Jet lag disorder

Anna Monica Fermin MD (Dr. Fermin of SUNY Upstate Medical University has no relevant financial relationships to disclose.)
Antonio Culebras MD, editor. (Dr. Culebras of SUNY Upstate Medical University has no relevant financial relationships to disclose.)
Originally released November 22, 1993; last updated January 31, 2017; expires January 31, 2020

This article includes discussion of jet lag disorder, jet lag, jet lag disorder, time-zone change sleep disorder, transmeridian dyschronism, and transmeridian flight desynchronosis. The foregoing terms may include synonyms, similar disorders, variations in usage, and abbreviations.

Overview

In today's society air travel is a common mode of transportation. Individuals crossing several time zones can experience jet lag disorder, which is characterized by excessive daytime sleepiness, general malaise, and somatic complaints. Jet lag may be partially preventable or treatable by understanding the basics of the circadian clock and its interactions with the sleep-wake cycle. The author provides an update on the current understanding of jet lag disorder, including diagnostic criteria based on the ICSD-3, pathophysiology, and therapeutic approaches to prevent and minimize symptoms.

Key points

 

• Jet lag disorder is caused by a temporary mismatch between the timing of the sleep and wake cycle generated by the endogenous circadian clock and that of the sleep and wake pattern required by a change in time zone.

 

• Symptoms include difficulties in initiating and maintaining sleep, excessive daytime sleepiness, decrease in subjective alertness and performance, impairment of daytime functioning, and somatic complaints.

 

• Jet lag symptoms are more severe when flying eastward.

 

• The best strategy for brief stays (2 to 3 days) in the new time zone is to keep the original sleep-wake schedule, if at all possible.

 

• For longer stays, timed melatonin with strategic exposure to light and avoidance of light at particular times are the best strategies.

Historical note and terminology

Time-zone change syndrome (jet lag) did not exist prior to the invention of jet planes during World War II and became common when commercial transmeridian air travel by jet became commonplace in the 1960s. Hundreds of millions of travelers cross time zones by jet each year and, for the majority of travelers, jet lag is a minor and temporary nuisance. For a minority that travels frequently by jet, time-zone change syndrome is a major health problem. Throughout this topic I use the well-known, old names of this syndrome, “jet lag” (American Sleep Disorders Association 1997). The current formal name used in the 3rd edition of the International Classification of Sleep Disorders is jet lag disorder. Alternate names include time zone change syndrome, jet lag syndrome, and jet lag type (American Academy of Sleep Medicine 2014).

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