Jet lag and sleep phase disorders

Last reviewed: 1 Sep 2023
Last updated: 11 Jul 2023



History and exam

Key diagnostic factors

  • history of travel across at least 2 time zones
  • difficulty initiating sleep
  • difficulty maintaining sleep
  • daytime sleepiness
  • reduced daytime alertness
More key diagnostic factors

Other diagnostic factors

  • nausea, abdominal distension, constipation
  • general malaise
  • muscle cramps
Other diagnostic factors

Risk factors

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

Diagnostic investigations

1st investigations to order

  • no initial test
More 1st investigations to order

Investigations to consider

  • polysomnography
  • actigraphy
  • sleep diary
More investigations to consider

Treatment algorithm


short stay in the new time zone (≤3 days)

long stay in new time zone (>3 days)



Ashish Adlakha, MD

Assistant Clinical Professor

Neurology and Sleep Medicine

UConn School of Medicine

VA Connecticut Healthcare

West Haven



AA declares that he has no competing interests.


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


SC declares that he has no competing interests.

Peer reviewers

David N. Neubauer, MD

Associate Director

Johns Hopkins Sleep Disorders Center




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

  • Differentials

    • Travel-related fatigue
    • Psychophysiologic insomnia
    • Behavioral insomnia of childhood
    More Differentials
  • Guidelines

    • CDC Yellow Book: health information for international travel - jet lag
    • Nutrition for travel
    More Guidelines
  • Patient leaflets

    Jet lag

    More Patient leaflets
  • padlock-lockedLog in or subscribe to access all of BMJ Best Practice

Use of this content is subject to our disclaimer