Jet Lag
Definition
Jet lag is associated with the misalignement of the body’s normal day/night rythtm.
Flight across time zones (transmeridional flight) results in different body rythms that are not initially synchronized with the day-night cycle at destination time zone causing jet lag.
Almost universal in travellers.
Sleep disruption
Episode of daytime sleepiness
Episode of night time alertness
Weakness, slowed reflexes & myalgia
Headache
Irritability, depression
Poor concentration
Indigestion , hunger at odd hours
Lack of resistance to infections
Symptoms can persist for a week or more. Circadian rythms may take up to 2 weeks to adjust.
When possible choose day time flights to minimize loss of sleep & fatigue
Avoid large fatty meals, caffeine and alcohol during the flight.
Drink a lots of water
Exposure to bright light for 3-4 days
-Eastward travel , bright light in early morning at destination
-Westward travel, bright light in afternoon at destination
Adjust sleep schedule, starting 3 days prior departure
-Eastward travel, go to bed 1 hour earlier each succeeding night
-Westward travel, stay up later 1 hour more each night
There is no evidence of usefulness of homeopathic remedies or diet in the treatment or prevention of jet lag.
Melatonin
Eastward Travel
Away for 4 or more days: take a 3 to 5mg of melatonin at 1800 to1900 hours local time on the day of departure (if necessary, take while on the flight). On arrival, take 3 to 5 mg dose at local bed time, 2200 to 2300 hours for the next 4 days.
Away for less than 4 days: The evening preceding departure, take a dose of 3 to 5 mg of melatonin at 1800 to 1900 hours local time.
On arrival, take a daily dose 3 to 5mg at local bedtime, 2200 to 2300 hours until departure.
Westward Travel
Away for 4 or more days: take 3 to 5 mg dose daily at local bedtime, 2300 hours or later, for 4 days at the destination (or at each stop-over). If awake in the very early hours of the morning (before 4am), take another dose
Do not take melatonin pre-flight when flying west.
Away for less than 4 days: Take 3 to 5 mg of melatonin at bedtime the night before departure.
Cautions
Melatonin can produce sleepiness and reduced alertness. Persons taking melatonin should not drive, operate heavy machinery, or perform tasks requiring alertness for 4 to 5 hours after taking melatonin. The timing of the dose of melatonin needs to be precise, since mistiming the dose can worsen rather than improve the jet lag symptoms.
Persons who suffer from psychiatric problems or migraine headaches or who may be or intend to become pregnant should use melatonin with caution, if at all.
Hypnotics for jet lag
Zolpidem (Ambien)
10 mg tablet h.s at destination for 2-3 nights, can be use in combination with melatonin
Other short active hypnotics
Zaleplon
Temazepan
Triazolam
1. DuPont HL, Steffen R. Textbook of Travel Medicine and Health. First Edition. BC Decker Inc, Hamilton, London. 1997
2. Jong EC, McMullen R. The Travel and Tropical Medicine Manual .Third Edition. Saunders, Philadelphia, Pensylvania. 2003
3. Website: www.travax.com
Nicole Denommé
Ottawa Hospital-General Campus
Fax: (613) 737-8009
e-mail: ndenomme@ottawahospital.on.ca