Jet lag disorder

Sabra M Abbott MD PhD (Dr. Abbott of Northwestern University Medical School has no relevant financial relationships to disclose.)
Phyllis C Zee MD PhD (

Dr. Zee of Northwestern University Feinberg School of Medicine received consulting fees from Eisai, Philips, and Jazz as a scientific advisory board member; honorariums from Eisai, Jazz, Philips, Takeda, Sanofi-Aventis, Merck, and Pear for research and educational programs; and research grants from Philips, Apnimed, Jazz, and Harmony. Dr. Zee owns stock in Teva.

)
Michael J Howell MD, editor. (Dr. Howell of the University of Minnesota received grant support from Apnex and GE and honorariums from Inspire as a panel member.)
Originally released November 22, 1993; last updated August 17, 2019; expires August 17, 2022

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, transmeridian air travel is a common mode of transportation. Individuals crossing several time zones can experience jet lag disorder, which is characterized by symptoms of difficulty falling asleep and/or excessive daytime sleepiness, general malaise, and somatic complaints. Jet lag disorder may be partially preventable or treatable by understanding the basics of circadian rhythm physiology 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 minimize symptoms.

Key points

 

• Jet lag disorder is caused by a temporary mismatch between the timing of the sleep and wake rhythm generated by the endogenous circadian clock with that of the new time zone's imposed timing of sleep and wake pattern and other behaviors, as well as the change in the light-dark cycle.

 

• 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 for most individuals 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 to accelerate the alignment of endogenous circadian rhythms to the new time zone.

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 travel frequently by jet, time-zone change syndrome is a major health problem. 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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