Flying has revolutionised travel. Air travel is safe and

comfortable; however, 'air sickness' and jet lag are problems

that face many travellers.

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.

 Noise, vibration, air humidity and sitting still for long

 periods can influence jet lag.

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

Careful planning and a few simple hints observed during

and after the flight can ease jet lag.

• Allow plenty of time for planning.

• Plan a 'stopover' if possible.

• If possible, arrange the itinerary so that you are flying into

the night.

• Ensure a good sleep the night before flying.

• Ensure a relaxed trip to the airport.

• Take along earplugs if noise (75-100 decibels) bothers you.

•  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.

•  Dress: Women should wear loose clothes (e.g. long skirts,

comfortable jeans, 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. Consider using sedatives such as

temazepam (Euhypnos or Normison).

•   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.

•  Melatonin: This hormone is closely linked with our 

sleeping patterns and is claimed to prevent jet lag. Its use is

controversial, so check with your doctor.

Take a nap for 1-2 hours 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.

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 70 g/L)

• 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

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.

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