Jet lag and family travel

 Jet lag Tips for family travel

A family holiday is a much anticipated occurrence and an exciting time in the calendar. If you’re travelling further afield jet lag can be a factor and, whilst it is an individualised response, there are a few things you can do to mitigate the effects of jet lag so as not to spoil the start of your holiday. Having a management plan around jet lag can help you maintain your sleep schedule and overall wellness during your travels, so you can make the most of your trip.

Jet lag is essentially a desynchronisation of the body’s circadian rhythm.  These are the body’s natural rhythms which help keep us in a much needed state of balance. They are free running rhythms meaning they don’t rely on external stimuli. Commonly known rhythms are our sleep pattern, appetite and hormone release. When we rapidly change time zones, such as on a long haul flight, greater than 3 hours and in an easterly or westerly direction, the body’s circadian rhythms are put off balance and it can take a while for them to readjust.

Rapid change in time zones, such as on a flight, mean we can travel to destinations quickly, but our body’s knowledge of where we are in time and space lags behind.  Therefore, long-haul travel poses a fundamental risk to our general wellbeing due to its effect on the stability of our daily rhythms.

Symptoms of jet lag can vary, but the most common ones are; trouble falling asleep and getting up, disorientation, grogginess, a reduction in alertness, loss of concentration, slower reaction times and gastrointestinal issues such as nausea or a loss of appetite. How a person responds to jet lag is largely determined by some precipitating factors.  For example, pre-travel sleep patterns, alcohol intake and general level of stress.

The general rule of thumb is for every time zone crossed, it takes a day to realign the body’s rhythms.  However, jet lag is highly individualised so managing it can vary from person to person. Harder too for parents who have to focus on the needs of their children whilst travelling, particularly with young children. Your own recovery from jet lag can take a back seat as you focus on what the children need. However, where possible try to manage your jet lag as its your holiday too and you want to enjoy family time, so plan as much as possible(!) to mitigate jet lag symptoms.

The direction of travel can also have an effect. West is best for adapting to new time zones, whereas travelling East generally holds a greater challenge to the body in terms of adapting to a new place. Days become longer when travelling East-to-West and it is relatively easier to adapt daily rhythms to local time zones. On the other hand, days become shorter when travelling West-to-East and it can be harder to adapt daily rhythms to local time zones. North or South travel doesn’t tend to offer the same impact on our body’s rhythms as trans-meridian travel, but the associated travel fatigue can still take effect. More on this later in the article.

In terms of long haul travel, there are many ways of adjusting to a new time zone and it very much depends on how extreme a person’s jet lag symptoms are and how far they have travelled. Here are a few tips which may help realign to a new time zone well.

  • Melatonin is a naturally occurring hormone that is fundamentally involved in regulation of the sleep and wake cycle. Dim light in the evening signals the brain to release melatonin and helps prepare the body for night time sleep. Melatonin levels need to be rising in order to fall asleep and typically, levels peak after about two hours. Morning light on the other hand suppresses the melatonin release, so levels fall and the body wakes up. Seeking light in the daytime, particularly the morning, helps the body to realign where it is in time and space and normalise daily rhythms, particularly in terms of being asleep or awake.

  • Seek natural light in the daytime, particularly the morning of the first few days if flying westward and the afternoon if eastward. Don’t worry if this isn’t followed stringently, it’d be hard to do so on a family holiday! Remember that light is our biggest driver in terms of realigning our daily rhythms. It synchronises the body clock and lets the body know it should be awake.

  • Avoid bright lights in the evening once in your new time zone. This will suppress melatonin and make it harder to fall asleep.

  • Plan meal times around travelling and eat at normal times for your new time zone. Appetite is also a strong signaller of rhythm, so if you can eat at the correct meal times for your new time zone and access light at appropriate times, you’ll be onto a winner in terms of adjusting to your new destination.

  • Hydrate as much as possible during the travel phase, airline cabins will dehydrate you.

  • Move around as much as possible during travel or ensure you take time to walk around on arrival.

  • Avoid inappropriate napping to catch up on lost sleep. Only nap for 20-30’ in the afternoon and avoid long daytime sleeps. 

  • Physical activity can also help, particularly if done outdoors.  Easy with children as you can jump in the pool with them to stay awake!

  • In a technology driven world there are many apps available to help you plan your travel by giving you advice about when to be exposed to light and when to avoid light.

And what about the return journey? Coming home from holiday is always a period of mixed emotions. Looking forward to getting home, yet sad to be leaving a fab holiday and lots of quality family time. Once you’ve had a nice relaxing holiday it can be easy to forget to plan for the journey home. However, you need to combat jet lag on the return journey, particularly if you have a family and have to juggle the usual routine once home.

Depending on your direction of travel, the same travel management tips apply. Night flights are good as you can sleep and then recover at home whilst getting to grips with your new time zone in a familiar routine.  Parental recovery is often harder as you’re more travel fatigued from travelling with children, never mind the jet lag! As you readjust to a UK time zone, access to daylight at the right times, correct meal times, hydration and physical activity are your best friends again.

It’s worth noting that it’s not just long haul travel that can affect us when travelling, especially with children. Short haul travel can take its toll, for example with symptoms such as tiredness and headaches, so if you’re planning a short trip the last thing you need is associated fatigue spoiling your holiday fun.

Short haul travel challenges are essentially the same as long haul without the jet lag, but worth having a plan for. Any shortfalls from inadequate travel times can be overcome with a sensible, albeit pragmatic, approach to the travel logistics. For example, try to have maximal sleep on the nights leading to travel (hard with a young family I appreciate) and try to avoid travelling overnight. Early morning flights will disrupt sleep too, so either stay in an airport hotel the night before, or avoid the very early flights. Best practice would be to fly in the middle of the day when the body’s ‘get up’ time is not affected, thus desynchronising sleep practices is minimised. Also, allow for recovery time from travel and don’t leave planning to the last minute. Plan ahead and establish a travel routine that works for your family. Accept you can’t control travel decisions and be practical in your approach to manage the situation as best you can.

Finally, some commonly asked questions relating to jet lag and flying with children are a) is long haul a good idea and b) when’s the best time to fly? 

In terms long haul, yes do it! If you’re able to, taking children to far off places is an incredible experience for them and you. Regarding jet lag, there’s no escaping the misalignment of the body’s daily rhythms, whether you’re a child or an adult. Being prepared and having a plan for during travel, including accessories (e.g. games, snacks and eye masks) will help.

Lots of factors go into deciding your holiday, cost being a high priority, but the timing of your flight can make all the difference. Obviously go with what works best for your family, but don’t shy away from a night flight, particularly if travelling long haul. Pack in your cabin bag suitable things to help with this such as favourite PJ’s, familiar teddy and an eye mask. Children may not sleep as much as they would at home, but then neither does anyone on a plane, and remember, you can get back on routine once on arrival, so enjoy any peace and quiet you do get! If travelling short haul, it’s better to have a reasonably timed day flight and plan accordingly for that.

If you need further advice relating to any aspect of sleep health you can find more information on www.gilchristperformance.co.uk, Instagram Gilchrist or LinkedIn SarahLGilchrist.

Seeing the light

The explosion in technological devices within our homes over recent years, along with the recent Covid-19 pandemic has resulted in a marked increase in the use of ‘screen time’ within the home. The Catch 22 of the benefits of remote working, online education resources and mobile entertainment devices (Tablets, Games consoles etc.), with the associated potential issues with vison and sleep, mean the decision over how to manage screen time is a hard one.

 

This article isn’t about screen time and whether we should engage with it or not. An emotive issue in hard, anxious time times.  Simply, the article is intended to provide an explanation of the benefits and disadvantages bright light exposure and why managing exposure to light at certain parts of the day is important in terms of our sleep.

 

Light wavelengths

It’s probably pertinent to talk a bit about light and wavelengths before we delve into the benefits or disadvantages of light and our sleep health. 

 

Light acts on the body by two pathways.  Firstly, what you can see and therefore do as a result (visual perception and responses/reflexes) are governed by the primary optic tract.  Secondly, the retino-hypothalamic tract governs our circadian, endocrine (hormones), and neural-behavioural functions (nervous system and behaviour).  It is this tract which is most sensitive to light (Holzman, 2010) and can have an impact on our sleep. 

 

Visible light has many wavelengths to it (measured in nanometres) and is comprised of a spectrum of different colours (remember the prism of light from your school physics lesson?).  It is our brain that tells us that visible light is white.  Although other colours in the white light spectrum (400-700 nm) can be detected by cells in our retina (the light sensitive tissue layer of our eye). One in particular, is blue light wavelengths (450-495 nm) which can play a part in affecting our overall sleep health.

 

Rhythms and light

I’ve written before on how our bodies rely on routine and the fact that having regular synchronicity to our day is important not only for our physical, but also our mental wellbeing (And the beat goes on).  The reason being is in our brain.

 

All humans have a natural, intrinsic rhythm. A circadian rhythm.  Essentially it is a recurring cycle over 24 hours which governs our body’s need to maintain balance (homeostasis). It regulates all our biological and physiological processes such as digestive activity, body temperature, physical activity, alertness, hormone levels, immune function and perhaps most critically, sleep. It also helps our bodies respond and adapt to any environmental changes.  It is the sleep rhythm that is so important to consider as it significantly impacts on all areas of our physical and mental health. 

 

Our sleep/wake rhythm that is inextricably linked to the light/dark cycle.  Previously it was thought that humans were insensitive to light and that the light dark cycle had little to do with our biological rhythms.  However, it became widely accepted that cells in the eye (photoreceptors) were sensitive to light and dark and ultimately communicated with areas in the brain to inform us if it was night or daytime and therefore, time to go to sleep or wake up.  

 

This process of informing the body of a sleep or wake state involves a complex interaction of photic (light) information which passes from the retina, through the aforementioned retino-hypothalamic tract, deep into an area of the brain, called the hypothalamus.  This houses the governor of our circadian rhythms, the Suprachiasmic Nucleus (SCN) and it is this which communicates to other areas of the brain to start the process to fall asleep or remain alert and awake.  

A fundamental part of this communication is the SCN’s message to the pineal gland to release Melatonin, a sleep inducing hormone, typically referred to as the vampire hormone as it only comes out at night.  Melatonin is key to the onset of sleep and the suppression of which, through light, is a contributing factor to poor sleep health. 

 

The complex interaction between our sleep/wake and light/dark cycles means the light/dark cycle entrains our circadian rhythm for sleep and if this is skewed our body homeostasis (balance) is disrupted.  This can cause significant issues, particularly in relation to sleep, the impact of which is relative to how desynchronised our light dark cycle has become e.g.  time zone shifts, circadian rhythm disorder or shift work.   

 So we can see how daylight is crucial to our daily rhythmic routine and our night time sleep.  Light is effectively the ‘sleep robber’ given its effect on melatonin release.  During daylight, bright light helps our alertness as it sends signals to the SCN that daylight is abundant and thus melatonin is suppressed.  We remain alert and awake until night time ensues and melatonin is stimulated once more.   

 

Light and health

Stimulation from certain wavelengths of light helps us stay alert, whether this comes from a natural source like the sun, or from electronic devices that emit blue light (e.g. screens).  Through the mechanism of suppressing melatonin, bright light can have a therapeutic effect in certain disorders. For example, commonly experienced in the winter months are feelings of low mood and lethargy which is partly related to sleep and the light/dark cycle and the fact that during the winter months, days are shorter and daylight can be rather dull.  As melatonin levels remain elevated with the relatively darker days, associated serotonin levels (a mood regulator) are suppressed and we are more susceptible to gloomy feelings.  In extreme cases this can be related to Seasonal Affective Disorder (SAD), a pattern of recurrent significant depressive episodes that most commonly occur during the seasons of autumn or winter and reduce as spring arrives.  Symptoms vary but usually include a persistent low mood, a loss of pleasure or interest in normal everyday activities, irritability and sleeping for longer than normal and finding it hard to get up in the morning.  Feelings are more pronounced than occasional ‘winter blues’ with the prevalence of SAD ranging from 1.5 % to 9 %, depending on latitude (Nussbaumer-Streit et al., 2019). 

 

The good news is, regular exposure of daylight, particularly morning light, even for just 15-30 minutes a day, is enough to lift our mood and help our sleep/wake balance, improve focus and attention and ultimately boost overall health and wellbeing.  It is here where light therapy (phototherapy) has come to the forefront.

 

Light box therapy, or phototherapy, relates to an intervention to help certain sleep disorders through exposure to light of a particular illumination (brightness is measured in ‘Lux’).  Light therapy is most effective when you have the proper combination of light intensity, duration and timing, which ultimately are dependent on the disorder being treated, but usually first thing in the morning is best with consistent use until symptoms subside. 

 

How light box therapy works is that light, imitating outdoor light, is delivered through a fixed light box or, more directly, through light glasses.  Glasses offer a suitable alternative due to the length of exposure required to reap the benefits of light therapy (typically 30-60 minutes). Due to the direct nature of the light glasses on the eye, the intensity of the light will be slightly less. 

 

Benefits of light therapy may broadly include improved sleepiness, enhanced vigilance and cognition, improved mood and consequently a reduced risk of accidents (Comtet et al, 2019).  To be safe and assured that you have the correct protocol for effective treatment (i.e. brightness (intensity), timing, duration, type of light), you should seek medical advice before attempting light therapy and always follow medical recommendations and manufacturers guidelines.  

 

Note that there are some risks associated with light therapy for certain individuals so it can require careful management and therefore medical input.  If you suspect you are suffering from SAD, also seek medical advice as medications or other alternative therapies can be prescribed e.g. cognitive behavioural therapy.

 

Light blocking

While the stimulation from light is helpful during the day, at night it can interfere with sleep through the suppression of melatonin (Corliss, 2021).  This is where screen time becomes a problem for sleep health and evening use of items such as televisions, laptops, phones, etc. can be harmful to our sleep.

 

Emerging studies have investigated the effects of blue light blocking glasses in the hope these will reduce the negative effects of blue light on sleep health.  However studies to date lack sufficient detail and are inconclusive.  Added to this, is the fact that there is little to no standardisation of the commercially available products to block blue light, so you cannot conclusively know which wavelengths are being blocked, nor whether this affects only visual function, or nonvisual functions, such as alertness and your circadian rhythm (Corliss, 2021). 

 

Current advice to block the stimulating blue light seems to focus on limiting screen time after dusk, particularly in the 2-3 hour window pre-bedtime.  Leave your phone in another room, avoid TVs in the bedroom or try certain computer software to reduce the amount of blue light emitted e.g. Apple’s Night Shift function.  Not only good for reducing the impact on sleep, but also for potential issues in eye strain.  The  American Academy of Ophthalmology advise using the ‘20-20-20 rule’, which is every 20 minutes look away from your screen, at an object approximately 20 feet away, for approximately 20 seconds. 

 

Avoiding screens in a technological age is probably futile.  However, addressing the amount of exposure to screens that you have, particularly later in the day is worth considering for your sleep health and ultimately your eyesight too. Not to mention the fact that using screens may induce anxiety e.g. hearing/reading bad news, and negate decreasing your brain’s arousal state pre-sleep.

 

Overall, with regards to light and sleep, in daytime hours try and get as much daylight as possible as this has many health benefits.  Also, address any additional issues affecting your sleep e.g. noise, routine etc.  More info on good sleep health strategies can be found in another of my articles here.

 

Happy sleeping!

 

 

References

Holman, D. C., (2010),  Environmental Health Perspectives , 18(1)

Corliss, J., (2021),  Can blue light blocking glasses improve your sleep?   Harvard Heart Letter.

Nussbaumer‐Streit B., Forneris C. A., Morgan L. C., Van Noord M. G., Gaynes B. N., Greenblatt A., Wipplinger J., Lux L. J., Winkler D. & Gartlehner G. (2019), Light therapy for preventing seasonal affective disorder. Cochrane Database of Systematic Reviews (3)

Daily Rhythms

Time cues and anchors to our day have never been so important. In a period of unrest and change, such as with Covid-19 and the disruption it has brought to our lives, having regular synchronicity to our day is important not only for our physical, but also our mental wellbeing.

Daily rhthms.JPG

Why? The answer lies deep in the brain and our relationship with night and day. 

Inherent to all humans is a natural, intrinsic rhythm. A circadian rhythm. Essentially it is a recurring cycle over 24 hours which governs our body’s need to maintain balance (homeostasis). It regulates all our biological and physiological processes and helps our bodies respond and adapt to any environmental changes. Everyone has a circadian rhythm which changes throughout our lifespan; from babies to teenagers, generally settling in adulthood and altering again as we age.

Throughout day and night our circadian rhythm drives several body processes such as digestive activity, body temperature, physical activity, alertness, hormone levels, immune function and perhaps most critically, sleep. It is the sleep rhythm that is so important to consider as it it significantly impacts on all areas of our physical and mental health. 

We are all generally entrained to a 24 hour circadian rhythm, of which our sleep/wake rhythm is inextricably linked to the light/dark cycle. How we interact with light and dark involves a complex interaction of photic (light) information which passes through the retina, deep into the brain, to the hypothalamus which houses the governor of our circadian rhythms, the Suprachiasmic Nucleus (SCN). If this becomes damaged in any way our circadian rhythm becomes offset and body balance (homeostasis) is disrupted. The level of which depends on how desynchronised our light/dark cycle has become.  

SCN.jpg

In terms of sleep, under normal circumstances, the circadian rhythm will naturally rise in the early morning as depicted by the dark blue line in the below illustration, promoting wakefulness and alertness, and will reach a peak in the evening. After a waking period of approximately 14-16 hours the pressure to sleep increases and we become tired. With the onset of darkness, the circadian rhythm drops to the lowest level, a hormone called Melatonin is released, and sleep ensues (The Sleep Council 2020). This is why regularity breeds sleep and our daily routines are so important for promoting good sleep habits. In normally entrained individuals, your circadian rhythm interacts with this homeostatic sleep drive in an opposing manner to provide consolidated wakefulness during the daytime hours and continuous sleep during the night. When this doesn’t occur sleep problems can exist and you should seek advice from your GP regarding persistent disruptions to your sleep/wake cycle.

CR graph.jpg

Typically our regular rhythm of sleep and wake fall into our daily routine of life events (work, school etc.). Through our daily routine we have natural time cues or ‘anchors’ that help us maintain the body’s balance in terms of where it’s at at any given point in the day i.e. hungry, tired, seeking light etc. However, circadian rhythms can become disrupted through a number of ways, either external factors (e.g. shift work, travel, lifestyle, health condition) or a sleep disorder. When daily life gets interrupted, such as is the case during the Covid-19 pandemic, our daily anchors become offset and it is easy to lose the routine, with sleep patterns often paying the price. 

The good news is ensuring you maintain a healthy daily rhythm, in the absence of our normal time cues, can be achieved following some simple steps - outlined below. Try some of these if you're experiencing difficulty with sleep or maintaining a daily routine during this most bizarre of times.

Sleep strategy

  • Develop a ‘strategy to sleep’ and ensure you’re getting the recommended 7-9 hours sleep

  • Ensure you have a sleep routine with a regular bed time and get up time.

  • Regular bed and wake times help sleep onset & ensure sleep is maintained throughout the night. Set a wake-up time and work backwards in 90 min cycles to get the right bed-time.  

  • Avoid regular excessively late nights or long lie ins

  • Only go to your room when you’re ready to sleep.

  • Be realistic if making changes e.g. try 3/7 nights at first

  • Protect your sleep time.

Environment & Behaviours

  • Seek natural sunlight as much as possible during the day

  • Eat at normal meal times with a small snack in between if needed

  • Avoid large meals before bed

  • Ensure you have a sleep environment to help good sleep (calm, low light, no noise, comfortable, ambient temperature)

  • Avoid devices in bed/bedroom - minimise exposure to blue light 

  • Avoid stressful news/situations before sleep time

  • Try some gentle interventions to help poor sleep e.g. cognitive behavioural therapy (CBT - see your GP for advice)

  • Engage in some physical activity regularly (preferably outside if possible)

  • Avoid screen time before bed

  • Limit caffeine & alcohol intake (avoid excessive caffeine, alcohol especially before bed)

  • Use sleep medication as a last port of call. See GP. Only take sleep medication once you’ve exhausted all other practical strategies to improve your sleep.

  • Recognise everyone has an individual need. What works for one person might not work for you.

  • Change one aspect of your sleep strategy at a time, then you know what works for you.