By Virginia Gurley, MD, MPH

MB (Marc Braman, MD, MPH):
Our topic this session, in Sleep 201, “Lifestyle Prescriptions for Reducing Jet Lag”. Welcome back, Dr. Gurley. Let’s jump right in here.
So, jet lag is such a drag. I mean, you feel like you are in a fog. Can you walk us through a lifestyle medicine prescription for minimizing jet lag?

VG (Virginia Gurley, MD, MPH):
Sure, well, so there are two main factors that determine what you can do to reduce the effects of multi-time zone travel. The first is the direction of your travel, like are you traveling to a time zone to the east, which means you need to advance your body’s clock by shifting it forward, or are you traveling to a time zone to the west of your home, which means you need to delay your body’s clock by shifting it backward.

MB:
So, in other words, it’s a matter of whether I am traveling with the sun, in the same direction, or whether am I going against the sun. What is the other main factor?

VG:
The second major factor is what’s called your “chronotype” which is a fancy word for whether you tend to wake up early, or whether you tend to stay up late. So, early risers are often referred to as “larks” and those that tend to stay up late are often called “owls.” Early risers, or larks, often have an easier time traveling eastward, and really struggle to shift their bedtime later when they’re travel west. And for owls, the late night folks, they usually tend to have any easier time traveling westward, but really struggle to shift their wakeup time earlier when they travel eastward.

MB:
Ok, so chronotype is whether you’re a morning person or a night person. Let’s say I am traveling East or going against the direction of the sun – what lifestyle treatment can I use for jet lag?

VG:
If you are traveling eastward, and especially if you are an owl like a night person, you will adjust to your new time zone much faster if you can get up like an hour earlier each day for the 2 to 3 days before your trip, and eat breakfast as soon as possible after you wake up, like no more than 30 minutes after you wake up. Then on the day of travel do not eat anything after your destination’s dinner time, and then eat breakfast at the appropriate time when you arrive at your destination. This helps shift your internal food clock, which seems to be the main driver for adjusting to a new wake-up time. Also, getting plenty of bright morning light will help you with this shift too.

MB:
Excellent, and if I am traveling West or going with the sun, what lifestyle treatment can I use?

VG:
Yeah, if you are traveling westward, and especially if you are a lark, you will adjust to your new time zone much faster if on the day of travel and for the first 2 or 3 days after you arrive, you get lots of late afternoon and evening sunlight and bright indoor light until about 60 minutes before your new bedtime. This helps delay and shift the time when your body starts releasing the sleep hormone called melatonin so you can stay awake until its the bedtime in your new time zone. And also eating dinner later at night in your new time zone can help with this shift too.

MB:
Great. What about really big shifts in time zones, like last summer we went from Portland Oregon to Munich Germany, you know, in one trip. That was kind of rough. What lifestyle medicine could I have used to treat my poor confused brain and body?

VG:
Yeah, really big time zone shifts, like when you travel to a new time zone that is eight or more hours different from home, it’s interesting, some people’s internal clock will adjust by advancing, while some people’s internal clock will adjust by delaying. So far, researchers haven’t really figured out how to predict who will adjust by advancing their clocks and who will adjust by delaying their clocks. But if you’re a lark focusing on using light to shift your bedtime is likely to be most helpful since staying awake later is often the problem for larks, and if you are an owl, focusing on using breakfast to shift your wake-up time is likely to be most helpful.

MB:
Excellent, very useful, doable options for managing jet lag. So we, essentially, want to use the part of our day that is the most challenging for us to best manage our sleep cycle. So, if we’re a morning person, we want to manage our evening to sync with nature for our new time zone. And, if we are a night person, we want to manage our morning intelligently.
So, there is your prescription for treating the causes of jet lag with lifestyle medicine. Sweet dreams in your new time zone!

How to Trick Mother Nature into Letting You Fly Around or Stay Up All Night. Revell V, Eastman CI. Journal of Biological Rhythms. 2005;20(4):353-365. doi:10.1177/0748730405277233.

Nutrients, Clock Genes, and Chrononutrition. Like H, Oishi K, Kobori M. Curr Nutr Rep. 2014; 3:204-212. doi:10.1007/s13668-014-0082-6.

Identifying some determinants of “jet lag” and its symptoms: a study of athletes and other travellers. Waterhouse J, Edwards B, Nevill A, et al. Br J Sports Med. 2002. 36:54-60, doi:10.1136/bjsm.36.1.54.

Virginia Gurley, MD, MPH

Dr. Gurley is Founder and President of AuraViva, a health education organization dedicated to increasing accessibility and efficacy of healthy lifestyle strategies. She has over 25 years experience designing and implementing health promotion and disease prevention programs and has served 15 years in physician executive positions. She is faculty at the American College of Lifestyle Medicine and member of American Academy of Sleep Medicine.

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