×
Human Performance, Performance | Sep 26, 2016
A sleep doctor’s prescription.

Dr Meeta Singh specializes in sleep medicine and has worked with the likes of the Detroit Lions and Detroit Tigers on performance optimization through improved sleeping habits. In an exclusive piece for the Leaders Performance Institute, Dr Singh gives her jet lag prescription for the frequent flying athlete.


Introduction

Air travel for games and competition is a norm for elite athletes and often involves crossing multiple time zones. These travels may range from single competitions in a different city/country/continent, to prolonged sojourns when tournaments are involved. Jet lag is a unique phenomenon that occurs following trans-meridian travel (crossing time zones when travelling East or West) and is a result of an individual’s internal body clock being out of sync with the destination time clock. It is different from travel fatigue that consists of sleepiness, feeling cramped or dehydrated from prolonged travel within same time zone. For athletes, coaches and teams looking to maximize performance, understanding jet lag and using strategies to combat the deleterious effects of jet lag is critical for top performance.

So let’s start with some basics.

What is Jet Lag?

The American Academy of Sleep Medicine defines jet lag as a syndrome of insomnia or excessive sleepiness following travel across at least two time zones. This can result in impaired performance, fatigue and, intestinal symptoms lasting up to several days following travel. The main sleep disturbances after travel appear to be difficulty falling asleep at the beginning of the night and difficulty getting back to sleep after multiple awakenings during the night. Other symptoms include feeling unable to concentrate, decreased mental and physical performance, headaches and irritability during the day. These symptoms can affect all aspects of athletic performance.

 

Volvo Ocean Race 2014-2015 - Leg 6

 

Why Does This Happen?

When we cross time zones our internal clock ends up being out of sync with the environmental light dark (day and night) patterns of our new destination. As this internal clock begins to adjust to this ‘new’ time zone the mismatch between our biological rhythms and the environment produces the symptoms of ‘jet lag’.

What is the Internal Clock?

We have an internal clock in our brains that controls the timing of sleep patterns, hormones, and alertness. These rhythms are internally generated and normally synchronized to the external light/dark cycles of day and night. This is how our body functions in a cyclic manner to a 24-hour routine. Normally, our body clock adjusts slowly to changes in the light/dark schedules and it typically takes one day per time zone to adjust. For example, it would take six-nine days to adjust naturally if we travelled from anywhere in the US to England.  The problem of jet lag arises when we cross time zones rapidly (as in air travel) and our biological clock is trying to catch up to the new time zone.

How Does Jet Lag Effect Athletes?

Athletes are particularly prone to developing jet lag as they travel often and their competition times are often in close proximity to travel times. In athletes, symptoms can include those above (eg, sleepiness, fatigue, stomach upset), and jet lag may also have a negative impact on the athlete’s ability to perform physically.

Let’s explore this in some more detail.  When we travel we are likely to get less sleep and this combination of sleep loss and jet lag acts as a double whammy on athletic performance. This results in increased reaction time and decreased accuracy both of which are undesirable when you compete. Additionally, the risk of getting injured increases, pain sensitivity increases and the combined effects of reduced levels of testosterone and growth hormone, and increased levels of hormones that break down protein and muscle, result in slower recovery. There is reduction in anaerobic power and capacity, and dynamic strength. Finally, this double whammy of sleep loss and jet lag lends to increased errors and results in increased fouls. All these effects are highly undesirable to any performance.

How to Combat This?

Although the approach to preventing and treating the symptoms of jet lag will always require an ‘individualized’ plan depending on travel and scheduling circumstances, there are some general principles that should always be kept in mind.

These principles depend on using time cues (zeitgebers) that normally synchronize our body clock on a daily basis. The main cues used are light exposure and avoidance and sleep scheduling. In addition, we can also try to adjust to the new time zones by using melatonin supplements, timing of meals, and exercise; and I will briefly touch on these issues as well.

How Do These Cues Work?

Light is the strongest natural cue for resetting your biological clock. Exposure to light and avoidance of light at specific times will shift your clock. This strategy is simple, but the timing is key. So when travelling westwards, light exposure should be sought in the early evening and first half of the night (according to home time and not destination time). Additionally, light should be avoided in the second half of the night and early morning.  For travelling eastwards, the opposite is true for timing of light exposure and avoidance of light. A detailed individualized light therapy guideline, based on direction of travel and time zones crossed, is very useful and can be supplemented by using light boxes that are travel friendly.

 

David Warner Portrait Session

 

Melatonin is a natural hormone that is secreted during darkness and promotes sleep. When travelling, this production is out of sync and can contribute to jet lag symptoms. Timely use of melatonin supplements can promote adaptation. Melatonin affects the clock in the opposite direction as light. The general guideline would be to take it before the intended bedtime to trick the brain into thinking it’s ready to sleep. The dosage and timing again would need individualized planning by a sleep doctor.

Exercise can affect your clock, so appropriate scheduling would allow one to potentially, take advantage of this cue. Its affect is similar to light and so it can be scheduled close to the timed light exposure.

Diet and Meal Planning play a role in providing cues to our biological clock and these patterns with the accompanied patterns of digestive hormone secretions, gut motility and absorption of nutrients are often out of sync when we travel. Eating meals at the appropriate destination time is helpful in adjusting to the new time zone.

Now With These Basics, How Do We Beat Jet Lag?

When I am consulted to help with travel optimization, I look at each trip individually. I typically evaluate the athlete’s sleep cycle to find out exactly what time they sleep and wake up and whether they are early morning larks or night owls by nature. All of this information helps to make an individualized travel plan. In this role, I work closely with the team physician, the athletic trainer or coach.

For starters, providing basic education information about sleep and the biological clock, to the athlete and other team members is essential to the success of these strategies.

The First Question to Answer, of Course, Is How Long the Trip Will Be

For trips that are short (one-two days) and that cross two-four times zones only, I often advise that it is best not to attempt to adapt. This is because the time duration is too short to achieve full adaptation. Instead the recommendation would be to try to stay on home time zone, and this would work if the game/competition timings allows for such a schedule. For example, for a team flying for two days from California to New York for an 8pm local game, the advice would be to stay on California time when the team flies into New York and play at 8pm, (5pm local California time) and then fly back. This schedule would be less disruptive to the team while they were on the trip as well as when they get back home.

Of course, when the direction of travel is reversed, this wouldn’t work.  For example if a New York team had to make a one-two day trip to California for a local 8pm game, this game would now start at 8pm local California time (11pm NY time) and keeping the team at local New York time zone would be impractical. Sometimes, in these cases, my suggestion would be for the New York team to shift to California time while at home even before the journey to help adjust. Again this would work if the home game timings permit this shift.

When this is not possible due to fixed activity schedules, then my advice is to enhance alertness at destination by utilizing short naps and caffeine. Also protecting athletes’ sleep and bedtimes and using winding down strategies to help sleep are very useful.

For longer trips of more than four-five days, there are many strategies that I will describe in detail.

I like to break down these recommendations into three categories.

 

Kansas City Royals v Oakland Athletics

 

Pre-flight Strategies

Ideally, jet lag planning starts well before the actual day of travel.

  • My first suggestion is for athletes to sleep well in the days leading up to travel. This would mean eight-nine hours of sleep on a daily basis. Here, the key is to not go into a situation where we know sleep will be disrupted with sleep debt already on board.
  • If schedule permits, it is often advisable to adapt to a new time zone while still at home. Both, strategic light exposure and avoidance, and shifting sleep times, can effect small shifts in biological clock to adjust to the destination time. Of course this is limited by schedules, especially if athletes are playing/competing right before departure.
  • Finally, it helps to choose flight timings such that athletes arrive in the early evening at the destination so that they get a chance to sleep there. For long overall flight (crossing ten or more time zones) using layovers can be helpful.

In-flight Strategies

These can be generalized for all flights regardless of whether the destination is east or westwards.

The first step is to ask the team members to set their watches to destination time as soon as they board the plane as this helps them prepare mentally for the journey.  The advice then is to eat, sleep and stay awake on the plane according to local destination time.

While sleeping on board a plane, using ear plugs or noise cancelling headphones and eye shades helps. If unable to sleep, the athlete should practice mind body rest. (Lay in seat with eye closed, focusing on breathing). During this time electronics should be avoided. In addition, hydration is key and so is avoiding alcohol. During times of wakefulness the athletes should get up and walk around periodically.

Post-flight Strategies

In the best case scenarios the team/athletes would get to the destination, days before the competition to help with the time change adjustment.

Once at destination time, while travelling east or west, it is important to stay awake until local bedtimes and avoid long naps during the day. For westwards travelers there may be issues with early morning awakenings while for eastward travelers, the main issue may be inability to fall asleep at local bedtimes.

I typically will advise light exposure and avoidance in a specific timed manner to enhance the adjustment. Additionally, I may prescribe melatonin on a case by case basis.

For example when travelling from New York to London, it’s important to avoid exposure to light before 11am in the while in London for the first four days. Exposure to bright light in the early afternoon would be recommended. Melatonin would be prescribed on an individual basis.

Similar adjustments to the training/practice schedules and meal timings will further help this adjustment. Avoiding spicy foods is important as is avoiding caffeine close to local bedtimes.

Conclusions

For athletes and sports teams that frequently travel, utilizing these guidelines would help them adjust to the new time zone. The most optimal strategy would be to individualize the recommendations based on specific travel plans, as each journey is unique and athletes differ in the way they respond to jet lag. Beating jet lag would add to their competitive edge and seeking advice from a sleep doctor with experience in treating jet lag is key in this process. In my experience while working with professional sports teams and elite athletes, detailed and individualized travel optimization takes the headache out of ‘winging it’ and is often instrumental to aiding the all-important win!


References

Atkinson G, Reilly T. Circadian variation in sports performance. Sports Med. 1996;21:292-312

Atkinson G, Spiers L. Diurnal variations in tennis serve. Percept Mot Skills. 1998;86(3):1335-1338

Burgess HJ, Crowley SJ, Gazda CJ, Fogg LF, Eastman CI. Preflight adjustment to eastward travel: 3 days of advancing sleep with and without morning bright light. J Biol Rhythms. 2003;18:318-328

Coste O, Lagarde D. Clinical management of jet lag: what can be proposed when performance is critical?Travel Med Infect Dis. 2009;7(2):82-87

Czeisler CA, Allan JS, Strogatz SH, et al. Bright light resets the human circadian pacemaker independent of the timing of the sleep-wake cycle. Science. 1986;233(4764):667-671

Czeisler CA, Kronauer RE, Allan JS, et al. Bright light induction of strong resetting of the human circadian pacemaker. Science. 1989;244(4910):1328-133


 

Sign up to our newsletters

To ensure you’re keeping up to date with the latest intelligence, sign up (for free) to receive newsletters. Get exclusive insight from top organisations worldwide on leadership & culture, human performance, coaching & development and data & innovation.

Subscribe

Become a member

Join our exclusive community of leading global performance organisations to target all aspects of high performance and challenge thinking with access to game-changing knowledge, connections and perspectives that can’t be found anywhere else.

Become a member