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How to manage travel fatigue and jet lag in athletes? A systematic review of interventions
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  1. Dina C(Christa) Janse van Rensburg1,2,
  2. Audrey Jansen van Rensburg1,
  3. Peter Fowler3,
  4. Hugh Fullagar4,
  5. David Stevens5,
  6. Shona Halson6,
  7. Amy Bender7,
  8. Grace Vincent8,
  9. Amanda Claassen-Smithers9,
  10. Ian Dunican10,
  11. Gregory Daniel Roach11,
  12. Charli Sargent11,
  13. Michele Lastella11,
  14. Tanita Cronje12
  1. 1 Faculty of Health Science, Section Sports Medicine & Sport Exercise Medicine and Lifestyle Institute (SEMLI), University of Pretoria, Pretoria, Gauteng, South Africa
  2. 2 Medical Board Member, International Netball Federation, Manchester, UK
  3. 3 School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
  4. 4 Sport and Exercise Science, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
  5. 5 Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
  6. 6 School of Behavioural and Health Sciences, McAuley at Banyo, Australian Catholic University, Brisbane, Queensland, Australia
  7. 7 Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
  8. 8 Appleton Institute for Behavioural Science, Central Queensland University, Rockhampton, Queensland, Australia
  9. 9 The South African Institute for Drug-Free Sport, Cape Town, South Africa
  10. 10 Centre for Sleep Science, The University of Western Australia Faculty of Health and Medical Sciences, Perth, Western Australia, Australia
  11. 11 Appleton Institute for Behavioural Science, Central Queensland University, Adelaide, Queensland, Australia
  12. 12 Faculty of Natural and Agricultural Sciences, Department of Statistics, University of Pretoria, Pretoria, South Africa
  1. Correspondence to Professor Dina C(Christa) Janse van Rensburg, Faculty of Health Science, Section Sports Medicine & Sport Exercise Medicine and Lifestyle Institute (SEMLI), University of Pretoria, Pretoria, Gauteng, South Africa; christa.jansevanrensburg{at}up.ac.za

Abstract

Objectives We investigated the management of travel fatigue and jet lag in athlete populations by evaluating studies that have applied non-pharmacological interventions (exercise, sleep, light and nutrition), and pharmacological interventions (melatonin, sedatives, stimulants, melatonin analogues, glucocorticoids and antihistamines) following long-haul transmeridian travel-based, or laboratory-based circadian system phase-shifts.

Design Systematic review

Eligibility criteria

Randomised controlled trials (RCTs), and non-RCTs including experimental studies and observational studies, exploring interventions to manage travel fatigue and jet lag involving actual travel-based or laboratory-based phase-shifts. Studies included participants who were athletes, except for interventions rendering no athlete studies, then the search was expanded to include studies on healthy populations.

Data sources Electronic searches in PubMed, MEDLINE, CINAHL, Google Scholar and SPORTDiscus from inception to March 2019. We assessed included articles for risk of bias, methodological quality, level of evidence and quality of evidence.

Results Twenty-two articles were included: 8 non-RCTs and 14 RCTs. No relevant travel fatigue papers were found. For jet lag, only 12 athlete-specific studies were available (six non-RCTs, six RCTs). In total (athletes and healthy populations), 11 non-pharmacological studies (participants 600; intervention group 290; four non-RCTs, seven RCTs) and 11 pharmacological studies (participants 1202; intervention group 870; four non-RCTs, seven RCTs) were included. For non-pharmacological interventions, seven studies across interventions related to actual travel and four to simulated travel. For pharmacological interventions, eight studies were based on actual travel and three on simulated travel.

Conclusions We found no literature pertaining to the management of travel fatigue. Evidence for the successful management of jet lag in athletes was of low quality. More field-based studies specifically on athlete populations are required with a multifaceted approach, better design and implementation to draw valid conclusions.

PROSPERO registration number

The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO: CRD42019126852).

  • non-pharmacological interventions [exercise, sleep, light, nutrition]
  • pharmacological interventions [melatonin, sedatives, stimulants, melatonin analogues, glucocorticoids, antihistamines]
  • circadian rhythm
  • phase-shift

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Footnotes

  • Twitter @ChristaJVR, @Audrey_JvR, @fowlerp85, @HughFullagar, @sleepyDJS, @ShonaHalson, @sleep4sport, @PhDsleepy, @sleep4perform, @CBTmin, @ThePhaseShifter, @sleeppsyc, @Tcnita

  • Contributors CJvR: Responsible for the overall idea for this review article, content concept, manuscript planning, search strategy, search and manuscript (first draft), manuscript editing. AJvR: Manuscript (first draft), content contribution, manuscript planning, search strategy, manuscript editing. All authors and co-authors searched library bases, identified relevant studies, reviewed studies, selected eligible studies, wrote the article with contributing input, manuscript editing. All authors revised and approved the final draft.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.