An in-flight wake-up call
Do you pop a pill before a long-haul flight? You're not alone. The pre-trip check list for many travellers nowadays goes something like this: passport, ticket, money ... sleeping tablet.
In a culture where prescription tranquillisers are in rampant use, your GP probably won't bat an eyelid if you ask for one. Tell them you're a nervous flyer and need a bit of shut-eye to get you through the jet lag, and the chances are they'll dole out a handful.
But while your doctor might live to regret signing the prescription, you may not. The case of a healthy young woman who died from deep-vein thrombosis during a transatlantic flight is a devastating reminder of the dangers of taking sleeping pills on aircraft.
In a recent report, the New England Journal of Medicine outlines the case of a 36-year-old woman who had taken a single sleeping pill shortly before departure and spent the entire flight asleep in one position, undoubtedly the critical factor in her death.
After seven hours at 30,000 feet, she woke to go to the bathroom and collapsed in the aisle. A doctor on board tried to resuscitate her and the plane made an emergency landing in Boston, two hours after her collapse. But it was too late.
Tests confirmed that she had suffered a massive pulmonary embolism with blood clots in her legs travelling through her veins and lodging in her heart and lungs, causing brain damage from lack of oxygen and coma. Almost two weeks later she was taken off life support and died.
This tragic story should serve as a salutary lesson to anyone who thinks medication can take the pain out of flying.
There's no easier way to get through a flight than sleep. What could be better than nodding off before the plane has even left the runway and waking up 10 hours later in your destination feeling refreshed and ready to go?
But our bodies are not designed to sleep sitting up. Being upright compresses the veins of the pelvis and slows down blood flow through to the calves. Simple rotations of the calf muscles, something we should all practise every time we fly, counteracts this effect.
If you're the sort of nervous flier who simply can't get through a flight without knocking yourself out with a pill or a few glasses of wine, you need to be aware of the potentially fatal risks you face by staying motionless for long periods.
Being in a cabin with reduced oxygen pressure increases your risk of clotting even more, especially on flights of more than eight hours.
People who are obese, pregnant, smokers, have varicose veins or cancer are in even more danger.
The only time you should use medication to help you sleep in the air is if you are travelling business class and know you will be able to lie out flat and move comfortably.
Otherwise, the smart way to get through your flight is to grab an aisle seat and stretch your legs every 20 minutes.
You might annoy your travelling companions, but at least you won't start your holiday in an ambulance.