Jet lag and sleep phase disorders affect millions of travelers worldwide.
Rapid change in time zone produces a constellation of symptoms called jet lag disorder.
Symptoms include difficulty initiating and maintaining sleep, reduced daytime alertness, general malaise, and gastrointestinal symptoms.
Severity of symptoms depends on the number of time zones crossed, times of travel, quality of sleep in flight, circadian time cues at the place of travel, individual propensity, and direction of travel.
A temporary condition; symptoms are self-limited. Treatments include melatonin and alteration of light exposure.
Jet lag disorder is a temporary desynchronization between endogenous body rhythms and exogenous environmental rhythms, caused by rapid transmeridian travel across different time zones, leading to sleep disturbance, reduced alertness, general malaise, and gastrointestinal symptoms.
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
Other diagnostic factors
- nausea, abdominal distension, constipation
- general malaise
- muscle cramps
- multiple time zones crossed and rapidity of travel
- sleep deprivation
- individual susceptibility to time zone shifts
- excessive alcohol or caffeine consumption
1st investigations to order
- no initial test
Investigations to consider
- sleep diary
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
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.
David N. Neubauer, MD
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.
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- Psychophysiologic insomnia
- Behavioral insomnia of childhood
- CDC health information for international travel (the Yellow Book): jet lag
- Nutrition for travel
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