How to survive a marathon flight

Surviving long-haul flights wasn’t Akshay Nanavati’s top concern as a Marine. Nanavati, who served as a communication liaison in Iraq, worried more about what would happen after the 15-hour trip from San Diego to Baghdad.

“We had to hit the ground running,” remembers Nanavati, now a consultant based in Basking Ridge, N.J.

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He made it through his tour of duty, but his capacity for enduring long flights with equanimity did not. After a recent 18-hour flight from New York to Bangalore, “I arrived in India groggy,” he recalls. “I couldn’t work or spend quality time with my family for two full days.”

Sitting motionless in a pressurized aluminum tube for hours at a time can take a heavy toll on your body. Potential side effects include dehydration, fatigue and an increased risk of deep vein thrombosis, a potentially fatal condition. At the same time, we are all spending more time on planes. For example, a nonstop flight from New York to Houston takes about four hours — a flight that took only 2½ hours in 1973. Why? Planes are flying slower to save fuel, some airlines are padding their schedules to ensure on-time arrivals, and there’s just a lot more air traffic.

New research conducted by the University of Sydney’s Charles Perkins Center is taking an interdisciplinary approach to preventing the fatigue associated with marathon flights. Scientists are reviewing issues including nutrition, physical activity and sleep, hoping to help travelers avoid reactions like Nanavati’s.

The project is a collaboration with Qantas, which will use the results to develop a new approach to long-haul travel ahead of the first Boeing 787 Dreamliner flights later this year. The aircraft will fly routes that include London to Perth, which at almost 17 hours is the third-longest passenger flight in the world.

“We’re developing a suite of interventions and services that support health and wellness in the air and assist in shifting body clocks to ease the effects of jet lag,” says Perkins Center Academic Director Stephen Simpson. “Ultimately, these will begin in the days leading up to flight in the form of advice delivered through apps and devices, then in features of the transit lounges, in the services offered onboard the aircraft, and then continue with further advice after arriving at the destination.”

Of course, one of the easiest ways to make a flight more bearable — and lessen the risk of deep vein thrombosis — is to offer passengers a reasonable amount of personal space. In an effort to squeeze more people onto planes, airlines have reduced the amount of legroom, a step that passenger advocates say can increase the likelihood of blood clots.

Philip Capps, the head of customer product and service development at Qantas, says the 787 has been designed to maximize comfort. “In business class, for example, the seats are laid out in a 1-2-1 configuration so that every passenger has direct aisle access,” he says. And economy class passengers will get 32 inches of seat pitch — a rough measure of legroom — compared with the Airbus A380’s 31 inches.

But let’s face it, most of us won’t be flying on a Dreamliner any time soon. Until then, how do you get through a whole day on the plane?

Spending more than 12 hours on a plane is a mind game, says LaVonne Markus, a travel agent with Travel Leaders in Stillwater, Minn. “You have to accept that it will be a long flight,” she says.

Nanavati uses two strategies to avoid a repeat of his Bangalore flight. First, he stopped ordering Bloody Marys and switched to water to stay hydrated. Second, he stays up the night before his flight and brings an eye mask so that he can sleep on the plane. That helps him adjust to new time zones faster.

Staying up late is only half the solution says Topher Morrison, an education consultant in Tampa who travels frequently. “Don’t follow the flight feeding schedule,” he says. “Follow the landing’s feeding schedule.” In other words, if you’re flying to Sydney, have lunch when it’s lunchtime in Sydney — even if it means getting up in the middle of the night to eat.

If you’re in economy class, you’ll be sitting in an upright position for hours at a time. “Get up and move,” advises Jeremy Smith, a spine surgeon at Hoag Orthopedic Institute in Irvine, Calif. Smith says you should give your body a break by standing up every 30 to 45 minutes. And don’t forget to bring a comfortable travel pillow for neck support.

In fact, if you do only one thing on your next long-haul flight, make sure you move, survivors like Kelly Merritt say. I use the term “survivor” literally. After a series of lengthy flights, she developed a pulmonary embolism that nearly killed her. She says her physician told her that flying was a contributing factor.

“It’s critical for travelers on long-haul flights to stay active during all aspects of the flight,” says Merritt, an author who lives in Pilot Mountain, N.C. “This can mean wiggling your feet and toes, getting up to walk around, anything that keeps the blood from pooling in your feet.”

Until science comes through with a workaround, this may be the best advice of all. If you want to survive, move.

12 thoughts on “How to survive a marathon flight

  1. I vote for “If appropriate, take a sleeping pill you know works, at a schedule that gets you as close to your destination’s sleep schedule as possible.” If it’s a REALLY long flight, I go with 1/2 of a tablet of generic Unisom SleepTabs (doxylamine succinate, a 1st-gen antihistamine that is similar to diphenhydramine, but for me works much better.) For a flight where 8 hours of sleep won’t fit or won’t be appropriate, I go with generic Rx Intermezzo (a low-dose Ambien that takes effect faster and only lasts four hours.)

    While there might be some healh risk to sleeping upright, there’s a much bigger risk I’m going to do something boneheaded like dazedly wander into traffic at my destination if I don’t have any sleep.

  2. The longest flight I have ever been on was SQ 19 (LAX-SIN). At that time, it was the 2nd longest non-stop in the world. It was such a comfortable flight that I didn’t feel any ill effects. In my opinion, the toughest flights are the 4-5 hour EB redeye flights. Short enough that you can’t sleep, long enough to be miserable.

    1. Back when they operated them, I did the SQ EWR-SIN nonstop (about 19 hours, straight over the pole). Long flight, but it was SQ business class. I would have been happy to have them do a couple of laps around Southeast Asia.

  3. I fly Seattle-LA-Sydney and back regularly and I swear by noise cancellation headphones and compression socks with running shoes.

    1. Be aware that though compression socks do help with swelling of the ankles and feet, they do NOT reduce your risk of serious DVT.

  4. How do you not follow the flight’s feeding schedule? You can’t tell the flight attendant, “Sorry, please bring my dinner back in 10 hours.” My favorite in-flight meal is on the 1:45 AM flight to Hong Kong, when they bring a full dinner around about an hour after takeoff. 3:00 AM, and everybody eats. Everybody!

    1. We have flown First Class and Business Class to Europe and Asia. We discovered that some airlines will serve our meals at the time that we want them and some don’t. When our son was young, it was common for him to be sleeping at meal time. Asiana is the best (they will serve any of the meal choices at our times)…United is the worst (the flight attendants disappeared after the meal for the rest of the flight). If you are flying with a young child (under the age of 5) then select Asiana or Cathay Pacific and they will treat the child like a rock star.

  5. Two very important clarifications need to be made in this article:

    1. WIGGLING YOUR FEET AROUND DOES NOT DECREASE YOUR RISK OF DEVELOPING DVT. ONLY getting up and walking around is effective. (Compression socks also do nothing to prevent serious DVT.) The physician’s advice in the article is correct. Kelly Merritt’s quote is DANGEROUSLY INACCURATE. The last sentence of the article should be amended to “If you want to survive, get up and move around.”

    2. MEDICAL STUDIES HAVE CLEARLY SHOWN NO INCREASED RISK OF DVT FROM CRAMPED SEATING. The so-called economy class syndrome is not real. There are medical dangers of cramped seating(eg- no room to assume crash position) and other possible dangers, especially with emergency egress, but it is dishonest to include risk of DVT among them.

  6. > ahead of the first Boeing 787 Dreamliner flights later this year

    > But let’s face it, most of us won’t be flying on a Dreamliner any time soon.

    The first commercial Dreamliner flight was six years ago, in 2011. There are 550 in service today, including 60+ on United and AA. I’m sure quite a few commenters will have been on one.

  7. “a nonstop flight from New York to Houston takes about four
    hours — a flight that took only 2½ hours in 1973”

    JFK to IAH is 1417 miles, per Great Circle Mapper. Divide that by 2.5 hours, and you have to average 567 mph. Although some aircraft can achieve that airspeed, many cannot, and max airspeed is NOT average airspeed. No one is going 567 mph during push back, taxi, climbing and descent, or in headwinds. And traffic on the ground and in the air slows everyone down. Surely you are not looking at flight schedules from 1973 and ignoring the one hour time change
    between NY and Houston? A flight departing at Noon in NY, arriving in Houston at 2:30 is 3.5 hours.
    While it is true that airspeeds are set for economics, we’re talking 5%, not 40% slower as your scenario suggests.

    And in the interest of being fair, people have choices. We used to have the choice to fly from NY to London or Paris at Mach 2, and save hours on the flight. BA and Air France stopped flying the Concorde, because there was not enough demand to keep it. Apparently most people value money over time.

    We have the choice to buy First or Business Class, or even the upgraded economy classes on most flights, which give us more room, and more comfort. But MOST customers value their
    money over their comfort, and opt for the cheapest flight possible. They have that right. But let’s not demonize the airline for finding ways to make that ride cheaper when their customers make it clear they want to save a few bucks, and will NOT pay extra for the extra inch or two. Don’t believe me? Remember AA’s “More Room Throughout Coach” campaign in the late 90s and early 2000s? It went away because, even though it was 34 inches versus 31-32 inches, people go on line and see AA for $300 and Delta or United for $295 and save the $5. So AA took the inches back from each row and added those 5-6 seats (and potential customers) back into the mix. People choose Spirit with 30 inches and no seat recline at all because it is a few bucks cheaper. They CHOOSE to give up comfort and space for a lower fare.
    I understand not everyone can afford these “better” choices; nor can everyone afford an SUV, a giant house, an acre lawn. Some people can only afford a cramped car, a cramped apartment, and a cramped airline seat. This is simple economics. If you don’t want to spend more money, stop expecting some company to give you more stuff.

  8. I’m concerned about the pilots who fly these routes. I understand helping make passengers more comfortable and safer but I don’t want my pilot suffering a dvt while in-flight.

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