Jet lag strategies for business travelers

Why jet lag happens

Your body clock runs on roughly a 24-hour cycle and takes cues from light, meals and activity. When you cross time zones quickly, the clock is still set to home time, which leaves you sleepy in meetings and wide awake at 3 a.m. The CDC Yellow Book notes that the body adjusts by roughly 1.5 hours per day after westward travel and about 1 hour per day after eastward travel.

Eastward travel is harder because it requires the clock to advance, while our internal clock naturally runs slightly longer than 24 hours and finds delaying easier.

Ten strategies that help

• 1. Shift your sleep about 1 hour per day toward destination time for 2 to 3 days before departure
• 2. Going east: seek bright light in the morning at your destination and avoid it in the evening
• 3. Going west: seek light in the late afternoon and evening and avoid early-morning light
• 4. Consider melatonin: 0.5 to 1 mg is often enough; the CDC notes doses above 5 mg are not recommended
• 5. Time melatonin correctly: early evening destination time helps eastward shifts
• 6. Use caffeine for daytime alertness, and stop about 6 hours before your planned bedtime
• 7. Keep naps short, around 20 to 30 minutes, to avoid wrecking night sleep
• 8. Skip or limit alcohol in flight; it fragments sleep and adds to dehydration
• 9. Eat meals on destination time as soon as practical
• 10. For short trips of one or two days, consider staying on home time and scheduling key meetings accordingly

Light is the strongest lever

Light is the most powerful signal to your body clock, and its timing determines whether it moves your clock earlier or later. Morning light advances the clock, which helps after flying east. Evening light delays it, which helps after flying west. The best timing depends on how many time zones you cross, so a quick consult with a light-timing plan or app can help for long trips.

When light is in the wrong window, sunglasses can be just as useful as a walk outside.

Melatonin: what to know

Melatonin can help shift the body clock when taken at the right time. The CDC Yellow Book notes that doses of 0.5 to 1 mg are often sufficient and that higher doses above 5 mg are not recommended. Because FDA does not regulate melatonin as a drug, the amount in a product may differ from the label. Talk with a clinician first if you take blood thinners, seizure medicines or other medications, or if you are pregnant.

Sleep medicines: use with care

Some travelers use short-acting prescription sleep medicines for the first nights. The CDC notes that sedating antihistamines and long-acting sedatives should be avoided because they can impair thinking, increase fall risk and cause other side effects. Never combine sleep medicines with alcohol, and do not take them for the first time on a flight or before an important meeting.

Plan the schedule, not just the sleep

If you can, schedule demanding meetings for the time of day you are naturally most alert in home-clock terms. After an eastward overnight flight, that often means avoiding early-morning presentations on day one. Building in a few hours of buffer after arrival costs less than a poor decision made while exhausted.

A sample plan for a New York to London trip

London is five hours ahead of New York, so this is an eastward trip that requires advancing your clock. For two or three nights before departure, go to bed and wake up about an hour earlier each day. On the overnight flight, eat lightly, skip alcohol and try to sleep as soon as possible after the meal service. On arrival, get outdoors in daylight from late morning onward, keep any nap to around 20 to 30 minutes and stay active until a normal local bedtime.

If you use melatonin, a low dose in the early evening London time for the first few nights may help. Keep coffee to the morning and early afternoon. Expect the first two days to feel imperfect; the goal is to shorten jet lag, not erase it.

When to involve a clinician

Frequent long-haul travelers with ongoing sleep problems, people with sleep apnea who use CPAP, and anyone managing diabetes medications across time zones should plan with a clinician. Long flights also raise the risk of blood clots, so move around, stay hydrated and ask about compression stockings if you have risk factors.