Combatting Jet Lag with Melatonin and Light + a note on DVT

by Meg Gawler
(Gex, France)

The following is from my own experience plus an article by Jane Brody of the New York Times Service and the work of circadian rhythm specialist, Dr Alfred Lewy of the Oregon Health Sciences University. This is my personal battle plan – what works for you may be different.

Melatonin is a hormone released at night by the pineal gland, which, together with bright light, sets body rhythms – making you feel sleepy at bedtime and awake during the day. Bright daylight suppresses the release of melatonin. These body rhythms are tenacious, and without help, it generally takes one day to adjust to each time zone you cross. One problem with using melatonin to combat jet lag, is that adjusting our internal clock is complicated. Body rhythms can be adjusted either by advancing or delaying them. The basic recommendations are as follows:

1) Use doses of no more than half a milligram: tablets of 200 micrograms are quite sufficient. If you can only find 500 microgram tablets, I suggest you cut them in half.

2) You must start the day before your departure. Two days of pre-programming your body clock before you arrive in your new time zone is the key to success.

3) Don’t forget to take along a visor and dark sunglasses to protect you from bright light at the wrong time of day.

4) When crossing ten time zones or more travelling east, all the rules change because it is easier to delay the body clock by 14 hours, than it is to advance it by 10.

5) Even micro-doses of melatonin can cause extreme drowsiness, so be careful after taking it: avoid driving, operating machinery, etc.

6) On the plane, drink lots of water and arrange to sleep. If you have a night flight, eat a solid meal before boarding so that you can go to sleep right away. Take a “sleep kit” for the flight (ear plugs, neck pillow, eye mask). However, to avoid deep vein thrombosis, it is better to take only short periods of sleep, and move around in between, unless you can get into a normal sleeping position (i.e., business or first class seats/beds).

7) When you arrive in your new time zone, plunge headlong into the local time, and avoid taking naps. Drink lots of water; get exercise (a walk is great). If you are not sleepy at bedtime, Passiflora may help; this is an herbal sedative that enhances sleep with no known side effects.

Going EAST to WEST:

1 - 6 time zones:
When to take melatonin the day before and the day of departure: On awakening, regardless of the time.
When to take melatonin upon arrival: Day 1: On awakening. Days 2-3: 1-2 hours later than the previous day.
Light exposure: Get light late in the day.

7 - 9 time zones:
When to take melatonin the day before and the day of departure: On awakening, regardless of the time.
When to take melatonin upon arrival: Day 1: On awakening. Days 2-4: 1-2 hours later than on the previous day.
Light exposure: Get midday light. Avoid late-day light.

10 or more time zones:
When to take melatonin the day before and the day of departure: On awakening, regardless of the time.
When to take melatonin upon arrival: Day 1: When it is the same time that you took it yesterday at your point of departure. Days 2-4: 1-2 hours later than on the previous day.
Light exposure: Get morning light. Avoid light the rest of the day.

Going WEST to EAST:
1 - 6 time zones:
When to take melatonin the day before and the day of departure: About 3:00 p.m.
When to take melatonin upon arrival: Day 1: When it is the same time that you took it yesterday at your point of departure. Days 2-3: 1-2 hours earlier than the previous day.
Light exposure: Get morning light.

7 - 9 time zones:
When to take melatonin the day before and the day of departure: About 3:00 p.m.
When to take melatonin upon arrival: Day 1: When it is the same time that you took it yesterday at your point of departure. Days 2-4: 1-2 hours earlier than the previous day.
Light exposure: Avoid morning light. Get midday light.

10 or more time zones:
When to take melatonin the day before and the day of departure: On awakening, regardless of the time.
When to take melatonin upon arrival: Day 1: When it is the same time that you took it yesterday at your point of departure. Days 2-4: 1-2 hours earlier than the previous day.
Light exposure: Get morning light. Avoid light the rest of the day.

Happy body rhythms!


A Note on DEEP VEIN THROMBOSIS

DVT – deep vein thrombosis – from an article by Roger Collis of the International Herald Tribune: DVT is a condition in which blood clots form in the legs as a result of prolonged immobility, especially in cramped seats on long-haul flights. Then a week or so later, they either dissolve, or they break off and travel to the lungs, causing serious injury or death. Often there are no symptoms at all. First signs may be sudden swelling, tenderness, redness or pain, often in one leg, especially at the back of the leg below the knee (this is different from the typical ankle swelling on long-haul flights). The pain may be made worse by flexing the foot towards the knee. Symptoms typically develop a week to ten days after the flight. Sharp pains in the chest and shortness of breath may be signs of a pulmonary embolism that can lead to sudden collapse.

Preventive measures include the following:
1. Take a low-dose aspirin before the flight (unless contra-indicated).
2. Wear compression stockings and loose clothing.
3. Avoid leg discomfort during the flight.
4. Avoid clogging up the space under the seat in front of you with lots of carry-on baggage.
5. Unless you can stretch out fully, take only short periods of sleep and do not use sleeping pills during the flight.
6. Move around in your seat and in the cabin as much as possible.
7. Exercise your calf muscles for a few minutes every half hour by flexing and rotating your feet.
8. Drink lots of water, and avoid excess alcohol and caffeine.


For a good site on the various health risks of travel, go to: http://www.travel-medicine.info.