When we take a flight across time zones, our circadian timing system has no knowledge of the shift to a new light-dark cycle, so it stays at home base, and adjusts only gradually.  On landing, the inner clock may be set to night, even if it is midday outdoors.  The conflict produces jet lag, with a host of psychological and physical symptoms that can seriously disrupt one’s trip.

Management of jet lag has taken two forms:

  • Proactive: beginning to reset in the inner clock toward the day-night cycle of the travel destination before the trip starts.
  • Retroactive: taking measures after arrival to expedite the clock-shift to the destination.

Tools to smooth the time shift include: timed light therapy; timed light exposure outdoors; use of protective eyewear when outdoors in the light during the circadian night; darkening the bedroom if there is daylight during the circadian night; and timed melatonin tablets to expedite the clock’s shift into nighttime mode.

Because of the complexity of these maneuvers, they are often difficult to follow, and success can be elusive. There are other complications to jet lag, including travel stress, and adoption of a daily routine that markedly contrasts with home-based habits.

REFERENCES

Reviews

Boulos Z, Campbell SS, Lewy AJ, Terman M, Dijk D-J, Eastman CI. Light treatment for sleep disorders:  Consensus report. VII Jet lag. Journal of Biological Rhythms 1995; 10:167-176.
Arendt J. Managing jet lag: Some of the problems and possible new solutions. Sleep Medicine Reviews 2009;13:249-256.

Studies

Eastman CI, Burgess HJ. How to travel the world without jet lag. Sleep Medicine Clinics 2009;4:241-255.
Yamaguchi Y, Suzuki T, Mizoro Y, Kori H, Okada K, Chen Y, Fustin JM, Yamazaki F, Mizuguchi N, Zhang J, Dong X, Tsujimoto G, Okuno Y, Doi M, Okamura H. Mice genetically deficient in vasopressin V1a and V1b receptors are resistant to jet lag. Science 2013;342:85-90.