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Perspective: The following are 10 points to remember about jet lag:
- Jet lag is a sleep disorder that results from crossing time zones too rapidly for the circadian clock to keep pace. The latter is normally synchronized to the solar light-dark cycle and promotes alertness during the day and sleep at night. Jet lag is compounded by travel fatigue, dehydration, and prolonged immobility.
- Symptoms of jet lag include insomnia and daytime sleepiness, as well as dysfunction of mood, and physical and cognitive performance.
- Melatonin is a hormone secreted for about 10-12 hours at night and is synchronized to the light-dark cycle by the circadian clock.
- For short trips, jet lag can be minimized by maintaining the home sleep-wake schedule if it is possible, or alternatively for 2 days prior to the flight, shift the sleep schedule by 1-2 hours toward the destination time zone.
- Treatment for jet lag includes use of appropriate exposure to light, melatonin, or both; supplement as needed with medication to counteract insomnia or daytime sleepiness.
- In a comparison with melatonin, [a one of the short-acting nonbenzodiazepine hypnotics
] was more effective at reducing symptoms of jet lag, but it is not ideal because of duration of action. Upon landing in the new time zone, melatonin 0.5-3 mg may be helpful to promote sleep when traveling west to east. - Hypnosedatives need to be used with caution, as they may be expected to further increase the elevated risk for deep vein thrombosis.
- A short-acting sleeping pill during the flight is preferred, such as [ ]. Sedatives should not be combined with alcohol.
- Prior to and during the trip, hydration will help as well as avoiding caffeine for several hours prior to sleep time. When traveling east to west, seek bright sunlight in the evening; for west to east, seek bright sun in the morning.
- Increased consumption of caffeinated beverages may counteract daytime sleepiness. An alternative to increase alertness and reduce other symptoms of jet lag my be slow-release caffeine (300 mg). This strategy needs to be weighed against possible increase in insomnia.
Professor of Internal Medicine, University of Michigan Health System Preventive Cardiology
General Statement of Disclosure:
Equity Interests: United Therapeutics; Equity Interests: ISIS Pharmaceutical; Consultant Fees/Honoraria: Pfizer; Other Financial Relationship: Cardiome Pharmaceutcial
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© 2009 American College of Cardiology Foundation
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