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Travel Travails (Not) of a Sleep Doctor

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Business people and vacationers alike know well the bipolar nature of travel across time zones. You hope to get much accomplished, see the world, have an adventure or just relax, but struggle to cope with your body adjusting to a different time zone. The test of our bodies' coping mechanism starts with travel even within the U.S., with a three-hour time difference between the coasts. Many frequent travelers figure out their own ways of dealing with it while others quietly suffer.

While I am writing this blog post, I am on the last leg of my journey across the globe taking me from the U.S. west coast to Europe and then to South Asia, 12 hours ahead, stopping briefly enough along the way so that my internal body clock never got a chance to adjust completely before moving on; then all the way back in eight days. I wonder if Jules Verne ever thought of the challenges of time zone change when writing Around the World in Eighty Days'?

Some of my friends commented on a picture I posted on my Facebook page from the wonderful Riva Hotel on Lake Constance in Southern Germany. "He tells others to sleep better. Look how sleep deprived he seems now!"

Thankfully, the problem was only with the quality of the self-portrait taken picture on my phone, and gladly, I am one of those few people who do at least try to follow the advice I give others. I felt fantastic and slept very well in spite of my friends' jealous wishes.

So here are some points for travelers to follow. My disclaimer: Like everything else in medicine these are general rules and you have to decide what really works for you.

1. Don't worry about sleeping but plan for it. Knowledge of your body is power. Worry messes up sleep.

2. Naps can be your best friend. Thirty minutes or less works best. Longer naps reset the built-in stopwatch in your brain making it harder to fall asleep later. Some people report surviving without regular sleep and with scheduled 30-minute naps for weeks.

3. Caffeine can be your next best friend while traveling across time zones. Utilize your friendship judiciously.

4. Melatonin was made for this purpose. Buy a major brand. No one needs more than 3 mg. Any additional supplements such as calming agents or vitamins may help but are not necessary. Starting with the first leg of your journey, if traveling from west to east, which is the hardest for the body to adapt to, take melatonin 8 to 10 hours after your "natural waking up time at home," not the time you woke up that day to catch the flight. Time it right. Continue with this routine throughout your travel going east. It will help adapt your circadian clock to the local bedtime.

5. Exercise for 30 minutes in the morning at your destination. Moderate to strenuous exercise helps keep you alert in the new time zone.

6. Plan meetings or tours early in the morning or late in the evening. You are likely to be sleepiest in the mid morning and early afternoon.

7. When having trouble falling asleep at night, do some breathing and stretching exercises or count backwards in coordination with breathing. Body scanning, a technique used in some forms of meditation, works well too.

8. Do not use alcohol to help you fall asleep. It is the worst thing you can do to yourself.

9. Sleep aids such as Benadryl, Ambien, etc., are often used by people and advocated by doctors. I personally don't find them helpful.

10. On the way back, think ahead of the time zone at home and plan to sleep during your flight or stay awake depending on the time of the flight and duration. You should not need to use melatonin on coming back. A body clock readjustment will be needed when you return. Caffeine will help, again, but use judiciously. Allow time for adjustment.

Traveling is fun, and sometimes necessary. Enjoy!

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