Jet lag

Source: Wikipedia, the free encyclopedia.

Jet lag
Other namesDesynchronosis, circadian dysrhythmia
World clocks in Parque do Pasatempo, Betanzos, Galicia, Spain.
World clocks
SpecialtyPsychiatry, neurology, aviation medicine

Jet lag, or desynchronosis, is a temporary

phase shift when travelling from east to west is referred to as phase-delay of the circadian cycle, whereas going west to east is phase-advance of the cycle. Most travellers find that it is harder to adjust time zones when travelling east.[1] Jet lag was previously classified as a circadian rhythm sleep disorder.[2]

The condition may last several days before a traveller becomes fully adjusted to a new time zone; it takes on average one day per time zone crossed to reach circadian

airline pilots, aircraft crew, and frequent travellers. Airlines have regulations aimed at combating pilot fatigue
caused by jet lag.

The term jet lag is used because before the arrival of passenger jet aircraft, it was uncommon to travel far and fast enough to cause the condition.[4]

Discovery

According to a 1969 study by the Federal Aviation Administration, aviator Wiley Post was the first to write about the effects of flying across time zones in his 1931 co-authored book, Around the World in Eight Days.[5][6]

Signs and symptoms

The symptoms of jet lag can be quite varied, depending on the amount of time zone alteration, time of day, and individual differences.

day–night cycle of the destination,[8] as well as the possibility of internal desynchronisation. Jet lag has been measured with simple analogue scales, but a study has shown that these are relatively blunt for assessing all the problems associated with jet lag. The Liverpool Jet Lag Questionnaire was developed to measure all the symptoms of jet lag at several times of day, and has been used to assess jet lag in athletes.[9]

Jet lag may require a change of three time zones or more to occur, though some individuals can be affected by as little as a single time zone or the single-hour shift to or from

Olympics and FIFA World Cup. However many athletes arrive at least 2–4 weeks ahead of these events, to help adjust from any jet lag issues.[10]

Travel fatigue

Travel fatigue is general fatigue, disorientation, and headache caused by a disruption in routine, time spent in a cramped space with little chance to move around, a low-oxygen environment, and dehydration caused by dry air and limited food and drink. It does not necessarily involve the shift in circadian rhythms that cause jet lag. Travel fatigue can occur without crossing time zones, and it often disappears after one day accompanied by a night of good quality sleep.[8]

Cause

Jet lag is a

body clock (circadian rhythm) will be out of synchronisation with the destination time, as it experiences daylight and darkness contrary to the rhythms to which it was accustomed. The body's natural pattern is disturbed, as the rhythms that dictate times for eating, sleeping, hormone regulation, body temperature variation
, and other functions no longer correspond to the environment, nor to each other in some cases. To the degree that the body cannot immediately realign these rhythms, it is jet lagged.

The speed at which the body adjusts to a new rhythm depends on the individual as well as the direction of travel; some people may require several days to adjust to a new time zone, while others experience little disruption.

Crossing the

UTC−10
, though the former is one day ahead of the latter.

Jet lag is linked only to the distance travelled along the east–west axis. A ten-hour flight between Europe and southern Africa does not cause jet lag, as the direction of travel is primarily north–south. A four-hour flight between

, in the United States may result in jet lag, as the direction of travel is primarily east–west.

Double desynchronisation

There are two separate processes related to biological timing:

circadian oscillators and homeostasis.[12][13] The circadian system is located in the suprachiasmatic nucleus (SCN) in the hypothalamus of the brain. The other process is homeostatic sleep propensity, which is a function of the amount of time elapsed since the last adequate sleep episode.[13]

The human body has a master clock in the SCN and peripheral oscillators in tissues. The SCN's role is to send signals to the peripheral oscillators, which synchronise them for physiological functions. The SCN responds to light information sent from the retina. It is hypothesised that peripheral oscillators respond to internal signals such as hormones, food intake, and "nervous stimuli".[14]

The implication of independent internal clocks may explain some of the symptoms of jet lag. People who travel across several time zones can, within a few days, adapt their sleep–wake cycles with light from the environment. However, their skeletal muscles, liver, lungs, and other organs will adapt at different rates.[15] This internal biological de-synchronisation is exacerbated as the body is not in sync with the environment – a double desynchronisation, which has implications for health and mood.[16]

Delayed sleep phase disorder

Delayed sleep phase disorder is a medical disorder characterised by delayed sleeping time and a proportionately delayed waking time due to a phase delay in the internal biological master clock. Specific genotypes underlie this disorder. If allowed to sleep as dictated by their endogenous clock these individuals will not have any ill effects as a result of their phase-shifted sleeping time.

Management

Light exposure

Light is the strongest stimulus, or zeitgeber, for realigning a person's circadian cycle, and the key to quick adaptation is therefore timed light exposure based on the traveller's sleep pattern, chronotype, and plans.

Timed light exposure can be effective to help people match their circadian rhythms with the expected cycle at their destination; it requires strict adherence to timing.[17] Light therapy is a popular method used by professional athletes to reduce jet lag.[18] Timed correctly, the light may contribute to an advance or delay of the circadian phase to match the destination.[19]

The

US Centers for Disease Control and Prevention (CDC) recommends mobile apps for the correct timing of light exposure and avoidance, when to use caffeine, and when to sleep.[20]

Melatonin administration

In addition to timed light exposure, the right type and dose of

anti-doping agencies may prohibit or limit its use.[10]

Melatonin can be considered to be a darkness signal, with effects on circadian timing that are the opposite of the effects of exposure to light.[22][23] Melatonin receptors are situated on the suprachiasmatic nucleus, which is the anatomical site of the circadian clock.[24] The results of a few field studies of melatonin administration, monitoring circadian phase, have provided evidence for a correlation between the reduction of jet lag symptoms and the accelerated realignment of the circadian clock.[25]

Short duration trips

In the case of short duration trips, jet lag may be minimised by maintaining a sleep-wake schedule based on the originating time zone after arriving at the destination, but this strategy is often impractical in regard to desired social activities or work obligations.[26] Shifting one's sleep schedule before departure by 1–2 hours to match the destination time zone may also shorten the duration of jet lag.[27] Symptoms can be further reduced through a combination of artificial exposure to light and rescheduling, as these have been shown to augment phase-shifting.[28]

Pharmacotherapy

The short-term use of

global amnesia.[34]

Mental health implications

Jet lag may affect the mental health of vulnerable individuals. When travelling across time zones, there is a "phase-shift of body temperature, rapid-eye-movement sleep, melatonin production, and other circadian rhythms".

psychotic disorders occurred more frequently when seven or more time zones had been crossed in the past week than when three or fewer had been crossed.[36] Although significant circadian rhythm disruption has been documented as affecting individuals with bipolar disorder, an Australian team studied suicide statistics from 1971 to 2001 to determine whether the one-hour shifts involved in daylight saving time had an effect. They found increased incidence of male suicide after the commencement of daylight saving time but not after returning to standard time.[37]

See also

References

  1. .
  2. ^ "Highlights of Changes from DSM-IV-TR to DSM-5" (PDF). American Psychiatric Association. 17 May 2013. Archived from the original (PDF) on 17 September 2013. Retrieved 23 May 2013.
  3. ^ "Jet Lag - an overview | ScienceDirect Topics". www.sciencedirect.com. Retrieved 15 February 2024.
  4. Smithsonian Magazine
    . Retrieved 12 April 2024.
  5. ^ Post, Wiley; Gatty, Harold (1931). Around the World in Eight Days. London: Hamilton.
  6. ^ Siegel, P. V.; Gerathewol, Siegfried J.; Mohler, Stanley R. (September 1969). Time-Zone Effects On the Long Distance Air Traveler (PDF) (Report). Federal Aviation Administration. p. 3. Archived from the original (PDF) on 13 April 2023.
  7. ^ Doyle, Ashley (10 January 2020). "Jet Lag: It's Symptoms and What you can do to stop it". Savvysleeper. Retrieved 3 June 2020.
  8. ^
    S2CID 1569314
    . Retrieved 1 August 2015.
  9. .
  10. ^ .
  11. .
  12. S2CID 17581306. {{cite book}}: |journal= ignored (help
    )
  13. ^ .
  14. ^ Brown, S. A. & Azzi, A. (2013). "Peripheral circadian oscillators in mammals". Circadian clocks. Berlin: Springer. pp. 45–66. Center for Substance Abuse Treatment (2008). "Appendix D: DSM-IV-TR Mood Disorders". Managing Depressive Symptoms in Substance Abuse Clients During Early Recovery. Treatment Improvement Protocol (TIP) Series, No. 48. Rockville, MD: Substance Abuse and Mental Health Services Administration.
  15. S2CID 8102779
    .
  16. .
  17. .
  18. ^ Mitchell, Peter (17 March 2014). "LA Dodgers bring secret weapon to Sydney". The Sydney Morning Herald. Retrieved 21 October 2014.
  19. ^ "The science of jet lag". Timeshifter. Retrieved 3 January 2023.
  20. CDC
    . Retrieved 3 January 2023.
  21. ^ "Melatonin for jet lag". Timeshifter. Retrieved 3 January 2023.
  22. ^ Lewy, A., Bauer, V. K., Ahmed, S., Thomas, K. H., Cutler, N. L., Singer, C. M., ... Sack, R. (1998). The human phase response curve (PRC) to melatonin is about 12 hours out of phase with the PRC to light. Chronobiology International, 15(1), 71–83.
  23. ^ Burgess, H. J., Revell, V. L., Eastman, C. I. (2008). A three pulse phase response curve to three milligrams of melatonin in humans. J Physiol, 586:639–47. doi:10.1113/jphysiol.2007.143180
  24. ^ Dubocovich, M. L., Benloucif, S., Masana, M. I. (1996). Melatonin receptors in the mammalian suprachiasmatic nucleus. Behav Brain Res, 73:141–7.
  25. ^ Piérard, C., Beaumont, M., Enslen, M. et al. (2001). Resynchronization of hormonal rhythms after an eastbound flight in humans: effects of slow-release caffeine and melatonin. Eur J Appl Physiol, 85:144. doi:10.1007/s004210100418
  26. ^ Lowden, A., Akerstedt, T. (1998). Retaining home-base sleep hours to prevent jet lag in connection with a westward flight across nine time zones. Chronobiol Int, 15:365–76.
  27. ^ Sack, R. L. (2010). Clinical practice : Jet lag. N Engl J Med, 362:440–7. doi:10.1056/NEJMcp0909838
  28. PMID 20204161
    .
  29. ^ Suhner, A., Schlagenhauf, P., Höfer, I., Johnson, R., Tschopp, A., Steffen, R. (2001). Effectiveness and tolerability of melatonin and zolpidem for the alleviation of jet lag. Aviat Space Environ Med, 72:638–46.
  30. ^ Reilly, T., Atkinson, G., Budgett, R. (2001). Effect of low-dose temazepam on physiological variables and performance tests following a westerly flight across five time zones. Int J Sports Med, 22:166–74. doi:10.1055/s-2001-16379
  31. ^ Jamieson, A.O., Zammit, G.K., Rosenberg, R.S., Davis, J. R., Walsh, J. K. (2001). Zolpidem reduces the sleep disturbance of jet lag. Sleep Med, 2:423–30.
  32. ^ Dolder, C. R., Nelson, M. H. (2008). Hypnosedative-induced complex behaviours: incidence, mechanisms and management. CNS Drugs, 22:1021–36. doi:10.2165/0023210-200822120-00005
  33. ^ "Should You Take Sleeping Pills on a Flight?". Condé Nast Traveler. 7 December 2016. Retrieved 27 July 2023.
  34. ^ Morris, H. H. III, Estes, M. L. (1987). Traveler's amnesia: transient global amnesia secondary to triazolam. JAMA, 258:945–6. doi:10.1001/jama.258.7.945
  35. PMID 7648847
    .
  36. .
  37. .