jet lag

jet lag, physiological desynchronization caused by transmeridian (east-west) travel between different time zones. The severity and extent of jet lag vary according to the number of time zones crossed as well as the direction of travel—most people find it difficult to travel eastward (i.e., to adapt to a shorter day as opposed to a longer one). The resulting symptoms include extreme fatigue, sleep disturbances, loss of concentration, disorientation, malaise, sluggishness, gastrointestinal upset, and loss of appetite.

In general, adjustment to a new time zone takes one day for each hour of time difference. Almost all of the body’s physiological processes have a rhythm, or pattern, that varies over the course of a day. The most obvious of these circadian rhythms are sleep and wakefulness, which are driven by physiological responses to light and dark; the internal body clock also controls alertness, hunger, digestion, urine production, body temperature, and the secretion of hormones. When these rhythms have been disrupted, they cannot all be brought back into synchrony at the same rates once the destination has been reached.

A stress hormone that is secreted in a circadian pattern and that is particularly sensitive to interruptions in sleep-wake cycles is cortisol. Levels of cortisol, which normally increase during the day and decrease at night, are found in unusually high levels in people who experience jet lag on a regular basis (e.g., flight attendants and pilots). Brain scans and memory performance tests of such crew members, who often work multiple transmeridian flights with brief in-between flight “recovery” times, show that they have reduced temporal lobes and poor short-term memory. Increasing cortisol levels corresponded with decreasing temporal lobe size in these individuals, suggesting a direct link between physiological desynchronization and decreased functionality of short-term memory. Fortunately, once synchronization is reestablished, short-term memory returns to its normal state.

The hormone melatonin plays a major role in regulating circadian sleep-wake rhythms, and its production is influenced by light-dark cycles. For example, when light is detected by the eye, signals to inhibit melatonin production are sent to the brain; this inhibition enables the brain and body to maintain a state of wakefulness during the day. In the absence of light, a tiny cone-shaped structure in the brain, known as the pineal gland, generates and secretes melatonin; this secretion results in the onset of physiological changes associated with sleep. Because long-distance transmeridian jet travelers normally experience a significant shift in the light-dark cycles, melatonin secretion is immediately “out of sync” upon arrival in a new time zone—thus jet lag. Studies have shown that judicious and carefully timed light exposure has a dramatic effect in alleviating jet lag. In addition, administration of melatonin offers a direct and practicable way of actually accelerating the resynchronization of the body clock to a new time zone. Although melatonin has been widely studied and appears to be effective and safe, it has not been evaluated or licensed by the U.S. Food and Drug Administration (FDA) or by regulatory agencies elsewhere.

There has been interest in identifying and characterizing the molecular basis of jet lag for the purpose of not only finding alternative ways to treat jet lag but also better understanding the biology and physiology of circadian rhythm. Studies have identified circadian clock genes in mammals and have indicated that the suprachiasmatic nucleus (SCN) in the brain serves as their principal regulator. The SCN transmits the signals that suppress melatonin secretion during the day. That brake may be responsible for preventing the body from instantly adapting to a new time zone following transmeridian jet travel. Research in mice has indicated that genes in the SCN that are activated by light during the day are immediately shut off by a protein called SIK1. When the function of SIK1 was reduced, mice were able to quickly adjust their circadian clocks, which suggested that the protein was a promising drug target for jet lag.

Frequent travelers often develop their own strategies for managing jet lag, and following several simple guidelines can lessen symptoms of jet lag significantly. For example, during westbound flights, which have the effect of lengthening the day, naps should be avoided. In contrast, while flying eastbound, which has the effect of shortening the day, sleeping during flight is encouraged. In addition, daytime flights cause the least loss of sleep and the least fatigue, allowing the traveler to arrive in the best possible condition. It is most efficient to overcome jet lag by adjusting to the new time zone as soon as possible; this can be done simply by eating meals and going to bed at appropriate times and by spending plenty of time outdoors during the day. While flying, the consumption of alcohol and caffeine, which can interfere with sleep, should be avoided. Finally, the traveler should accept that there is bound to be some loss of performance when first arriving in a new time zone and should plan accordingly; for example, one should avoid important business meetings for the first 24 hours after arrival.