Jet lag

You can also try Simply Sleep, which is Tylenol PM without the Tylenol.

HI Richard,

I use gravol. It works quite well and I don't feel groggy when I wake up.

Paula

Gravol is not sold in the U.S under that name. Here, it's known as dramamine.

But you can buy Gravol from an online Canadian pharmacy and have them ship it to the U.S.

Ugh, I hear you Richard. I always wrestle with jetlag and it really sucks. I've tried all the homeopathic stuff, Rx med's, naps, fresh air, you name it but I still get affected by it. I usually cannot sleep on the flight over (uncomfortable and excited/nervous). The last time, I took an ativan and was able to sleep most of the way and arrived feeling fairly refreshed and able to tackle the train from CDG but after a day or two, I was really out of it. I've learned to plan for jetlag when I travel overseas now. Last summer, I wanted to check out Beaune and Dijon and then spend a week in Paris but I built in 3 days in Paris at the beginning of the trip just to get over the jetlag so I could nap if I needed to, wander around and not have any set schedule of things I "had" to see. I just went by how I felt and whatever tickled my fancy at the time, I checked out.

I hope maybe others can share some hints and secrets or some special potion I can take to get over the jetlag :)

I think the timing of your flight has a lot to do with it. We like the flights that depart Seattle in the evening and arrive in europe the next morning. You get a "short night," but we stay up the first day, walking around outside as much as possible to get natural light, and go to bed around 8 pm local time.

My husband (an MD) takes Ambien to sleep on the plane but I don't like sleeping pills. I am one of the lucky ones who usually can sleep on the plane, and I try to as much as possible.

Richard, what you do is what I used to do. That afternoon nap was just unavoidable (though we tried to keep to to about an hour). The next day felt pretty rocky too.

On my last trip, I had only fleeting jet lag. I spent my first day doing lots of sightseeing, including a wine tasting. It was like getting an extra day of vacation!

There is a LOT about this topic posted at this forum, you should search. And, every person is potentially different.

One thing to understand, though, is that jet lag is not lack of sleep but rather a difficulty in adjusting one's circadian clock. Sleeping on the plane is nice but less important than setting that clock. A lot less.

Make sure you test drive any pharmacuticals at home before trying at 40k feet!!

Adam and Tom are correct. Jet lag has nothing to do with lack of sleep, although lack of sleep does produce travel fatigue, which can exacerbate jet lag. The most important thing is to get out in the sunshine. And do it while it is still nighttime at home. Getting out at 4 PM in the afternoon is no help, because your body expects sunlight by that time.

Driving a car while under the influence of jet lag does not seem like a smart thing to do. I've fallen asleep on the train the first day. I'm glad I wasn't driving.

I have found that a short nap (1-2 hrs) before dinner helps to clear my head and make it easier to stay up until their bedtime.

Sleeping on the plane probably won't help that much, because your body still thinks the time is 7-8 hours earlier. There is no quick and easy way to adjust to the new time immediately. Plenty of sunlight will speed the process up a little bit. The medication Provigil (generic modafenil) can also help of reset your clock.

If you just want to sleep on the plane, the two most frequently prescribed medications for this purpose are the sedatives Ambien and Lunesta. Each has its own advantages and disadvantages. Ambien is better if you just need an extra nudge to fall asleep, Lunesta is better if you need something to keep you asleep. Lunesta also imparts an unpleasant taste in your mouth for several hours.

Most over-the-counter sleep aids (Tylenol PM, Nyquil, etc.) contain a sedating antihistamine. Because these can dry you out, I wouldn't recommend these as a first choice, unless you already have sinus congestion problems.

If you are prone to motion sickness, many of the anti-nausea medications are also sedating (phenergan, compazine, dramanine/gravol). However, the downside is that you usually wake up feeling quite groggy for several hours.

Some of the older antidepressants (trazadone, amitriptyline) and antipsychotic medications (seroquel), given in low doses, can also help people sleep.

The most important bits of advice: One, discuss it with your doctor. Two, as another poster mentioned, give it a trial run before you travel, so you know how it will affect you, you know what dose to take and when to time the dose.

Your opinions/comments/suggestions have all been great.

I thank each and every one of you.

Richard

Your 38th trip to Europe! I'm so envious. I also do not sleep on the plane--too excited. My routine upon arrival is exactly like yours. As a previous poster noted, any sleep aid should be tried out beforehand. For me, even Tylenol PM throws me for a loop and I really want to be with it during my flight and upon arrival. By the way, where are you travelling to on this trip? Have fun!

Hi Richard. When I was younger, the shear excitement of going meant I slept very little, if at all. As I got older, I started getting up a earlier each day a few days before I left. I found that it helped my body clock prepare for the time difference. When we landed we then forced ourselves to stay up until our normal bedtime in the time zone we are in. Now, for some reason it seems easier adjusting when flying east. We are flying to Hawaii soon and I find that much harder to adjust to.

I think taking that 2 hour nap might not be the best practice. I too, never, ever sleep on a plane, and though I am tired when I arrive, it is usually better to stay up, perhaps go to bed a little bit earlier. Be outside, go on a walking tour, explore the neighborhood where you are staying.

If you are going to take sleeping medications while flying, then the thought of you getting off that plane and jumping into a car sounds a bit scary to me.

Is it possible for you guys to travel to the UK and Europe in the day time? I have found jet lag is decreased considerably when my flight is in daylight hours. However, we can only achieve this by having an overnight stop eg Singapore.

I set my watch to destination local time at the departure airport. While on the plane, I try to think local time at the destination. Usually after dinner will be a normal bed time, so I take a PM tablet and get some sleep.

I also try to have a physical, outside in the sunlight, day my first day to stay awake and get my blood pumping.

Another technique I've seen recently and will try next time is to take a PM tablet when I go to bed the first night to help avoid being wide awake in the middle of the night.

After that I think I'll be good, even if I'm not completely adjusted for a couple of days.

When I fly to Europe, I typically land in Munich at a time I'm normally asleep. A nap on the plane, perhaps with the help of a light sedative, helps to give me a few hours of extra energy after I land.

My main problem, though, is adjusting to a different circadian rhythm, so I make sure I don't sleep before local bedtime. That's usually not a problem. Then, one hour before going to sleep, I take a ½ to 1 tablet of melatonin to help kick in a sleep cycle. I repeat that for the next few days. Of all the things I've tried that seems to work the best.

Has anyone else tried melatonin to help adjust sleep cycles?

To Richard and Roland:

I have used Melatonin on all my trips to Europe. I take it on the plane, and then the first few nights I am there too (or all of the nights). It's natural; your body produces melatonin to sleep. When you take it orally it just kicks your body into that sleepy phase. The key is to only take half (or a quarter) of the recommended dosage. For some reason if you take the full dose it will kick into sleep cycle, but then I come out of it after four hours and I am wired awake. With the smaller dosage you don't get the rebound effect that so many people hate.

Anyway, it helps get your circadian clock into alignment with the new time zone and it doesn't have side effects like an Rx.

Good luck.

This from Rick on melatonin:

"Other travelers rave about melatonin, a hormone that supposedly helps re-calibrate your internal clock (available over-the-counter in the US, but illegal in some European countries)." (p. 301, Europe Through The Back Door 2009).

Here's a previous discussion thread on melatonin that some may find of interest; it includes posts by the only physician (that I know of) posting regularly on the Helpline:

http://www.ricksteves.com/graffiti/helpline/index.cfm/rurl/topic/35567/how-would-you-best-hande-this-jet-lag.html

I work the graveyard shift, so I take melatonin a few times a year to keep my body clock in check. In some people it does produce side-effects; it always gives me very vivid and intense dreams. Kind of like dreaming in high-definition. But it will knock you out. It's only available without a prescription in the US because of a loophole in the law; in most other countries it is illegal to bring it across the border. Back in the mid-90s there were media reports of Canadian Customs confiscating it from US travelers. But from what I understand it's now available in Canada without a prescription.

http://en.wikipedia.org/wiki/Melatonin#Use_as_medication_or_dietary_supplement

Melatonin is available in US without a prescription-I've bought it for my hubby over the counter and it's available in 1mg or 3mg strengths. I pretty sure we've bought it at Wal Mart before. I just confirmed by checking out Walgreen's website, but it's more expensive there. My husband usually takes a half of a 3mg and it works well for him. Benadryl (Tylenol PM) leaves him in a daze the following day, so melatonin is his sleep-aid of choice. I only take benadryl if I have a cold with stuffiness that I'm trying to overcome. I'm planning on giving the melatonin a trial run before we leave.

Melatonin probably won't work for the indication the initial poster inquired about, ie, trying to stay awake when he arrives to Europe. The clearest benefit it has shown over placebo is in reducing sleep latency in people who's circadian rhythm's are out of sync. In layman's terms, that means it helps you fall asleep when you are already tired but your body's internal clock thinks you should be awake.