National Sleep Foundation

Chapter 5: Circadian Rhythm Sleep Disorders

Treatment

Jet lag’s effects can be reduced through:75 76

·         Simulating the destination’s schedule before traveling and during the flight

·         Staying hydrated and moving around during the flight

·         Eating healthy and avoiding caffeine and alcohol

·         Using melatonin and bright lights to reset the circadian rhythm (see below).

Light therapy

Carefully timed bright light therapy can be effective in treating jet lag.

Carefully timed bright light therapy can be effective in treating jet lag. Various three-day studies have found that three hours of bright light in the morning can help advance circadian rhythms before eastward travel.77 78

Pharmacological options

Pharmacological options include melatonin and hypnotic agents.

A systematic review of randomized trials comparing the efficacy of melatonin vs. placebo in air travelers found that melatonin was highly effective in reducing or preventing jet lag.79

Melatonin in doses of 0.5 to 5 mg promoted sleep and decreased jet lag in travelers crossing five or more time zones. (Higher doses promoted more rapid sleep than lower doses, but doses greater than 5 mg had no additional benefit.) For greatest efficacy, melatonin should be taken at the target (i.e., destination) bedtime, optimally starting several days before departure, depending on the number of time zones to be crossed. Although studies have looked at melatonin in addition to bright light, it is yet to be determined whether this can further accelerate adaptation to the new time zone.81

Randomized controlled trials have demonstrated that inducing sleep during a long flight with short-acting hypnotics can facilitate adaptation of circadian rhythms.82

 

References

75. Stone BM, Turner C. Promoting sleep in shiftworkers and intercontinental travelers. Chronobiol Int. 1997;14:133-143.

76. Drake CL, Wright KP, “Shift Work, Shift-Work Disorder, and Jet Lag,” in In Kryger M, Roth T, Dement W (ed.), Principles and Practice of Sleep Medicine (5th Edition), St. Louis: Elsevier Saunders, 2011, pages 784-798.

77. Burgess HJ, Crowley SJ, Gazda CJ, Fogg LF, Eastman CI. Preflight adjustment to eastward travel: 3 days of advancing sleep with and without morning bright light. J Biol Rhythms. 2003;18:318-228.

78. Eastman CI, Gazda CJ, Burgess HJ, Crowley SJ, Fogg LF. Advancing circadian rhythms before eastward flight: a strategy to prevent or reduce jet lag. Sleep. 2005;28:33-44.

79. Caspi O. Melatonin for the prevention and treatment of jet lag. Altern Ther Health Med. 2004;10:74-78.

80. Centers for Disease Control and Prevention (CDC), CDC Health Information for International Travel, Chapter 2: Self-Treatable Conditions, Jet Lag. Atlanta: CDC, 2014. Available at http://wwwnc.cdc.gov/travel/page/yellowbook-home-2014.

81. Buscemi N, Vandermeer B, Hooton N, et al. Efficacy and safety of exogenous melatonin for secondary sleep disorders and sleep disorders accompanying sleep restriction: meta-analysis. BMJ. 2006;332:385-393.

82.Buxton OM, Copinschi G, Van Onderbergen A, Karrison TG, Van Cauter E. A benzodiazepine hypnotic facilitates adaptation of circadian rhythms and sleep-wake homeostasis to an eight hour delay shift simulating westward jet lag. Sleep. 2000;23:915-927.