Advertisement

New weapons in travelers’ round-the-clock jet-lag fight

Share
Special to The Times

A new generation of sleeping pills, approved to combat insomnia, is helping travelers find relief from jet lag by helping them sleep when needed.

Three new sleeping pills, Ambien, Lunesta and Sonata, have fewer and less-severe adverse effects, such as lingering sleepiness during the day and dependence. That may be because the drugs stay in the body for briefer periods than the older pills such as Dalmane (flurazepam) and Restoril (temazepam), among others, according to a 2005 National Institutes of Health consensus panel on insomnia.

(There have been recent reports that Ambien caused some users to sleepwalk or even sleep-drive, although its manufacturer, Sanofi-Aventis, says such events are rare.)

Advertisement

Although the U.S. Food and Drug Administration has not approved these sleeping pills to counteract jet lag, such “off-label use” is a common and legal practice when evidence or observation suggests a medication can work for another purpose.

Jet lag is a frequent complaint among the patients of Dr. Terri Rock, a travel medicine specialist in Santa Monica. When prescribing one of the newer sleeping pills, she takes into account a traveler’s sleeping schedule. “Ambien (zolpidem tartrate) gets you seven or eight hours of sleep,” she says. “Lunesta (eszopiclone) provides seven or eight hours. Sonata (zaleplon) is better when a person has limited time to sleep, say five or six hours.”

She instructs travelers on a long flight to take the sleeping pill after they arrive, at bedtime at their destination. “A lot of travelers will take it on the flight, but you are supposed to get up and move around during an eight-hour flight [to prevent circulation problems and blood clots],” she says. Unless of course you are lucky enough to be flying in business or first-class seats that convert to beds.

Jet lag, which affects millions each year, according to the National Sleep Foundation, is the result of a disruption of normal circadian or body clock rhythm that occurs after travel across time zones. Its symptoms include poor nighttime sleep, fatigue, irritability, increased sleepiness during the day and gastrointestinal problems.

Another strategy works on changing circadian rhythms, but takes a more natural approach by combining melatonin and light-box therapy as you shift your bedtime and wake-up time, says Charmane Eastman, director of the Biological Rhythms Research Lab at Rush University Medical Center in Chicago.

Melatonin, available over the counter, helps regulate a body’s circadian rhythms. Jet lag can be prevented entirely, Eastman believes, by shifting rhythms before the flight.

Advertisement

Here’s how: If you are flying from Los Angeles to London, start three days or more before your departure, Eastman says, and take a low dose of melatonin about five hours before your usual fall-asleep time. “We used .5 milligrams. A bigger dose can make you sleepy.”

On the first day, go to bed one hour earlier and wake up one hour earlier than you normally do. On the second day, go to bed an hour earlier than you did the night before and get up an hour earlier than you did the day before.

“Every day go to bed one hour earlier and wake up one hour earlier,” she says.

“In the morning, use a light box, the sooner the better after waking up,” she says. Light boxes, widely used to treat people with seasonal affective disorder, or the “winter blues,” are sold online starting at about $175.

Try to use the light box intermittently for the three hours after awakening, Eastman says, and “if it happens to be light outside, that’s even better than the light box.”

Squeezing in a shower, breakfast or other morning rituals is OK, she says.

“All of this pushes your body clock earlier,” she says.

In her lab, Eastman tried this strategy on 44 men and women, ages 19 to 45, reporting the results in the January issue of the Journal of Clinical Endocrinology & Metabolism. Subjects were given either a .5-milligram dose, a 3-milligram dose or a placebo tablet. The melatonin doses reset the body clock about equally, but the larger dose made people sleepier.

“This [strategy] is not about using melatonin as a sleeping pill; this is about using it to reset the body clock.”

Advertisement

She says this therapy is more effective when traveling west to east than in the reverse direction, because west to east jet lag is typically worse.

*

Healthy Traveler appears every other week. Kathleen Doheny can be reached at kathleendoheny@earthlink.net.

Advertisement