Elsevier

Sleep Medicine Clinics

Volume 4, Issue 2, June 2009, Pages 241-255
Sleep Medicine Clinics

How to Travel the World Without Jet Lag

https://doi.org/10.1016/j.jsmc.2009.02.006Get rights and content

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Symptoms, health, and safety consequences of jet lag

Jet travel across multiple time zones produces jet lag, which includes difficulty initiating or main-taining nighttime sleep, daytime sleepiness, decreased alertness, loss of concentration, impaired performance, fatigue, irritability, disorientation, depressed mood, and gastrointestinal disturbances.5, 6, 7, 8 Jet lag is not just the bane of tourists; it can impair the judgment of business people and politicians, compromise the performance of athletes,5, 6 and pose a threat to public safety as

Duration of jet lag and why there is more jet lag after flying east

Jet lag is caused by a temporary misalignment between the endogenous circadian clock, specifically the dorsomedial region of the suprachiasmatic nucleus,21 which controls the body's circadian rhythms and the destination time zone and sleep/wake schedule. The symptoms of jet lag dissipate as the circadian clock is gradually reset (gradually phase shifts) to realign (re-entrain) to the time cues (zeitgebers) of the new time zone, primarily the LD cycle. Flying east requires a phase advance of the

Light and melatonin phase response curves

The most effective treatments for jet lag rely on shifting the circadian clock to the new time zone as fast as possible. To understand these schemes, one must understand phase response curves (PRCs). Fig. 2 shows that bright light can help produce phase advances when applied late in the sleep episode and in the morning after the Tmin and can help produce phase delays when applied early in the sleep episode before the Tmin. Most human light PRCs show the crossover point from phase advances to

How to minimize or avoid jet lag

Given the knowledge of when to apply bright light or give melatonin pills to get the largest phase shifts, how can we help Henry minimize or avoid jet lag? Fig. 4 shows one possibility. Henry uses a bright light box in the 2 hours before sleep the two nights before the flight to China. Commercially available light boxes are usually advertised for the treatment of winter depression or seasonal affective disorder, but these boxes are also useful for helping to phase shift the circadian clock, and

Drugs only mask jet lag and are limited in their effects

With no preparation before jet travel and random light exposure on arrival, the nighttime insomnia and daytime sleepiness often associated with jet lag can be treated with drugs and naps as a last resort. In this scenario, one treats the symptoms only, and the cause, the underlying circadian misalignment, will continue until the circadian clock finally re-entrains to the new time zone. Re-entrainment to the new time zone may take a week or more (see Fig. 1) or longer still if you are

Summary

In this article we have explained the circadian principles behind how to phase shift the circadian clock with bright light and melatonin and have presented current light and melatonin PRCs that indicate the correct timing of these zeitgebers to produce the desired phase shifting effect. We have provided detailed examples of a few jet travel plans and hope that you are now equipped to devise your own. If you have difficulty doing this, you are invited to contact us for advice.

Acknowledgments

The authors thank Heather Holly and Tom Molina for their help in preparing the figures.

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    This work was supported by grants R01 NR07677 and R01 HL086934 from the National Institutes of Health and by grant R01 OH003954 from the National Institute of Occupational Safety and Health (NIOSH) and the Centers for Disease Control and Prevention (CDC). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Nursing Research, the National Heart, Lung, and Blood Institute, the National Institutes of Health, the NIOSH, or the CDC.

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