Ask the doctor
Q. My wife and I are planning a trip to Europe and we are dreading the jet lag, which hits both of us hard. Is there any evidence that melatonin really helps? Are there any prescription drugs we could ask our doctor about?
A. Jet lag refers to fatigue or a disturbed sleep pattern after travel across multiple time zones. Some small studies have suggested that melatonin is helpful for jet lag if taken a few days before and after travel. Melatonin is a natural substance released by our brain to help with our circadian (day/night) rhythm. This rhythm is disturbed with travel across three or more time zones.
When traveling eastward to Europe, daytime sleepiness and insomnia could be a big challenge. After the westward return leg, early morning awakening would be more typical. Melatonin has been more effective at treating eastward jet lag, and so might be more helpful to you on the outbound trip—when taken close to the target bedtime. Typical dosages in melatonin dietary supplements are 3 to 5 mg.
Other possible ways to combat jet lag include exposure to a special bright-light source in the early morning, starting earlier each day for several days before travel, to mimic the change in time zones. Once again, this would be useful after the eastbound flight, when the destination wake-up time will be earlier than your usual time.
Long-distance flyers commonly use prescription sleep aids, such as zolpidem (Ambien), to get more sleep during the uncomfortable travel period, but they don't treat the circadian rhythm disturbance. In addition, some individuals experience hangover effects from these medications. It is a good idea to take a trial run with these medications at home before travel to make sure you can tolerate them.
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