Sunday, August 15, 2010

How to Fall Asleep with Jet Lag

What is jet lag or desynchronosis? It is a temporary condition people experience due to crossing several time zones or the earth’s meridians in a short period of time causing the traveler’s sleep/wake cycle to become out of sync creating an almost bipolar condition. The earth’s meridians distinguish geographic position in relation to the earth’s poles defining time zones. Jet lag is a sleep disorder not caused by abnormal sleep problems, but due to your body subjected to external stimuli and local timetables while trying to establish a new sleep/wake pattern in its new location. This adjustment involves the circadian rhythms associated within the body and its ability to learn how to fall asleep with jet lag. Circadian rhythms relate to changes in body function that occur during a 24 hour period. Circadian rhythms not only affect your sleep/wake cycle they also regulate your body temperature, operate gland and hormone, airway and kidney functions.

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As well as feelings of a "tired-wired” or bipolar like symptoms that causes the traveler to experience highs (too excited, can't sleep) and lows (fatigued, sleep problems), other symptoms such as insomnia, restlessness, headaches and irritability also occur with jet lag. Not everyone is affected by jet lag while some may experience the symptoms for a week or more and others can return to their normal sleep pattern after a day or two. The degree of disruption varies greatly among people; some may not be bothered at all. Some symptoms of jet lag are caused by the dry air in the plane, the pressurization, vibrations and even the cramped space one has to stay in for a period of time. These external conditions can cause dry eyes, irritated sinuses, headaches, earaches, muscle cramps and occasionally swollen feet and ankles.

If a change in your body temperature and dry air causes you to have constricted airway passages that occur during your flight your circadian rhythms will be influenced by these environmental conflicts causing you to not be able to function properly during the day let alone regulate your sleep/wake cycle at night. People naturally synchronize their internal clock with day-night cycles that allow them to stay awake during the day and fall asleep easy at night. The body regulates its sleep/wake cycle with daylight as light stimulates the nerves in the eyes that will pass it along to the nerves in the brain that houses the hypothalamus which in turn controls the body’s circadian rhythms thus regulating its 24-hour cycle with the earth’s 24 hour cycle. Sounds like the children’s nursery rhyme The Little House that Jack Built… we go on our natural reoccurring path until we decide to fly across the big pond with its new day and night cycle then our circadian rhythms cannot adjust right away or “lag” in time and that is why it is called jet lag.

Our body organizes its wake time with all the body functions that are best administered during the day and are slow to adapt to external changes like new time zones. One’s ability to readjust their biological clock may take hours to days depending on how many time zones were traveled. There is no specific treatment just many weary travelers that try to adjust to the new time zone as soon as possible. Many travel only during the day if they are heading eastbound as they may arrive at their destination in the middle of the day or early evening and go to bed at a normal time in the new time zone. Westbound travel is easier to adapt to because it is easier to extend one’s day by staying up longer then by shortening one’s day by going to sleep earlier.

The researchers also suggested that around 70 million cases of jet lag occurred in 2007, based on the number of international airplane passengers and those with reported medical cases.  According to some simple behavioral adjustments before, during and after arrival at your destination can help minimize some of the side effects of jet lag.

• Select a flight that allows early evening arrival and stay up until 10 p.m. local time. (If you must sleep during the day, take a short nap in the early afternoon, but no longer than two hours. Set an alarm to be sure not to over sleep.)

• Anticipate the time change for trips by getting up and going to bed earlier several days prior to an eastward trip and later for a westward trip.

• Upon boarding the plane, change your watch to the destination time zone.

• Avoid alcohol or caffeine at least three to four hours before bedtime. Both act as "stimulants" and prevent sleep.

• Upon arrival at a destination, avoid heavy meals (a snack—not chocolate—is okay).

• Avoid any heavy exercise close to bedtime. (Light exercise earlier in the day is fine.)

• Bring earplugs and blindfolds to help dampen noise and block out unwanted light while sleeping.

• Try to get outside in the sunlight whenever possible. Daylight is a powerful stimulant for regulating the biological clock. (Staying indoors worsens jet lag.)

• Contrary to popular belief, the types of foods we eat have no effect on minimizing jet lag.

Stress is another problem that can lead to sleeplessness. Two common travel related stress conditions are the "First Night Effect" and the "On-Call Effect." The first condition occurs when trying to sleep in a new or unfamiliar environment. The second is caused by the nagging worry that something just might wake you up, such as the possibility of a phone ringing, hallway noise or another disruption.

Try these tips on you next trip to help avoid travel-related stress and subsequent sleeplessness.

• Bring elements or objects from home like a picture of the family, favorite pillow, blanket or even a coffee mug) to ease the feeling of being in a new environment.

• Check with the hotel to see if voice mail services are available to guests. Then, whenever possible, have your calls handled by the service.

• Check your room for potential sleep disturbances that may be avoided; e.g., light shining through the drapes, unwanted in-room noise, etc.

• Request two wake-up calls in case you miss the first one.

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There are a number of external conditions you can control and not control when trying to sleep in a new unfamiliar environment. The most common environmental factors that affect our sleep are noise, the bed, temperature or climate, and altitude. Your age and gender also play a part in how we are influenced by these factors. One study found that women are more easily awakened, although deeper sleeper than men, by sonic booms and aircraft noise, while men may be more noise sensitive as they are lighter sleepers. See more information on how men and women sleep on my article on How We Can Sleep Easy.

Even at home we hear the dogs barking, the neighbor’s music and the toilet running as we are trying to fall asleep, however have you experienced the absence of a familiar noise that also kept you awake? Many city dwellers find it hard to fall asleep in the country and vice-versa as our mind is aware of familiar sounds that have gradually been incorporated into our sleep routine even though we are not aware of them until we sleep outside our natural surroundings. Studies show that you can get used to traffic in one weeks time but noises like fire alarms, cat fights, sirens, loud thunder or hearing your name called will wake us up right away every time. Easy listening music, classical music, a fan, air conditioner can often block out the crying baby in the next room or kids jumping on the bed above your head (irks me!) and allows you to fall asleep really fast. Or you can make use of those earplugs you wore on the flight.

Ah the bed….my advice is to always have enough room to turn over whether you are travelling with your partner or not and the bigger the bed the better. As for the bedding you have limited control as I always bring my pillow with me unless I am travelling to a very, very nice hotel or resort as you never know where that pillow has been. If your skin is sensitive to certain detergents or industrial bleach it may be advised to at least take a pillow case with you.

If you can control the temperature in your room it is best to keep the temperature between 65 and 70 degrees unless you are experiencing night sweats then the lower the better for an uninterrupted night’s sleep.

Heading to altitudes of 13,200 feet or more? Diminished oxygen levels and changes in your respiration will take two to three weeks on average for your body to adjust to as these altitudes cause the greatest sleep disruptions.

Sleep aides such as over-the-counter medications, prescription drugs and supplements like melatonin can help alleviate sleep disruptions, but do not resolve the biological imbalance caused by jet lag. They may manage short-term insomnia, but are not recommended for long-term use as prescription drugs and some OTC medications can be addictive and melatonin is not regulated by the FDA. With any sleep aid it is advisable to consult with your primary caretaker before taking it because there may be an interaction with other medication or health issues.

There is another drug to help people cope with jet lag, but has yet to be approved by the FDA and is only available through clinical trials. Tasimelteon has shown significant improvements in all major sleep disturbances for those experiencing transient insomnia or “first-night effect”. Tasimelteon improved sleep efficiency, total sleep time, wake time after sleep onset, latency to sleep onset, and latency to persistent sleep compared with a placebo.

Melatonin itself does not make a practical drug for treating circadian rhythm-associated insomnias because of its pharmacokinetic properties. The pharmacokinetics of tasimelteon deserved closer scrutiny, because of the relatively high doses needed to reduce insomnia. Studies were unable to evaluate daytime side effects such as restlessness and impaired performance often seen with other sleep aides. It will be an added benefit if tasimelteon proves to improve sleep without side effects. Despite the encouraging results, tasimelteon faces an uncertain future and is still facing additional clinic trails on how to fall asleep with jet lag before it is approved by the FDA.

The content provided is for information purposes only, intended to raise the awareness of different solutions for sleep problems and should not be considered medical advice. For medical diagnosis and treatment, please see your qualified health-care professional.
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