Managing jet lag: Some of the problems and possible new solutions.

Jet lag is due to the misalignment of the internal circadian clock(s) with external time cues. For short stopovers (1-2 days) adapting the circadian system is not advised, and at present immediate circadian adaptation is virtually impossible. The use of short-term measures such as judicious naps, caffeine and short acting hypnotics to maintain alertness and sleep is preferred. For intermediate length stays (3-5 days) a phase position with the circadian nadir situated within the sleep period is desirable but difficult to achieve. For longer stays (more than 4-5 days) strategies to hasten adaptation include timed exposure to and avoidance of light. The use of artificial light enriched with short wavelengths may be beneficial. The American Academy of Sleep Medicine recommends the timed use of the chronobiotic melatonin to hasten adaptation. Large individual differences in rate and direction of adaptation make timing treatment according to individual circadian phase difficult. Individual differences in tolerance to the sleep deprivation of jet lag may relate to a length polymorphism in the human clock gene PER3. The maximum efficacy for jet lag avoidance is by pre-flight adaptation, however, this requires time and commitment.