Dear Doctors: We are flying overseas, and, although I would love to snooze through most of the 15-hour flight, I’m generally not able to sleep on a plane. Melatonin doesn’t work for me. I’ve taken Ambien, but I’m concerned about the negative effects I’ve read about. Any advice?
Dear Reader: Long-haul flights can be arduous. Sleeping conditions are less than optimal: being packed into close quarters and seated upright with limited legroom and minimal privacy. Add in the 75 to 85 decibels of ambient aircraft noise — in the neighborhood of a hair dryer or a vacuum — and falling asleep becomes a challenge.
Some travelers swear by melatonin, a hormone secreted by the brain in response to darkness. Melatonin influences the rhythms of the internal 24-hour clock and plays a role in preparing the body and brain for sleep. While melatonin can be helpful in setting the stage to slip into sleep, it does not act as a sedative.
Prescription drugs can induce sleep but have potential side effects including dizziness, fatigue or grogginess upon awakening. Some prescription sleep medications can result in abnormal sleep-related behaviors, such as sleepwalking.
Though occasional use is considered safe, these drugs have addictive and abusive potential. If someone opts for a sedative, we encourage using a trial dose at home prior to a flight to ensure tolerance.
Anyone using a sleep medication should time the dose to have a few waking hours at the end of the flight to recover from any grogginess or other possible aftereffects.
With sleep, remember the physical environment plays a role. Dress in comfortable, loose-fitting layers. Studies show swapping your shoes for a pair of thick, warm sleep socks can speed the onset of sleep and help you sleep longer.
Earplugs or noise-canceling headphones to mitigate engine noise, along with a well-fitted sleep mask, improve your chances of dropping off and staying asleep. Lavender oil has been found to increase slow-wave, refreshing deep sleep.
Given the limited degree to which most aircraft seats recline, passengers need to get creative about finding a comfortable position. This includes using a pillow that will provide complete support and keep your head from bobbing. Creating a footrest with a carry-on or other device can not ease discomfort and help prevent blood clots.
Abstain from screens, caffeine and alcohol. They can interfere with sleep.
When you’re not asleep, remember to get up periodically to walk and stretch. And drink plenty of water.
Dr Eve Glazier and Dr. Elizabeth Ko are UCLA Health internists.