Dr Sarah Jarvis is the Clinical Director of the Patient Platform, an active medical writer, broadcaster, and the resident doctor for BBC Radio 2.
If you’re like most people, you see holidays as a time to relax and unwind – or perhaps to broaden your horizons and experience new adventures. Either way, chances are you look at holidays as a break from the pressures of daily life. The one thing that’s unlikely to be on your wish list is coming down with illness on your holiday, or before you even arrive.
Yet leisure sickness, where you fall ill as soon as you switch off (either on holiday or even at weekends), is a very real phenomenon to many people. The name was first coined 25 years ago by a Dutch psychologist, who found people commonly associated holidays with coming down with colds, headaches or migraines, tiredness, muscle aches, feeling sick and more.
Even if you’re not prone to the sort of hormonal changes that may lead to leisure sickness, there are plenty of other pitfalls which make holidays a peak time for illness. Time zones, lack of sleep, new food and exposure to different germs can all scupper your holiday vibe.
Fortunately, there are plenty of steps you can take to stack the odds in favour of a healthy holiday.
What Can Make You Ill on Holiday?
The “Let-Down Effect”
Your body is finely tuned to help you cope with stress. If you’re under pressure, your body releases chemicals and hormones (including cortisol, often known as the stress hormone). If you’re exposed to chronic stress, high cortisol levels suppress your immune system and can weaken your immune response. But in the short term, among other roles, these hormones mobilise your immune system to be on high alert.
It’s all too common to put yourself under pressure to get everything at work completed before you leave for your holiday. By the time you finally leave, the sudden shift in hormones can leave your immune system vulnerable.
Travel Tiredness
One of the joys of a holiday is getting out of a rut and changing your usual routine. But disrupting your routine can put your sleep pattern out of synch – especially if you’re crossing time zones or getting up early for the airport. Excitement floods your body with adrenaline, which makes you more alert – and anxiety about possible travel glitches does the same. Add long car journeys or crowded trains, airports and uncomfortable plane seats into the mix, and it’s a recipe for disaster where your body clock is concerned.
Fatigue has a direct impact on immune function. When you are sleep-deprived or physically drained, your body is less effective at fighting off infections. Additionally, the stress of navigating unfamiliar environments, dealing with delays, or managing travel logistics can further strain your system.
Air travel in particular can increase your exposure to pathogens. Although modern aircraft have good ventilation systems, you are still in close proximity to many people for extended periods, increasing the likelihood of encountering viruses.
Jet Lag Joys (or Not)
Another major cause of disruption to your circadian rhythm, or body clock, is jet lag. Jey lag tends to be worse when you’re travelling east, and the clocks go forward at your destination, and less marked when you’re travelling west, and the clocks go back. That’s because your natural body clock is set at slightly longer than 24 hours. If your day has been longer because you’ve arrived somewhere where the clocks are further back, you’re more likely to be ready to sleep come bedtime at your destination.
Poor sleep due to jet lag has the same effect on your immune system as tiredness due to poor sleep. So taking precautions to minimise jet lag can boost your ability to fight off bugs on holiday.
READ MORE: How to Beat Jet Lag and Holiday Insomnia
The Sleep Disruptors
Even though it may seem like a real treat to be able to stay up late and lie in, this too can affect your circadian rhythm. Alcohol too can disrupt your sleep pattern – while you may find it makes it easier to drop off, you’ll often wake up early, needing to visit the loo, and find you can’t get back to sleep. Alcohol also disrupts your sleep, reducing the amount of restorative REM (dreaming) sleep.
On the whole, regular exercise is your friend where sleep is concerned. But if you overdo the physical activity, especially in hot climates or late in the evening, you can be prone to dehydration or exhaustion.
Add to this changes to your diet, which often include richer food, which can make you prone to bloating and heartburn at night, and your sleep and immune system can all struggle.
Exposure to New Environments and Germs
When you travel, especially internationally, you’re exposed to new environments, climates, and microorganisms. Your immune system may not be familiar with bacteria or viruses present in your destination, making you more susceptible to illness.
This is particularly relevant for gastrointestinal issues, often caused by differences in food preparation, water quality, or hygiene standards. Even in destinations with high standards, your body may react to unfamiliar foods or ingredients.
Climate change can also play a role. Moving from a cold to a hot climate (or vice versa) can put additional stress on your body. Air conditioning, for instance, can dry out your airways, making it easier for viruses to take hold, while extreme heat can lead to dehydration and fatigue.
READ MORE: What Medical Conditions Get Worse in Hot Weather?
How to Avoid Getting Ill on Holiday
Although it may not be possible to eliminate all risks, there are several practical steps you can take to reduce the likelihood of becoming ill during your holiday.
Manage Stress Before You Travel
Rather than working at full intensity until the last possible moment, try to ease into your holiday. The five Ps apply to your holiday run-up: “Proper Planning Prevents Poor Performance”. Start getting work jobs (and holiday-related jobs such as packing, organising travel insurance, etc.) sorted well in advance, so you have a buffer period before departure.
READ MORE: What does Stress Do to Us, and How Can We Cope?
Prioritise Sleep
If you’re crossing time zones, try to start adjusting your bedtime and light exposure a couple of days in advance for every hour of time difference – so up to 2 weeks ahead if there’s a 7-hour difference. Try to sleep on your flight to fit in with the times at your destination and avoid alcohol and caffeine while travelling. If it’s daytime at your destination, get outside in the daylight as much as possible. If you do need a nap, make it a short one.
Even without time-zone travel, keeping a regular bedtime and waking time will help your body adjust.
Stay Hydrated
Dehydration can exacerbate fatigue and weaken your immune system, especially during air travel and in hot climates. Drink plenty of water instead of alcoholic drinks – but once you’re at your destination, caffeine in moderation (up to 4 cups of coffee or 8 of tea, unless you’re pregnant) also counts towards your fluid intake.
READ MORE: Top Tips for Staying Hydrated on Holiday
Be Mindful of Food and Hygiene
Tummy bugs are one of the commonest causes of acute travel illness. If you’re in a country where food hygiene standards may not be as high as at home, stick to the mantra of ‘Boil it, peel it, cook it or forget it’. Stick to boiled or bottled drinks and don’t put ice (which may have been made from contaminated water) into them.
Don’t Overdo It
It can be tempting to pack your itinerary with activities, but you can end up exhausted and run down. Build in breaks and stagger your sightseeing.
Be Prepared
Make sure you’ve taken out specialist travel insurance that covers any pre-existing conditions you have. Using a specialist insurer such as Medical Travel Compared means illness won’t result in financial worries.
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