Managing Jet Lag

By Dr. Gregg D. Jacobs
August 9, 2004

Many insomniacs who travel regularly know all too well that jet lag can significantly exacerbate insomnia. In addition to making it harder to sleep, jet lag can also result in sleepiness during the day, disorientation and difficulty concentrating and gastrointestinal upset.

Depending upon the number of time zones crossed and whether travel is eastbound or westbound, jet lag can produce a significant phase advance (e.g., our circadian rhythm is shifted earlier) or a phase delay (our circadian rhythm is shifted later), resulting in sleep maintenance or sleep-onset insomnia. The duration and severity of jet lag symptoms increases with the number of time zones crossed.

In general, we require about one day per time zone crossed to synchronize our circadian rhythm to the new time zone. Crossing one time zone might result in only mild or no symptoms of jet lag, while flying halfway around the world can produce symptoms that last for weeks. Being unable to sleep comfortably on airplanes, along with the stress of traveling in today's security-conscious world, exacerbates jet lag symptoms.

If you are crossing several time zones but plan to stay at your destination for only a few days, you will not have time to adjust to the new time. Therefore, you are better off maintaining your normal sleep-wake schedule as much as possible. If you are staying in the new time zone for more than a few days, the following tips will help you to minimize jet lag:

Gradually adjust your bedtimes and arising times to the destination time zone before leaving on your trip. This means arising and going to bed earlier for eastbound flights and going to bed later and arising later for westbound flights.
Drink plenty of water and avoid caffeine and alcohol during your flight to minimize dehydration, which exacerbates jet lag.
A sleeping pill for a night or two may make it easier to sleep on the plane and adjust to the new time zone. Use a newer generation, short-acting sleeping pill like Sonata or Ambien.
Upon arrival in the new time zone, adjust your sleep schedule immediately to the local time (e.g., don't sleep during the day). Use outdoor light and physical activity to prevent daytime sleepiness. Schedule meals at the local time. Try not to go to bed until it is bedtime in the local time zone. If necessary, take a short nap of an hour or less to help you get through the day. Follow the same procedures upon your return home.
Give yourself some time to adjust to the new time zone and don't schedule much the first day. If you are on business, arrive a day or two before meetings if possible.