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Beating the clock

Published: 01/05/2006 - Filed under: Features » Lifestyle » Fit to Fly / Wellness » Archive » 2006 » May 2006 » Lifestyle »

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Every business traveller has felt it: that fuzzy-headed sensation as you lose the thread of a meeting you had to cross continents to attend. Then, that night, after a short sleep, you're staring at the ceiling of your hotel room because your body thinks it's lunchtime. Most business travellers regard jet lag as an unavoidable part of life. From experience, the only proven remedy is listening to other travellers talk about it – sleep normally follows pretty quickly. But how does jet lag affect our performance at work and does it have any effect on our health?

It is well known that sleep deprivation can impair both judgment and performance. One interesting statistic has it that US baseball teams playing homes games scored 1.24 more runs than usual when their visitors had taken long flights eastwards to reach the match. Business travellers, while not required to hit home runs, are compromised in other ways. Sleep loss and disruption to our body clocks can reduce communication skills by 30 per cent, memory by 20 per cent and decision making by up to 50 per cent, according to British Airways.

As a result, it's not surprising that we turn to our favourite stimulants for comfort. Research by Hilton Hotels in conjunction with Alertness Solutions, a Californian sleep consultancy, found that business travellers drink 30 per cent more alcohol and 14 per cent more coffee while away – a classic example of giving with one hand and taking with the other.

Most of us seem to rely on caffeine, alcohol and little else to combat jet lag. In a survey on businesstraveller.com, 58 per cent of respondents said they didn't use any jet lag remedies, and many of the travelling executives who spoke to Business Traveller about jet lag (see page 63) seem to live by several pieces of advice. They include setting your watch to the destination time as soon as you step on the plane, drinking plenty of water, trying to sleep in-flight, using the hotel gym when you arrive, and resisting the urge to nap before bedtime at your destination.

The big sleep

But are we taking jet lag seriously enough? According to Professor Jim Horne of the Sleep Research Centre in Loughborough, who has just published a book containing jet lag advice called Sleep Faring: A Journey Through the Science of Sleep, it can affect us more than we realise.

He says: "Your abilities to make decisions, to absorb large amounts of information and to make plans are all affected by sleep loss. One big problem is that people who go abroad don't give themselves sufficient time to adapt. A lot of flights are at night, you may only have had a couple of hours' sleep and you're expected to go to work and make decisions. It's counter-productive – you may be saving on hotel costs but your brain hasn't recovered adequately and, at a very high level, it might cost your company millions."

Dr Chris Idzikowski of the Edinburgh Sleep Centre believes more effort needs to be put into educating air travellers about the effects of jet lag. His research with BA suggests many passengers treat jet lag as though it were all in the mind. This is not the case, he says. "The mind over matter approach to jet lag is as effective as a mind over matter approach to excessive alcohol consumption – that is, it doesn't work."

The good news for experienced business travellers is that those who couldn't handle the jet lag would have weeded themselves out of such a career long ago – what Idzikowski calls the "survivor effect" – but that's not to say that those that remain are immune. Idzikowski emphasises the importance of "body clock awareness" – that is, working out when to avoid scheduling your meetings to avoid your periods of maximum tiredness. Sleep is influenced by a 24-hour (or circadian) biological clock which controls our natural cycle of sleepiness and wakefulness as well as other body functions such as digestion, body temperature and excretion. The clock sets itself using external cues including light, sleep, exercise, eating, drinking and social interaction. Depositing yourself rapidly into a new time zone leaves your clock behind and it needs time to catch up – it takes approximately one day to recover for every time zone crossed.

Says Idzikowski: "Maximum sleepiness occurs at 4am and from that time onwards alertness gradually increases until 10pm and then plummets again. So if you have a meeting at between 3-5am, home time, that's the worst possible time to have it."

Don't say you haven't been warned. But this means if you're in, for example, Tokyo you'll be at your most inefficient between noon and 2pm, which is an inconvenient time to feel the urge to curl up in a darkened room.

Helping yourself

So how do you stay awake for those few hours that might really count? The low-tech method is to try and be well rested before you travel and then to try to sleep as much as possible en route. Idzikowski says: "If someone can accumulate enough sleep they'll still be able to overcome jet lag – so if you can manage your sleep, even if it's at the wrong time, you'll be able to manage your business performance."

Some travellers use sleeping pills to sleep in-flight, but they may leave you feeling groggy, and lying immobile for several hours can increase your risk of deep-vein thrombosis (see page 64). Dr Adrian Williams of St Thomas' Hospital Sleep Disorders Centre believes they can be helpful in small doses: "They don't produce normal sleep, but you perhaps don't get that on a plane anyway. But if you really need to sleep they can help."

Then there's melatonin, a hormone secreted naturally by the pineal gland in the brain. As melatonin levels rise at night and tail off in the day, many sleep researchers believe it is connected with the sleep mechanism. In drug form, melatonin is not approved by the FDA in the US but is sold as a nutritional supplement; in Europe you have to be prescribed the drug by your GP.

Melatonin is viewed by some as a wonder drug for jet lag. Business travellers we spoke to gave a mixed response (see opposite). Andrew Solum, UK-based outsource travel manager and frequent flyer, says he uses it on journeys with large time changes, such as Hong Kong, Tokyo or California: "If I wake up at 3am and have a meeting at 9am, Ambien [a sleeping pill] knocks me out for six hours exactly so I can't use that. So instead I take melatonin. It gives me a gentle push back to sleep. I see a lot of people in the departure lounge taking a tablet before they get on board."

But in February a review in the British Medical Journal pronounced that melatonin does not help jet lag sufferers. Researchers at the University of Alberta examined studies of more than 500 patients with secondary sleep problems, including jet lag sufferers, and found the latter showed no improvement at all with melatonin – either in the amount of sleep or the time taken to nod off.

There has been much debate since this study. Dr Adrian Williams says: "It surprised many of us, but the studies that were reviewed were small and not particularly well done. Those of us using it in the sleep field strongly believe it is useful in the field of circadian sleep disorders, which includes jet lag."

As melatonin is an unregulated drug, travellers may not be taking an effective dosage. Idzikowski says: "One thing I say to people is if you take melatonin and it doesn't work then try reducing the dose – sometimes you are swamping the internal clock. If you reduce the dose you might just catch the effect you're after."

Most importantly, melatonin must be taken at the right time to have the desired effect. The body's natural secretion of melatonin reaches a maximum level at around 4am or 5am, called the "circadian zero point". Taking melatonin at different times relative to this point has very different effects – and if you take it at the wrong time it can make matters worse.

Says Williams: "It has a slightly soporific effect when taken in the evening but not, apparently, if taken in the morning." The theory goes that if you take melatonin a few hours before your natural melatonin secretion begins (ie: around dusk, as secretion begins at night) it shortens your day – that is, it makes you feel ready for bed. If you take it after that point, say at 6am, it has the opposite effect and helps you stay up for longer.
Many people therefore recommend a low dose (0.5mg) in the morning before travelling west, to delay your body clock and help to bring it into line with local time. When heading east you should take it at local bedtime to bring your clock forward.

Thinking ahead

If you prefer to avoid pill-popping, another possibility is to prepare in advance by changing your sleep patterns. For example, several days before flying to Asia you should begin going to bed and rising earlier and earlier so that the time zone jump is less of a shock. A similar principle is the Anti-Jet-Lag Diet devised by the Argonne National Laboratory in Chicago, which coordinates eating, rest and exercise into a pattern that, it is claimed, will speed up your adjustment to a new schedule. It involves alternate days of moderate "feasting" and "fasting" for three days before you fly, with high-protein meals for breakfast and lunch to keep the body alert, followed by a high carbohydrate evening meal, which helps the body to produce chemicals that encourage sleep.

This sort of approach may be helpful if you can find the time in your schedule but, as business traveller Daniela Chandler, sales and training manager, puts it: "With the amount of travelling I do, if I did spend days in advance doing special diets and adjusting my bedtime schedule, I would be out of sync permanently."

Even having to plan one day in advance can be too much, says Andrew Solum: "The night before I go away I'm up until midnight working or out at the theatre. Why would I want to curb my lifestyle in terms of missing a dinner with friends because I'm getting ready for jet lag?"

Seeing the light

Pills only treat the symptoms and advance planning is not always practical – so is there an alternative? According to sleep experts, it's light. In itself this isn't new – traditional advice used to be give yourself a dose of sunlight as soon as you step off the plane – but it's more subtle than that. Light receptors in the eye are directly linked to the 20,000-odd nerves in the brain that constitute the biological clock, and scientists believe seeking and avoiding light at the right times can speed up the resetting of the clock. Like melatonin, seeking light at the wrong time can do more harm than good.

By exposing yourself to light just before your zero point (4am) you can fool it into thinking this point is occurring later, thus speeding it up to be more in line with your new destination. With this approach, instead of taking one day to recover for each time zone you can shift your clock up to three hours forward in one day.

Jet lag "calculators" can do the sums for you. Idzikowski has devised one at ba.com/jetlag, into which you enter the time difference and your usual wake-up time, and it does the rest. For example, for a trip from London to Tokyo it recommends seeking light on the first day from 11am-1.30pm and avoiding it from 1.30pm-4pm. As Tokyo is nine hours ahead, you are seeking light when your body clock is most sluggish – that is, 2am-4.30am London time – and following this with a period of darkness to yank it forward. The jet lag advisor also gives you the times to seek light on the second day, by which time you should have shifted your clock forward up to six hours.

You might wonder how you can explain having to slip out of your meeting at 11am to "reset your clock". Fortunately it is now thought that even slipping on a pair of sunglasses at the appropriate time can block out enough light to be effective. And if it's dark when you need light, well just switch on the bedside lamp.

Melatonin and light together could be even better. In November, researchers at the Rush University Medical Center in Chicago found that both melatonin and bright light shifted the biological clock further forward than light alone. They recommend that business travellers, before flying east, should go to bed and wake up earlier each day while using the light box in the morning and taking melatonin in the evening, saying: "If they did this for the number of days equivalent to the time zones crossed then they should be completely adjusted to the new time zone before they fly." Again, this requires forward planning, which won't suit everybody's schedule or personality.

Chris Idzikowski plans to look at how other factors affect jet lag. He believes pressurisation inside aircraft affects the biological clock and hopes to convince airlines to experiment more with lighting; the clock may be more sensitive to blue light, which airlines and lounges could use at certain times to aid jet-lagged passengers.

Many business travellers have clearly found their own ways of coping with jet lag, and there's no knocking the tried and tested strategies of hardened frequent flyers. But it's just possible that light, melatonin, or a combination thereof, could make your travelling life easier. Time to dig out those dark glasses.

Need some help nodding off?

AIRLINES

Some airlines take jet lag more seriously than others. Gulf Air recently calculated that business travellers function 27 per cent better after a good night's sleep, saving their companies about £1.7 billion.

On some lucrative business routes, airlines offer special services to maximise sleep. BA and Virgin Atlantic serve full meals in their lounges at New York JFK so that passengers can go straight to sleep on their flatbed seats once en route to London.

Some airlines use their lighting systems. Emirates introduced "mood" lighting on its Airbus A340-500s and Boeing 777-300ERs; the lights change slowly from sunshine to dusk, followed by night-time — complete with an image of a starry night. Boeing has also announced plans to introduce innovative lighting on its aircraft that will be sympathetic to passengers' body clocks.

HOTELS

Many hotels offer spa treatments aimed at relieving jet lag; 12 per cent of business travellers who completed our online survey said they use massage as a jet lag remedy. The Oriental Bangkok has a jet lag massage for 60/90 minutes (US$75/100), intended to stimulate and invigorate. Intercontinental Pudong Shanghai's I-Spa offers a jet lag revival treatment (90 minutes for RMB900), which includes an aromatherapy massage and express facial.

Some hotels, such as the Steigenberger Airport Hotel Frankfurt, offer "early bird" check-in for early arrivals who desperately need to sleep. The Okura Hotel in Amsterdam has gone even further by developing an entire jet lag programme. Guests can borrow a light box from reception, and are advised to exercise in the health centre on arrival, as well as eating a high-protein breakfast followed by a high-carbohydrate dinner.

Crowne Plaza Hotels & Resorts in the US offers a Sleep Advantage programme. Guests are allocated to a "quiet zone", guaranteed to be far from the elevators, ice machines and rowdy groups. They also receive a sleep kit with ear plugs and eye mask, plus a sleep CD and a guaranteed wake-up call (if it fails you get a refund).

What you said about...

Melatonin

• I used to use melatonin but I can't any more — it gives me nightmares. Paul Massot, director of hotel development

• I have tried melatonin and it doesn't help me that much, but I could always sleep on long-haul flights anyway. Brenton Mauriello, director of international business development

• In the past I've tried melatonin, but only because it knocks me out fairly fast. I've also noticed that there can be a bit of a drowsy hangover effect with it, so I tend not to use it much these days. Patrick Lodge, trend analyst

Exercise

• For me it's exercise — a really intense workout is the ideal way to get over jet lag. It's the last thing you feel like doing but if you get through the first 20 minutes you'll notice the difference. PM

• Whenever I get anywhere I always make use of the spa/gym as it both relaxes you and helps make you tired if you need it, and freshens you up when you first arrive. Tony Mather, IT

Spa treatments

• Massage doesn't really help with jet lag, it only makes you feel good. BM

• It's important to rest, relax with a massage and have time to acclimatise before meetings start, otherwise jet lag can be hell. Kathleen Curran, sales and marketing director

Sleeping pills

• I don't like the thought of sleeping pills — if you have to start taking such pills for work, then you're in the wrong work. BM

• Valerian [a herbal drug] seems to have the right sedative effect without the thick head after a few hours' sleep. PL

• I have tried herbal sleeping tablets. I don't want to take more powerful medicaton, but feel that natural remedies do help. TM

• If I know my schedule is really tight when I land and it is imperative that I sleep, I will take a quarter of a sleeping tablet. Daniela Chandler, sales and training manager

Just say no

• You need the security to admit you're not superman. Business people have this image of how to behave, and not admitting you need to get a bit of kip is part of that. Laurie Young, author and consultant

• On business trips, don't be afraid to say no to entertaining. Many companies feel obliged to take you out every night, but on occasion you need to say no and be firm about your schedule. Oliver Johnson, chief executive

Preparing in advance

• When I am travelling east, I try to get myself into the destination time zone the day before. This usually involves limiting my sleep to 4-5 hours the night before and on the flight, so that I feel tired on arrival. Chris Walker, channel development manager

• Who's got the time? I think you just have to be sensible. LY

Short-haul can be worse

• With shorter flights you're expected to be on top form, but do three or four such time changes in a week and you end up having slept for only four hours a day for, say, five days in a row. BM

• It can be as stressful going on a European trip. You have to leave at 4am and then have a meeting all day in a stuffy room, and then get home at about 11pm. That can be just as stressful and damaging as an international trip — I no longer do European trips in a day. LY

Hotels

• Hotels should be flexible and offer 24/7 room service, 24/7 fitness and early, special check-in. Jet lag is very personal and guests have to do what it takes to adjust, but hotels need to be able to respond to special demands and requests. Chip Stuckmeyer, senior director, sales and marketing strategy

• It's nice to be given a quiet room and offered eye masks and ear plugs to block out light and noise. OJ

Stay hydrated

• Before I fly long-haul I increase the amount of water I drink. I ensure that I drink two litres each day for a week before I fly. Steve Waller, sales and marketing director

• Drinking water is crucial before, during and after the flight. Dehydration tends to make you feel tired and sluggish. Wendy Walker, PR

General survival

• I don't really think about where I've come from — I'm just in the moment. And I sleep pretty well on the plane. Alcohol helps, of course. Chris Barnard, lawyer

• I'm a huge believer in naps. I take 20-minute naps and set the alarm on my phone — you can just go out cold for 20 minutes and it's like resetting a computer. Andrew Solum, outsource travel manager

• I try and nap on the flight and then tough out the first jet-lagged day without a nap. Melissa Micallef, marketing communications

• If you're flying west you need to keep going all day — even if it's 4 or 5 in the morning you need to keep going until after 10 in the evening. PM

• The best antidote I found was a trip to the zoo, as it involves fresh air and plenty to keep your senses stimulated. Failing that, a brisk walk followed by as much sleep as you need, and work from home the following day. Teresa Fearis, Partner Manager, SHL UK

...or find a new career

• I'd be happy to be done with it all if I was having real sleep problems due to jet lag... PL

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