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Jet lag and sleep phase disorders

  • Overview
  • Theory
  • Diagnosis
  • Management
  • Follow up
  • Resources
Last reviewed: 3 Apr 2025
Last updated: 21 May 2024

Summary

Definition

History and exam

Key diagnostic factors

  • history of jet travel across at least 2 time zones
  • difficulty initiating or maintaining sleep
  • reduction of total sleep time
  • daytime sleepiness
  • reduced daytime alertness
Full details

Other diagnostic factors

  • nausea, abdominal distension, constipation
  • general malaise
  • muscle cramps
Full details

Risk factors

  • multiple time zones crossed and rapidity of travel
  • sleep deprivation
  • individual susceptibility to time zone shifts
  • excessive alcohol or caffeine consumption
  • stress
Full details

Diagnostic tests

1st tests to order

  • no initial test
Full details

Treatment algorithm

ACUTE

short stay in the new time zone (≤2 days)

long stay in new time zone (>2 days)

Contributors

Authors

Ashish Adlakha, MD

Assistant Clinical Professor

Neurology and Sleep Medicine

UConn School of Medicine

VA Connecticut Healthcare

West Haven

CT

Disclosures

AA declares that he has no competing interests.

Acknowledgements

Dr Ashish Adlakha would like to gratefully acknowledge Dr Sudhansu Chokroverty, a previous contributor to this topic.

Disclosures

SC declares that he has no competing interests.

Peer reviewers

David N. Neubauer, MD

Associate Director

Johns Hopkins Sleep Disorders Center

Baltimore

MD

Disclosures

DNN has received consulting fees and honoraria for speaking programs from Sanofi-Aventis and Takeda Pharmaceuticals. These companies manufacture medications mentioned in this topic.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

American Academy of Sleep Medicine. The International Classification of Sleep Disorders: Diagnostic and Coding Manual (ICSD-3). 3rd ed. Westchester, IL: American Academy of Sleep Medicine; 2023.

Morgenthaler TI, Lee-Chiong T, Alessi C, et al. Practice parameters for the clinical evaluation and treatment of circadian rhythm sleep disorders. Sleep. 2007 Nov;30(11):1445-59.Full text  Abstract

Centers for Disease Control and Prevention. CDC Yellow Book 2024: health information for international travel. Section 8: Travel by air, land & sea - jet lag. May 2023 [internet publication].Full text

Herxheimer A, Petrie KJ. Melatonin for the prevention and treatment of jet lag. Cochrane Database Syst Rev. 2002;(2):CD001520.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

  • Differentials

    • Travel-related fatigue
    • Short-term insomnia disorder
    • Chronic insomnia disorder
    More Differentials

  • Guidelines

    • International classification of sleep disorders, 3rd edition, text revision (ICSD-3-TR)
    • CDC Yellow Book: health information for international travel - jet lag
    More Guidelines

  • Patient information

    Jet lag

    More Patient information
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