Dealing with jet lag and motion sickness

One of the most mysterious and arcane topics among airplane travelers is jet lag and its incapacitating effects on the traveler. Having firsthand experience from traveling frequently over a 6-year period from New York to numerous destinations in Asia, I have found that jet lag is a debilitating experience that, fortunately, can be dealt with.

I can vividly remember flying 14 hours nonstop from JFK to Tokyo, having a 4-hour layover and catching a 5½-hour nonstop flight to Manila, Philippines. That common air travel route took me across the International Date Line and 12 time zones. My body went through a cavalcade of symptoms, such as severe fatigue, slight disorientation, irritability and a greatly disturbed sleep pattern.

In fact, when I arrived in Manila at 11 p.m. — and two days later, at that — I was wide awake and could not go to sleep. My body’s clock was set to Eastern Standard Time and, as far as my body was concerned, it was really 11 a.m. This conundrum is a common experience among air travelers.

Causes of jet lag

The staggering fact is that jet lag affects over 90% of long-haul air travelers and disturbs the body’s sleep cycle.

The body has naturally occurring rhythms that keep us awake during the day and sleeping at night. The rhythms that cause us to do that are called circadian rhythms, which control the body’s biologic clock. The word circadian comes from a Latin phrase meaning “about a day.” Circadian rhythms are physiological and behavioral characteristics that follow a daily, or circadian, pattern.

Jet lag is a severe disruption of circadian rhythms that is related to some of the following factors:

• time zones changes,

• a dry cabin atmosphere and changes in cabin pressure,

• alcohol consumption predeparture and

• lack of exercise during the flight.

Time zone changes seem to be the main contributor to jet lag. Traveling in an easterly versus westerly direction has worse effects. Jet lag can even be experienced in travelers flying from coast to coast in the U.S., traversing only three times zones.

Generally, adults who easily adjust to changes in routine experience less jet lag effects than those who are in a more fixed daily schedule.

The cabin environment plays an important role in the effects of jet lag, and air quality aboard jets tends to be dry. For those individuals who reside in more humid climates the change can be significant. A dry aircraft environment is known to cause dry mucosal tissue in the nose, mouth and throat and can cause headaches. This can predispose the traveler to a sore throat and catching a cold or perhaps the flu.

The best suggestion to remember on any flight, short or long, is to drink plenty of water. Keep oral and nasal tissues and membranes well hydrated. There are over-the-counter saline nasal sprays, which help keep membranes moist.

Alcohol has profound effects on people when they’re flying. The influence of alcohol on those flying is several times more intoxicating than on those on the ground.

One of the most challenging aspects of long-haul flight is lack of exercise due to in-flight conditions and remaining in a confined space. Major U.S. and international air carriers are concerned about the lack of in-flight exercise and have developed seat exercises for passengers.

The Journal of Travel Medicine recently had an article dedicated to the benefits of in-flight exercise and the incidence of Deep Vein Thrombosis (DVT), which is the development of blood clots in the legs on long flights. The conclusions drawn highlighted the benefits of in-seat exercises, which prevent cramping and improve circulation in the legs.

Minimizing jet lag

The reduction of jet lag can be realized by following these tips:

• Reduce stress. This can be achieved by getting all of your important duties and business affairs settled before your departure. Getting a good exercise workout and a good night’s sleep before you leave will help in reducing the effects of jet lag.

• Drink plenty of fluids. Dry air in the aircraft causes dehydration. Drink plenty of nonalcoholic beverages, preferably water. Alcoholic beverages will not help the dryness and will lead to an exacerbated feeling of intoxication.

• Consider taking melatonin and other sleeping pills. Melatonin is a naturally occurring body hormone that has direct effects on the sleep/wake cycle. Travelers who take melatonin, an over-the-counter preparation, seem to lessen the effects of jet lag. Check with your physician before taking melatonin or any other medication.

• Exercise in flight. Getting up and walking around, when possible, standing and stretching and doing twisting exercises all stimulate circulation and relax the muscles. If you have a layover, get out of the plane and walk around.

• Try the anti-jet lag diet. Developed by Dr. Charles Ehret of the Argonne National Laboratory (Box 847, Downers Grove, IL 60515; visit www.antijetlagdiet.com), this diet has been effective in reducing the effects of jet lag. It involves a 4-day predeparture feasting and fasting cycle of eating high proteins and carbohydrates and light foods, with restrictions on caffeinated beverages. Some travelers find it a cumbersome diet to follow.

Motion Sickness

Motion sickness is one of the most common illnesses affecting the traveler, and it is estimated that over 80% of the normal population has experienced it. Motion sickness does not discriminate between age, gender, travel experience and method of travel, and close to one-half of airline passengers experience it.

Motion sickness occurs when the body is subjected to movement in different directions or under conditions where visual contact with the actual outside horizon is lost and is associated with up-and-down movement. (The up-and-down movement pertains to when an individual’s position is changed to a to-and-fro motion, thus exacerbating the episode of motion sickness.)

Symptoms include but are not limited to dizziness, nausea and vomiting, malaise, sweats, pallor, yawning and abdominal discomfort.

Here are some effective tips on how to reduce the effects of motion sickness:

• Close your eyes, if possible.

• Place yourself where the motion is least, like the front seat of the car or over the wing of the plane.

• Fix your gaze on the horizon or a distant object.

• Minimize head movement. Lie back or lie down. Support your head.

• Do not read while feeling any symptoms of motion sickness; this will make you feel worse.

• Consult your physician; there are many anti-motion sickness medications available that are effective.

Dr. Larry G. Baratta is chief medical officer of Passport Health (www.passporthealthusa.com), with clinics nationwide.