip, Or, just want to live vicariously.

 It's time to go to mini medical school.  I always like to get started with a definition. Let's start with circadian rhythm. It's the 24 hour process that helps our bodies react appropriately to day and night, light and dark as the earth spins on its axis. Normally melatonin levels start to increase when light starts to decrease. 

Ideally, this happens about two hours before bedtime. And the term for this is dim light melatonin onset, or DLMO. This secretion in melatonin causes a drop in core body temperature, which in turn makes us a little groggy.  This signals our body that it's time to get tucked in beneath the covers and get some shut eye.  The rise in melatonin continues and it hits its max level after about seven hours. This peak coincides with the lowest level of core body temperature. And these two things happen about three hours Prior to wake up time. In the morning, the melatonin levels drop to zero and our core body temperature starts to warm up, and this starts the wake cycle, which lasts about 16 hours. The sleep wake cycle can be modified and the internal clock can be reset.

Guess what the most powerful tool that resets the circadian rhythm is?  It's bright light. In the natural order of things, the sun comes up, the rooster says cock a doodle doo, the farmer gets out of bed, works 16 hours, and everyone goes to sleep. The cycle starts over the next morning. But then we invented all kinds of things that screwed it up from light bulbs to night shifts, to screens that emit blue light. And that has a huge impact on melatonin secretion, which is what gets this whole ball rolling.

When it comes to light, timing is everything. Let me introduce another term, entrainment. This is our ability to synchronize our internal clock based on external input from the environment.

This makes your body's physical functions line up with your daily routines to coincide with day and night. And that's why typically people don't have the urge to empty their bowels during the night. It's also why your gastrointestinal tract can be all messed up when you travel.  But other things besides light can help entrain circadian rhythm too, like exercise, meals, and social contact. Think about it. How many times have you stayed up late talking to friends? And then falling asleep when you're home alone or bored.  Get out your notebook now because here's the science you need to know about jet lag. It's all about phase shifting. Either delaying or advancing depending on which direction you're traveling.

Bright light packs the biggest punch when it shines during what should be night time. Because that's when melatonin is secreted, remember?

In normal people, the lowest core body temperature is in the evening. So bright light after the low core body temperature, moves that circadian rhythm forward. That's called a phase advance. Bright light after the DLMO, the dim light melatonin onset, and before the lowest core body temperature in the evening,  moves the sleep wake  cycle backwards.

That's called a phase delay. Got it? No? Okay. One more time.

Bright light after the body cools down moves the internal clock forward. And bright light after the dim light melatonin onset, but before the body cool down. You moves the clock backward. The problem is that even though bright light shifts the internal clock, this effect is delayed.

So when you fly to a different time zone, your body needs several days to adjust. The more time zones you cross, the more time it takes for your body to naturally reset. And all this talk about melatonin just might make you wonder, Can I take melatonin to help shift the internal clock? I'm so glad you asked.

The answer is  yes, but the action depends on the timing. Melatonin is a phase shifter.  What time of day it's taken can affect the sleep wake cycle. So, if you take it late in the afternoon or early in the evening, it That causes a phase advance and if you take it in the morning, it causes phase delay. 

Melatonin can also be sedating. The power of sedation and phase shifting is greater when melatonin is taken at a time when the body's pineal gland is not normally secreting it. That's why melatonin is more effective for jet lag than it is for sleep at bedtime. 

 We'll talk more specifics about melatonin doses in a minute. 

   Even without treatment, your circadian rhythm will adjust on its own. Hopefully, that happens before your trip is over. How long will it take? Well, that depends on how many time zones you cross and which direction you travel.  People who jet set around the globe for a living may experience more long term health effects than those of us who occasionally take a big trip.

Typically, it takes about one day to to adjust for one time zone if you're traveling eastward. So, if you cross more, it takes longer. Westward travel is a little easier and your body can compensate for 1. 5 time zones per day.  Your body's less confused when you travel west because the days are lengthened rather than shortened like they are when traveling east.

And if you're wondering why that matters, it's because Your internal clock is not exactly 24 hours, it's just a tad more. So stretching out a day more closely matches the natural rhythm. Go west young man, you'll feel better. 

Now, if you can sleep on the plane, you'll get a head start, but most of us just nap and wake up with a stiff neck. So, let's transition to treatment. The goal is to sleep at night and stay awake during the day. So, your internal clock needs to align with where you are instead of where you've been. It will happen naturally, but wouldn't it be nice if you could speed up the process and hit the ground running in paradise. 

Then go straight back to work when you get home. If your trip is shorter than three days, then forget it. You'll have less jet lag when you get home if you just stay on your home time zone so you don't miss a beat when you get back. You can try to take a sleep aid at night then power through the day with caffeine but of course there are risks with that. 

But let's assume you're traveling for more than three days and you want to treat or prevent jet lag. Treatment depends on which direction you're going. We will start by focusing on eastward travel, and remember that's the one that's more challenging. West is best and east is a beast when it comes to jet lag.

So you've booked your flight, hotel, maybe even some dinner reservations in advance,

And now it's time to prepare to reset your internal clock. For eastward travel, your circadian rhythm needs to advance to the new time zone. Remember, it's all about timing of light and melatonin. During the times you need to avoid light, you might try a sleep mask. Start three days prior to your scheduled departure, and I recommend just put it on your calendar.

There are even apps you can use. But here's the prescription. Three days before takeoff, set your alarm one hour earlier than you normally wake up. Get up. Get some bright light exposure. If the sun isn't up yet, you really want to maximize the effect, you could use a light box.

But try to mimic the time you'll wake up in your destination by getting maximum light exposure at that time. Then, darken the room and go to bed one hour early. and get that dim light exposure one hour before your new sleep time. Then each day move it up another hour. When you arrive at your destination, be intentional about light.

If you're crossing three to five time zones, avoid sunlight early in the morning,  but soak it up when you're up and around. If you're crossing more than five time zones.

Avoid bright morning light altogether and wait until afternoon to get out in the sun. The idea is to ease into the new time zone. Having said that once your phone changes to the new time zone, don't think about it. Don't even talk about what time it is at home. When in Rome, do as Romans do and live in their time zones without saying, okay.

Well, back home, it's 3 a. m.  Food is important too. Eat a hearty breakfast about 30 minutes after your new wake up time. If you do want to use melatonin, I recommend 3 milligrams. Pack it in your suitcase and don't take it until the evening after you get there.   I am not a big fan of taking benzodiazepines or sleeping pills, but if you do, Don't take melatonin with them because it might cause over sedation and impaired ability to think or drive.

 And you might want to skip that glass of wine on the plane too. Because that just compounds the problem. If you're like me and you're addicted to  caffeine, you'll need a jolt  to get you going in the morning. Don't overdo it, but a couple of cups of coffee or tea when you get up will help you feel more alert.

And if you're going far, far away and crossing eight or more time zones, then just try to delay rather than advance your sleep wake cycle. Get up and get sunlight first thing in the morning, and start dimming the lights in the early evening.  Let's talk about going west, and remember, traveling west is easier.

I'll say it again so you can remember, west is best and east is a beast. The goal with traveling west is to delay the circadian phase. Just try and stay up later and use light to cue your body that it's daytime and not bedtime. Keep the lights on and get as much sunlight as you can in the afternoon and the early evening.

Keep the lights on until about an hour before you get under the covers and then only dim light. After the new bedtime, avoid bright light. And melatonin doesn't really help much with westward travel unless you're going to the ends of the earth on the far side. Then you can take three milligrams at bedtime.

Always try and balance naps and caffeine for optimal effects. And as far as breakfast, the same rules apply. Eat a hearty breakfast within 30 to 45 minutes after wake up time. Eat a complex carbohydrate rich diet two to three hours before the new sleep time. And when you get back home, Melatonin may help you recover.

You can take 0. 25 mg about 3 to 4 hours before bedtime. If about an hour before you're trying to sleep you're still wide awake, repeat. 0. 25 milligrams.  This is a lot of information on top of your itinerary and your packing list, so I've tried to make it easy with two free downloadable graphics. One for eastward travel and one for westward travel.

This has been a lot of information and you may be thinking, well, that's really interesting, but would you just tell me what to do? Okay. Here's what's on the guide. If you're traveling east, remember east is a beast. So you might want to prepare about three days in advance, go to bed and wake up 30 minutes early or an hour early. 

If you can do that avoid light in the evening. But get bright light exposure. As soon as you get up. And when you travel, set your clock to your destination time, nap and rest on the plane and be sure and stay hydrated. Then sleep during the destination sleep time when you arrive, you want to avoid early morning light and get that sunlight exposure late in the morning. 

We're in the early afternoon, you can take melatonin at bedtime. If you need it short naps and caffeine in the morning may help. And while you're up, stay active. Okay. Remember west is best.

But again, about three days before your trip,  you can delay your bedtime as well as your wake. Time by about 30 minutes. Get your light exposure in the evening, not the morning. Again, set your clock to the destination time and avoid light and screens during what is going to be nighttime. Stay up when it's wake time, be sure and stay hydrated. 

Stay active. And have a cup of coffee to help you wake up if you need it.

Make sure your passport is up to date and most of all, enjoy your trip. Stay safe and stay healthy because healthy looks great on you.

RESOURCES

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