Long Day's Journey in Flight

Melatonin, light therapy, even caffeine—everyone, it seems, has a theory about how best to conquer jet lag. Amy Young investigates what really works.

Don't ask me about Melbourne. I have fond memories of the place, certainly, but my travel diary is of no help as far as specifics are concerned. About Donovan's, the big beach house of a restaurant in St. Kilda, I simply noted the "delicious soufflé the size of cat." About the lovely Fitzroy Gardens I scrawled: "Saw many trees and bats hanging on the frrrrrjrkels.…"

Jet lag was to blame. The 15-hour time difference left me too incapacitated to drink in the finer points of the city or record them properly. By the time I felt alert again I had moved on to Palm Cove and Sydney, then home, at which point I was out of sorts again.

"You're still not over it?" a friend asked, in the same impatient tone one might reserve for a graduate student who never gets around to finishing her doctoral thesis. I tried to explain myself, but I was just too tired. For anyone who hasn't recently traveled across many time zones, the level of exhaustion that hits in the middle of the day is hard to fathom.

Michael Smolensky, Ph.D., whose research and lecturing duties have taken him from Hawaii to Brazil to Texas in the course of one week, understands. "Our circadian rhythms support maximum alertness and energy efficiency during the day, and promote rest and rejuvenation during sleep," he tells me. "After flying over multiple time zones, we're displaced in time. At the destination, the twenty-four-hour cycle of environmental and social demands on the body is much different than at home, and our biological time structure is unsynchronized and scrambled."

Unsynchronized. Scrambled. No wonder I felt obtuse, irascible. At its best, the human body works like a well-oiled machine—but it's a machine that runs, literally, like clockwork. It's no coincidence, says Smolensky, an environmental physiologist at the University of Texas School of Public Health, in Houston, and coauthor of The Body Clock Guide to Better Health (Henry Holt), that we feel alert late in the morning and, as anyone who's pulled an all-nighter knows, helplessly brain dead around 4 a.m. Amount of sleep is a factor, of course, but so is what time we sleep.

The fact that few realize this worries Smolensky. Of the millions of people who travel around the globe each day, traipsing across time zones, some are undoubtedly driving cars or flying airplanes—not to mention making multimillion-dollar decisions. Little do they know that they're functioning under suboptimal mental and physical conditions. Though wireless technologies, speedier modes of transportation, and Palm-compatible guidebooks may have brought the ends of the earth closer together, jet lag prevents us from working up to our full potential.

The fringe of the health and beauty business would have you believe that the solution to this problem can be had in a big brown-speckled pill, an aromatherapeutic massage, or a hot bath [see sidebar below]. Airlines and hotels will convince you that for an extra few hundred dollars or so jet lag can be avoided—with more legroom, a wider choice of beverages, or an in-room butler. But this is a fallacy. The answer lies not in first-class lounge but in laboratory incubators, populated by not-so-pleasant organisms like fruit flies, mice, or bread mold. It's here that, in recent years, scientists have finally been abl to make real inroads into the study of chronobiology—the science of what makes things tick.

To appreciate the work of chronobiologists, one must comprehend what jet lag actually is and what it is not. Michael W. Young, Ph.D., who heads the laboratory of genetics at The Rockefeller University in New York City, set me straight on this matter: Jet lag is not simply a mental condition. While high altitudes, dry air, or stress may seem to exacerbate jet lag, these factors do not cause it. Jet lag, in fact, is very much a physical condition—a result of all our biological clocks going haywire, not just the one in our brain.

Yes, it turns out that we have more than one biological clock—and each is situated in various tissues throughout the body. The master clock sits in the suprachiasmatic nucleus (SCN), which consists o a bundle of nerve cells in an area of th brain known as the hypothalamus. It governs our sleep-wake cycles and synchronizes the timing of subsidiary clocks that control other biological functions, such as digestion and shifts in hormones.

When we wake, sunlight (many times more powerful than fluorescent bulbs or desk lamps) signals the SCN to trigger a complex series of molecular reactions that set our circadian clock. In the morning, for example, the SCN ensures that hormones such as adrenaline and cortisol are released in abundance, helping us stay alert. When the master clock shifts (as it does when we travel across time zones), the subordinate clocks (in the heart, kidneys, liver, and stomach, for instance) shift too—but there is a lag time. In some cases, Young tells me, it takes days before a clock resynchronizes itself.

Days? This to me was a revelation. This, after all, finally explained why the fish and chips I happily devoured at Doyles sat in my stomach like bricks for hours on end. And why, even when I was able to fall asleep at a decent hour at the tail end of my trip, I had to run to the bathroom throughout the night. Says Young: "The physical malaise we feel when we travel reflects a desynchronizing of all the clocks that reside in our tissues."

Researchers like Young are working to find a way that travelers can dispense with this malaise as easily as resetting their wristwatches. By manipulating the level of proteins that operate our biological clocks, scientists hope to eradicate the exhaustion we feel in a new time zone, and even provide relief for sufferers of other clock-related conditions, like Seasonal Affective Disorder and shift-work fatigue.

Only recently have scientists made real inroads in sequencing these proteins, a well as discovering new ones. In May 1998, scientists at the University of North Carolina at Chapel Hill realized that the pigments in the retina that synchronize our circadian clocks are not necessarily the same ones that are responsible for vision. No too long after that, at the National Institutes of Health, two teams of scientists determined the structure of the "melatonin rhythm enzyme" (arylalkylamine N-acetyl transferase). This enzyme controls levels of the hormone melatonin, which regulate the body's internal clock.

At Rockefeller, Young's population o perpetually jet-lagged fruit flies has also provided some intriguing clues. These flies are forever traveling between two incubators, one marked San Francisco and th other New York, each of which is lit and dimmed as the sun rises and sets in its corresponding city. By tracking the activity of the so-called clock proteins in these flies, Young has gleaned information about the molecular processes that take place when their day and night cues change. Most notably he shed light on "double time," a protein that seems to control the ticking of biological clocks in most animals, including humans.

Such basic science work may be too abstract to grab headlines (somehow, cloned sheep make for a sexier story than a sequenced protein). But these discoveries may provide the crucial groundwork for creating a new generation of drugs more potent than caffeine and more reliable than sleeping pills.

It will be years before we can pack those magic pills along with our passports an airplane tickets, however. In the meantime, Smolensky tells me that light therapy may be one of the best bets. Just as the term suggests, this technique consists of being exposed to a brilliant light (as bright as the light on a sunny day) at specific times to rapidly reset your clock to the new environment. Light boxes used to be th only source for therapeutic light, but more portable (although some say less effective) light visors are currently available. Earl this summer, psychedelic-looking light glasses called Somnavue, which (according to their manufacturer, Enlightened Technologies Associates) mimic the hues of an actual dawn, will hit the market.

"Light therapy is useful," agrees Young, who prefers to raise his shades when his flight nears his destination (even though flight attendants often ask passengers t pull them down so that those still functioning on the original time zone can sleep). "Adjusting to a new zone has less to do with how much sleep you've gotten and mor to do with how well you have readjusted your clock," he says. (Much to the chagrin, we presume, of the guy napping in the seat next to him.)

Another proponent of light therapy is Dan Oren, M.D., associate professor of psychiatry and author of How to Beat Jet Lag. His regimented program involves exposing yourself to sunlight during certain hours of the da and wearing dark glasses at other times. However, be warned—the steps are not necessarily intuitive, especially for the uninitiated. And you must be disciplined: One false move and you may actually shift the clock in the wrong direction—taking yourself on a psychic flight from New York to, say, London, as opposed to Los Angeles.

Beware too when opting for melatonin. Says Oren, the largest study on melatonin and jet lag failed to show that it was any more effective than th placebo. Some users report vivid dreams. What's more, because melatonin is sold as a supplement (and not a drug), the Food and Drug Administration does not set preproduction standards for safety and efficacy. This means the bottle you bring home could contain minimal amounts of the hormone or, worse, dangerous impurities.

A newer supplement, launched as ENADAlert this past December, has been said to increase alertness in jet-lagged travelers without the side effects of caffeine and other stimulants. It contains a form of a compound called NADH, which exists naturally in our body to trigger the biochemical processes that give us energy. But as is the case with melatonin, it doesn't seem to reset your clocks altogether (though it may help you get through a dull meeting).

What to do? The fact that trade organizations and nonprofit agencies alike are beginning to acknowledge the very real effects of jet lag on performance may spur further research. Already, the U.S. Olympics Committee recommends that team allot enough time to train at a competition site well before an event takes place, so athletes can adjust to any time changes (many, in fact, arrived in Sydney two to four weeks before the Games began). And just last fall, the Air Transport Association (the trade organization of the airline industry) launched its Alertness Management Initiative, which educates workers about issues concerning fatigue, including jet lag. (It is mind-boggling to think such steps had not been taken earlier!)

As for the rest of us who are not disciplined enough to sit in front of a light box or adventurous enough to experiment with melatonin, there's one last resort: a little bit of common sense (see Tricks o the Traveler's Trade). Don't let caffeine and alcohol wreck your already irregular sleep- wake schedule, for instance, and avoid scheduling meetings at hours that coincide with, say, 4 a.m. at your place of origin. A little awareness can move us closer to becoming a truly integrated global community—and, perhaps, convince me to weather another trip to Melbourne.


Jet Lag Luxe

If there ever was a hip travel ailment, jet lag would be it. Jet-lag treatments—most no doubt dreamed up by clever marketers—are becoming almost as rampant as airport coffee bars. Alas, spa treatments won't rewind your clock. But, then again, a little pampering never hurt anyone. A sampling:

THE RITZ-CARLTON caters to body-conscious jet-setters zipping in and out of Hong Kong and other Asian destinations by offering in-room fitness kits, complete with butler-drawn bath and smoothie at the conclusion of the workout. This way, those who fly in at, say, midnight can plunge into the midday workout they're accustomed to back home.

VIRGIN ATLANTIC AIRWAYS' team of "onboard beauty therapists" offers jet-lag treatments such as the "stress-busting face and scalp massage" and the "full backup massage" for its Upper Class customers.

THE WALDORF ASTORIA has specially designated Sleep-Tight rooms, which include black-out curtains and alarm clocks that bring on a simulated sunrise, as well as light boxes that have been scientifically prove to reset your biological clock.

THE REGENCY HOTEL in New York offers free 15-minute massages for guests, many of whom are Los Angelenos too wound up to sleep upon arrival.


Staying Awake

Surf the Net, browse the bookstores, and you'll find an array of jet-lag solutions, including anti-jet-lag accupressure and anti-jet-lag creams. There's even the Argonne Anti-Jet-Lag Diet, based on the 1983 book Overcoming Jet Lag, by Charles F. Ehret and Lynne Waller Scanlon (a very strict regimen alternating between feast and famine, and using xanthines, a chemical found in caffeine, as a trigger for resetting the clock). While any method will have its followers, chances are it will be merely as effective as the latest crash diet. Time is the only foolproof weapon against jet lag, but there are plenty of steps you can take to minimize the symptoms and mask your fatigue from clients and coworkers. Here's a checklist—don't leave your time zone without it.

Before You Go

1. Get a head start on your new time zone by shifting your bed- and waking time, as well as meal times, in the direction of your time-zone change. For instance, if you're flying from New York to London, which is five hours ahead, try to turn in around 9 p.m. or 10 p.m. (instead of, say, your usual bedtime of midnight), set your alarm to 6 a.m. (instead of 8 a.m.), eat around 5 p.m. (instead of 8 p.m.). It takes roughly a day to get accustomed to each time zone changed—so if you're going to Australia, prepare yourself early!

2. Book a flight that arrives at your new destination as close to bedtime (local time) as possible. This way you'll be able to sleep off fatigue instead of aggravating it by making your day longer.

In the Air

1. Set your clock to destination time.

2. Pass on the alcohol. Besides worsening your already dehydrated state (due to high altitudes) it will disrupt your ability to sleep. Drink lots of water instead.

3. Avoid fatty foods—they are very hard to digest and will keep you up at night. Eat carbohydrates if you are approaching bedtime (local time); eat protein if you plan on being active.

When You Arrive

1. Do as the natives do. If it's 8 a.m. in Madrid, avoid the temptation to sleep (even though it's 2 a.m. in your city of origin), and have breakfast instead. Sleep will only prolong the desynchrony of your clock; and meals, eaten at the appropriate time, are one of the most important social cues for getting your rhythm back. Likewise, if you just flew into Los Angeles from New York and have the urge to eat, say, at 3 p.m. (because your stomach think it's dinnertime), nibble on fruit or crackers instead of devouring a big meal.

2. Take it easy on your first day. Your mental capacities follow a circadian rhythm too, and chances are your brain has not yet reset itself. If you must attend a meeting or tour, schedule it at a time that corresponds to when your mind is usually more alert back home—typically midmorning. Avoid important activities when your mind is least alert—typically when your watch back home reads 4 a.m.

3. Being active, preferably in a social setting, and exposing yourself to sunlight will keep you awake. Going to bed in a dark, comfortable room will facilitate sleep. Phototherapy researchers have developed very specific bright-light regimens that they say will synchronize your clock more quickly. The methodology entails using the light box (or visor or glasses) at certain times of the day and wearing dark glasses at other times.


Tricks of the Traveler's Trade

Some jobs keep you constantly in flight, but these seasoned travelers are convinced that they've developed strategies to keep them grounded.

"Only one jet-lag prevention works: water. After years of suffering I finally asked a jet-setter wildlife photographer pal of mine, Gerry Ellis, how he does it (he's never tired). He said dehydration is the true culprit and told m to buy three liters…yes, three…of bottled water before my flight, and drink all three once I was airborne. I tried it on my next two European trips, and it really worked."
JESSICA MAXWELL
Author of "Femme D'Adventure: Travel Tales from Inner Montana to Outer Mongolia"

"To me, jet lag isn't about the length of the trip or the number of time zones traveled. It's a general attitude about travel. I don't eat airline food. If you eat it, you'll feel it for the rest of the flight. I get up from my seat regularly and walk around the airplane twice. Wherever I land, I stay up till midnight. I walk around or shoot hoops to stay awake, because if you don't, you won't end up cycling right the first night."
PETER GREENBERG
Travel editor, "Today Show"

"I travel 30 to 46 weeks a year, following the PGA, LPGA, and Senior PGA Tours. When I arrive at a destination I'm usually not hungry, so if I have a dinner meeting I order light—fish, vegetables, and rice. If I am not ready to go to sleep, I read a book or see a movie."
GIDGE MOODY
Manager of tour operations, Taylor Made

"Meetings and field projects take me away as much as twice a month, either to California, Europe, or faraway places like Kosovo, China, and South Africa. I always try to sit next to an aisle seat or emergency exit, so I have room to stretch my legs or get up when I want to. I try to psych myself into my new time zone, even if it means having a little wine when it's actually 8 a.m. back home. I drink a lot of water and try not to take in too much coffee."
KRIS TORGESON
Communications director, Doctors Without Borders

"I covered the White House for six years with Bill Plante, Rita Braver, and Scott Pelley. Our travel always consisted of a chartered press plane, sometimes good, sometimes not so good. My point is, it can be a lot easier to travel if you are not flying coach and eating stale peanuts with your knees shoved in your face. I don't take drugs or natural sleep aids. If I really know I need some sleep I might have some extra red wine, but that's it. If you can make it to at least nine that evening, you are home free the next morning. President Clinton never wanted to miss an opportunity to see the world. I have gone completely around the world with him in five days, stopping in more time zones than I can remember. Those trips are a survival of the fittest. Coca-Cola was my secret weapon."
BILL OWENS
Producer, "60 Minutes II" and former White House producer for "CBS News"

"Sometimes in one month I'll travel 16 to 20 days, and I rarely have jet lag. A lot of it is mind-set and planning ahead. When I'm flying during the day, I get an aisle seat so it's easy to get up and walk around. When I'm flying at night, on a red-eye, I get a window so I don't have someone climbing over me to get out when I'm sleeping. As soon as I get on the plane in night flight, I take one Extra Strength Tylenol or Advil so I don't have a headache the next day. When I arrive in China at, say, ten at night, I take a long, hot shower to relax and help me sleep. If I take a red-eye to D.C., I take a cool shower and wash my hair. That always wakes me up."
CAROL HALLETT
President and CEO of th Air Transport Association

"I eat before I get on the plane. I drink water. I try to do yoga once I land. I find that worrying about jet lag makes it more difficult to overcome, and it is really just best to ignore it by keeping busy and being outdoors as much as possible the first few days in your destination."
CHRISTY TURLINGTON
Model and president of Turly Inc.

"Since I have difficulty sleeping under the best of circumstances—even when I am not on a plane—I've found that the best thing to do is just to give in to jet lag: Relax and it will pass. With cable channels like CNN and CNBC now available twenty-four/seven, you can watch TV, stay up on the markets, and worry."
JONATHAN TISCH
President and CEO, Loews Hotels

"I try immediately to adapt to the new time zone by staying up late or going to bed early. This does not totally prevent jet lag, but it helps. The professional traveler knows that tomorrow is another, and hopefully better, day."
LOUIS LICARI
Owner of Louis Licari hair salons in New York and Los Angeles

Amy Young writes about health and lives in New York City.