There was a time when jumping on a plane was a relatively easy thing to do (assuming you had the money). But today’s flying
experience is often more of an ordeal than a pleasure, aggravated by concerns about terrorism, long queues for safety and
security checks, and other irritants such as checking the long lists of things you can and can’t take with you.
As well as the stress that precedes departure, there are the physical health issues, ranging from aching limbs, swollen ankles, and
sleep disruption, to what has been popularly described as “economy class syndrome” (the possibility of deep vein thrombosis,
DVT), and of course, coping with jet lag.
Yet despite these drawbacks, more of us are boarding planes than ever before. World air travel has grown by around 5% a year
over the past 30 years. In 2006, the world’s 2,000-plus airlines flew 23,000 aircraft carrying more than 2 billion passengers on
almost 28 million scheduled flights.
Perhaps our growing predilection for air travel is explained by Dr Roy L. DeHart, an expert in aerospace medicine, who in 2003
wrote: “although there are numerous health issues associated with air travel they pale in comparison to the enormous benefits to
the traveler, to commerce, to international affairs, and to the public’s health.”
So given there are some things we can’t change about air travel, what are the things we can do something about to protect our
health and ensure our comfort while flying?
This article offers you some tips garnered from various sources, including official advice from medical and travel experts, as well
as from frequent travellers’ personal experiences, on how to minimize the effects of jet lag, increase your comfort and chances of
getting some good sleep on board, and also tips on exercises and reducing the risk of DVT.
Jet lag is the result of travelling across several times zones, causing symptoms like fatigue and sleep disruption. Our biological
clock is attuned to the day-night cycle of the start of our journey, so when we travel to a different time zone quickly, as we do
when flying, our body is still functioning as if we were in the time zone we have left behind. It can take anything between 2 days
and 2 weeks for it to adjust completely to the new time zone, depending on how far you have travelled.
Also, you may find that different body rhythms adjust at different rates. For example, digestion can adapt more quickly than
Here are some tips to minimize the effects of jet lag:
Set your watch to the time zone of your destination before you depart.
If you are flying WEST (eg Paris to Vancouver, Bangkok to London): stay awake as long as you can when you get there. It
is easier to endure a longer day that it is to shorten your body’s natural rhythm. Also, if you can, try going to bed and getting up
later for a few days before you travel.
If you are flying EAST (eg Mexico City to Frankfurt, Johannesburg to Sydney): try to sleep on the plane while it is night time
at your destination. When you arrive, try not to sleep during the day, or it will take longer for your body clock to change to the
new time zone. You can also prepare for the adjustment by getting up and going to bed earlier for a few days before you
When you arrive at your destination, get into the local routine as soon as possible.
At your destination, try to stay outside during daylight as much as you can (while being sensible about sun exposure and
sunburn risk), because natural light helps your body clock to adjust.
If you have travelled west, go outdoors in the morning and stay indoors in the afternoon for the first few days: if you have
travelled east, avoid morning light and try to get more outdoor light in the afternoon.
If you are going on a short trip, for instance if you are a member of aircrew or a business person going to a meeting, then it
doesn’t make sense to try and adapt to the local time zone, you are probably best advised to keep to your home time zone.
If your business meeting is very important, getting there a half or full day early will give you more time to adapt and be
fully alert. Alternatively, try to schedule it to coincide with daytime in your home time zone.
Some research has found that taking Melatonin at bedtime in the new time zone is effective for about 50% of people, but clinical
studies have not yet been done to prove it is safe and effective and at what dose. According to the Civil Aviation Authority
(CAA) the UK’s specialist aviation regulator, aircrew are not allowed to use it. Melatonin is a hormone that is stimulated by
darkness and suppressed when it is light.
Some people swear by sleeping tablets, but healthcare provider BUPA warns you should first talk to your doctor before using
them on flights and for jet lag. He or she may advise you take them just for a couple of days while your body clock adjusts. But
you shouldn’t take them in flight because this will encourage you to sit still for too long which increases the risk of DVT (more about
this later). Also, you should not drink alcohol when taking sleeping tablets, as this can make you even sleepier and therefore less mobile.
Exercises you can do to relieve aching legs as well as reduce clotting risk are rotating the ankles, pushing down alternately with
heels and toes, standing calf raises (go to a corner near the toilets or the galley to do these), alternately tensing and relaxing parts
of the legs (working upwards from feet to thighs and hips then down again).
The back is a part of the body that often aches after a few hours flying. A good back stretch is to bring your chest down to meet
your thighs while seated. Elongate the spine and hold for 5 seconds, then gently sit back upright. Repeat two or three times, and
do it every hour or so.
Here’s a tip from bodybuilders for the arms. Hold them out straight out in front of you, with the hands relaxed downwards. Then
tense the whole of the arms and make hard fistballs with the hands. Hold for a couple of seconds, then suddenly open the fingers,
until the hands are stretched out like dried starfish, then close again, hard. Repeat a few times.
Here’s one for the shoulders: sit up straight, clasp hands behind the head with elbows out to the sides. Gently pull the elbows
backwards while bringing the shoulder blades down and together. This is probably not one to do in your seat as you may poke
your neighbours in the eye.
And finally, one for the neck: again, clasp hands behind the head and gently pull the head down onto your chest while keeping
spine stretched up. Keep pulling gently until you feel the stretch at the back of the neck into the shoulders. Hold for a few
seconds and repeat.
Fear of Flying
There are millions of people who have anxiety and panic attacks about flying. Fear of flying is the third most common phobia
after fear of snakes and spiders. Sometimes it arises from a bad flying experience, or an emotional reaction to news about
hijacking or a plane crash. It can also be triggered by claustrophobia, concern about heights, loss of control, and fear of the
If you are afraid of flying, then perhaps consider going on a course. Some airlines actually run courses that combine behavioral
techniques and education about aircraft, such as the different noises they make and what causes turbulence, one of the things that
can cause distress. Some of the courses also finish with a flight, under carefully controlled conditions. The CAA says research
has shown that such courses are effective and that the benefit may be sustained.
Fear of Flying Help is a free online course by currently flying Airline Captain Stacey Chance that offers educational
material and practical suggestions. For example in Chapter 4, Dr Arnold Bennett of MIT, gives a plausible argument for
persuading you that air travel is safer than many other ways of travelling. He also discusses how news media coverage can make
air accidents appear to be more frequent than they really are, and gives tips on overcoming fear of flying, such as exercising
regularly, eating a healthy diet, and getting plenty of sleep to increase your resilience and reduce vulnerability to stress.
Another tip commonly given on courses is, once you are on board, rather than dwell on your fear and let anxious thoughts
dominate, try to distract yourself by chatting to other passengers, watching the in-flight movie, eating, reading, or listening to your
portable music player.
A tip I have found useful to control anxiety in stressful situations is breathing relaxation. We tend to forget about breathing, it
happens automatically, but it is a powerful relaxation tool that we carry with us wherever we go. If you feel yourself getting
anxious, notice your breath, it is interesting how anxiety and shallow, quick breathing often go together. You can make yourself
calmer by focusing your attention on your breathing, and just gently pushing the anxious thoughts to one side. Feel how your
lower chest cavity swells as you gently inhale with the bottom of your lungs. Then feel it go in as you exhale. Don’t try to time
your in and out breaths, just breath gently, slowly, deeply, naturally.
You could also consider telling the cabin crew that you are nervous about flying – many are trained to deal with this and can
reassure you about strange sounds and other unexpected things that might make you anxious.
Traveldoctor.co.uk says if you are thinking of taking a tranquilliser before flying, you should remember that many of them do not
mix well with alcohol.
Written by Catharine Paddock PhD