Friendly Print preview

.. see also Preventing DVT (pdf - July 2001)

Travel: air travel

Flying has revolutionised travel. No longer does it take months to travel to the Northern Hemisphere. Air travel is safe and comfortable; however, 'air sickness' and jet lag are problems that face many travellers.

What is jet lag?

This is the uncomfortable aftermath of a long flight in which the person feels exhausted and disoriented, has poor concentration, insomnia and anxiety. The problem on arrival is poor concentration and judgment during daytime.

Other symptoms that may occur include anorexia, weakness, headache, blurred vision and dizziness.

Jet lag is a feature of flying long distances east-west or west-east through several time zones, causing the person's routine daily rhythm of activity and sleep to get out of phase. The worst cases appear to be persons travelling eastbound from England to Australia. It can occur with travel in any direction, but the north-south flights are not so bothersome.

What factors influence jet lag?

Personal factors

These include age, state of health, tolerance to change, preparation for the long trip and, very importantly, the emotional and mental state.

General factors

Noise, vibration, air humidity and sitting still for long periods can influence jet lag.

Specific factors

Duration of the flight, time of departure, changes in climate and culture at the destination affect the severity of jet lag.

The problem is aggravated by:

• stress of the pretrip planning
• last-minute rushing and anxiety
• lack of sleep during the trip
• overeating and excessive alcohol during the flight
• smoking

How can you minimise the problem?

Careful planning and a few simple hints observed during and after the flight can ease jet lag.

Before the flight

• Allow plenty of time for planning.
• Plan a 'stopover' if possible.

During the flight

• Fluids: Avoid alcohol and coffee. Drink plenty of non-alcoholic drinks such as orange juice and mineral water.
• Food: Eat only when hungry and even skip a meal or two. Eat the lighter, more digestible parts of your meal and avoid fatty foods and rich carbohydrate foods.
• Dress: Women should wear loose clothes (e.g. long skirts, comfortable jean, light jumpers) and avoid girdles or restrictive clothing. Wear comfortable (not tight) shoes and take them off during flight.
• Smoking: Reduce smoking to a minimum. Non-smokers should seek a non-smoking zone.
• Sleep: Try to sleep on longer sections of the flight (give the movies a miss). Close the blinds, wear special eye 'masks' and ask for a pillow. Sedatives such as temazepam (Euhypnos or Normison) or antihistamines can help you sleep.
• Activity: Try to take regular walks around the aircraft and exercise at airport stops. Keep your feet up when resting, and exercise by flexing the major muscles of the legs. Avoid resting the calves of your legs against the seat for long periods. Rest without napping during daylight sectors.
• Special body care: Continually wet the face and eyes. A wetting agent such as hydromellose 0.5 per cent eye drops can help those with a tendency to sore eyes.

At your destination

• Take a nap for 1 hour if possible.
• Wander around until you are tired and go to bed at the usual time. It is good to have a full day's convalescence and avoid big decision-making soon after arrival. Allow about 3 days for adjustment after the London to Australia flight.

Who is fit to fly?

• Patients with these problems should avoid flying:
• upper airways congested by infection, including influenza
• severe respiratory disease (emphysema, chronic bronchitis, pneumothorax)
• unstable heart failure
• severe anaemia (below 7 g/100 mL)
• pregnancy beyond 200 days (28 weeks)
• previous violent or unpredictable behaviour
• within 4 weeks of a myocardial infarction (coronary or heart attack)
• within 14 days of a cerebrovascular accident (stroke)
• within 14 days of major surgery
• brain tumour or recent skull fracture
• recent eye surgery
• high blood pressure that is not being controlled by treatment

Special precautions are required by travellers with:

• Colostomy: Patients should wear a large colostomy bag and take extra bags.
• Varicose veins: Wear supportive stockings and exercise frequently.
• Plaster casts: Those with broken limbs in plaster should be careful of swelling.
• Pacemakers: Those with pacemakers may have a problem with X-rays at some overseas airports. Mention it to officials before passing through security equipment.
• Epilepsy: Medication should be increased on the day of travel.
• Diabetes: Diabetics should discuss their therapy and control with their doctor.

  Copyright 1995: John Murtagh, Professor of General Practice
  Monash University, Melbourne, Australia