Odler Robert Jeanlouie, MD

Why are you that snappy with the cab driver for not picking your bag?  Finally you are on your way home from the airport, after a long- haul trip, why are you so irritable? You should be elated. For the next few days, you are nervous, exhausted, short-tempered and unable to concentrate.  Your sleep is fractionated, meaning you sleep a few hours, then wake up in the middle of the night, unable to fall asleep again.  You have to pee when everyone is asleep.  The next day, you feel so tired at work that you want to hide under your desk for a snooze a la George Constanza. Your energy is gone, so is your sexual drive. Your mouth is dry, your appetite is either poor or subjected to untimely feeding binges. This sounds pretty much like endogenous depression or an anxiety syndrome.  Fortunately, it is not.  It is only jet lag, a syndrome that plagues 96% of long-distance travelers (as per the 1994 New Zealand study of flight attendants). It will go away.  When?  According to NASA, it takes one day per time zone crossed to reset your body clock and get you out of the slump.  Others contend it takes one day per hour of time difference between your point of origin and your destination (18 hours between New Zealand and New York, 18 days to get rid of jet lag!) Jet lag is worse when you travel eastbound (e.g. New York to Paris) than when you travel westbound (e.g. New York to Los Angeles). Long-distance travel per se, though a cause for tiredness, does not cause the panoply of jet lag symptoms. Going through time zones is the root of the problem.  This implies you will be far sicker after a six-hour hop to London from New York, than after a ten-hour trip to Rio.  The former is a West-East flight over five time zones, the latter a North-South getaway involving only two time zones. How do you prevent jet lag?  That is the question. The lay and medical literatures propose an assortment of difficult, invalid or untested solutions. Sleeping comfortably the nights before the long trip is almost an oxymoron.  At destination, eating, dining and sleeping at home time is not feasible either.  Nevertheless, alcohol, coffee, tea, and other stimulants seem to worsen the problem; they should henceforth be avoided. Multivitamins, so-called time-zone diets, and a number of other fads are recommended, but none has been proven to make a difference in comparative studies. The most popular remedy is melatonin.   This substance, natural to the human body, found at higher blood concentration during sleep, seems to improve the ills of jet lag, when taken daily starting one or two nights before departure until after the return trip. Melatonin can be bought over the counter.  At what dose should it be taken?  No one is sure.  Users take an average of 1 to 5 mg a day. If you take it, be aware that melatonin bears its own side effects such as shrinking of your gonads (testes and ovaries), with whatever consequences may ensue…. (The Traveller, Monday, December 10. 2001)

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