What is Time Zone Change Syndrome?

Time zone change (jet lag) syndrome consists of varying degrees of difficulties in initiating or maintaining sleep, excessive sleepiness, decrements in subjective daytime alertness and performance, and somatic symptoms (largely related to gastrointestinal function) following rapid travel across multiple time zones.

What are the symptoms?

The symptoms begin within 1 or 2 days after air travel across at least 2 time zones. A discernable disruption of the normal circadian sleep-wake cycle is present.

• Insomnia
• Excessive sleepiness
• Decreased daytime performance
• Tired muscles
• Headaches
• Moodiness
• Altered apetite
• Stomach problems
• Increase in the frequency of nocturnal awakening to urinate
• Generally feeling unwell

How can I avoid these symptoms when traveling?

It is important to adapt yourself to the routine of your destination as soon as you board your flight.

• Reset your watch for the new time zone

• Control sleeping, including naps, to optimize sleep at the appropriate time in your new locale. Many travelers go to bed immediately after arriving on an overnight flight. They usually fall asleep quickly but sleep a relatively short time, tending to awaken at a time corresponding to the late morning of their hometime. Then later that night they would have problems falling asleep because of their unadjusted circadian system which would be telling them that it is not time to sleep yet. To counteract this, it is better to limit your sleep to to no more than 2 hours immediately after arrival.

• Eating foods that contain tryptophan (turkey, milk) can help induce sleep at the proper time at your destination. Some people even resort to taking small doses of hypnotics to produce sleep. Drugs such as temazepam (Restoril), brotizolam, and triazolam (Halcion) have been shown to produce high-quality sleep after extensive shifts in sleep schedules or after time zone transitions.

• Exposure to daylight can help reset your clock. Take a one hour walk as soon as you get up.

Things to avoid that will slow down your adaptation:

• long or innapropriate naps
• excessive caffeine
• social isolation
• poor sleep hygiene

Diagnostic Classification Steering Committee, Thorpy MJ, Chairman. International Classification of Sleep Disorders: Diagnostic and Coding Manual. Rochester, Minnesota: American Sleep Disorders Association, 1990.

Kryger, Meir H., Roth, Thomas, Dement, William C. Principles and Practice of Sleep Medicine, 2nd Edition. Philadelphia, Pennsylvania: W.B. Saunders Company, 1994.

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