Current Psychiatry Reports

, Volume 13, Issue 3, pp 187–192 | Cite as

Jet Lag and Psychotic Disorders

  • Gregory Katz


Jet lag syndrome appears after multiple time zone transitions as bodily rhythms shift out of phase with the local environment. The possible psychiatric complications of jet lag have been underinvestigated. In the present review, the symptoms of jet lag in the general population, the chronobiological aspects of psychosis, as well as a possible correlation between jet lag and psychosis are discussed. The conclusions are that jet lag, through disruption of biological rhythm and probably sleep deprivation, may yield an exacerbation of existing psychotic conditions. The evidence concerning the appearance of de novo psychosis triggered by jet lag is inconsistent and far from convincing.


Jet lag Psychosis Chronobiology Treatment 



No potential conflict of interest relevant to this article was reported.


Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. 1.
    Srinivasan V, Singh J, Pandi-Perumal SR, et al. Jet lag, circadian rhythm sleep disturbances, and depression: the role of melatonin and its analogs. Adv Ther. 2010;27(11):796–813.PubMedCrossRefGoogle Scholar
  2. 2.
    Waterhouse J, Reilly T, Atkinson G, et al. Jet lag: trends and coping strategies. Lancet. 2007;369(9567):1117–29.PubMedCrossRefGoogle Scholar
  3. 3.
    Silverman D, Gendreau M. Medical issues associated with commercial flights. Lancet. 2009;13(9680):2067–77.CrossRefGoogle Scholar
  4. 4.
    Arendt J. Managing jet lag: some of the problems and possible new solutions. Sleep Med Rev. 2009;13(4):249–56.PubMedCrossRefGoogle Scholar
  5. 5.
    Tresguerres JA, Ariznavarreta C, Granados B, et al. Circadian urinary 6-sulphatoxymelatonin, cortisol excretion and locomotor activity in airline pilots during transmeridian flights. J Pineal Res. 2001;31(1):16–22.PubMedCrossRefGoogle Scholar
  6. 6.
    Sack RL, Auckley D, Auger RR, et al. Circadian rhythm sleep disorders: part I, basic principles, and shift work and jet lag disorders. An American Academy of Sleep Medicine review. Sleep. 2007;30(11):1460–83.PubMedGoogle Scholar
  7. 7.
    Kiessling S, Eichele G, Oster H. Adrenal glucocorticoids have a key role in circadian resynchronization in a mouse model of jet lag. J Clin Invest. 2010;120(7):2600–9.PubMedCrossRefGoogle Scholar
  8. 8.
    • Doane LD, Kremen WS, Eaves LJ, et al. Associations between jet lag and cortisol diurnal rhythms after domestic travel. Health Psychol. 2010;29(2):117–23. The article analyzes in a large sample the variations in diurnal cortisol regulation during jet lag based on number of time zones traveled eastward or westward.PubMedCrossRefGoogle Scholar
  9. 9.
    Lowden A, Akerstedt T. Retaining home-base sleep hours to prevent jet lag in connection with a westward flight across nine time zones. Chronobiol Int. 1998;15(4):365–76.PubMedCrossRefGoogle Scholar
  10. 10.
    Eastman CI, Gazda CJ, Burgess HJ, et al. Advancing circadian rhythms before eastward flight: a strategy to prevent or reduce jet lag. Sleep. 2005;28(1):33–44.PubMedGoogle Scholar
  11. 11.
    Eastman CI, Burgess HJ. How to travel the world without jet lag. Sleep Med Clin. 2009;4(2):241–55.PubMedCrossRefGoogle Scholar
  12. 12.
    • Sack R. Jet lag. N Engl J Med. 2010;362(5):440–7. The article summarizes the most up-to-date data concerning the clinical aspects of jet lag.PubMedCrossRefGoogle Scholar
  13. 13.
    Boulos Z, Macchi MM, Sturchler MP, et al. Light visor treatment for jet lag after westward travel across six time zones. Aviat Space Environ Med. 2002;73(10):953–63.PubMedGoogle Scholar
  14. 14.
    Lahti T, Terttunen J, Leppämäki S, et al. Field trial of timed bright light exposure for jet lag among airline cabin crew. Int J Circumpolar Health. 2007;66(4):365–9.PubMedGoogle Scholar
  15. 15.
    Srinivasan V, Singh J, Pandi-Perumal SR, et al. Jet lag, circadian rhythm sleep disturbances, and depression: the role of melatonin and its analogs. Adv Ther. 2010;27(11):796–813.PubMedCrossRefGoogle Scholar
  16. 16.
    Zee PC, Wang-Weigand S, Wright KP, et al. Effects of ramelteon on insomnia symptoms induced by rapid, eastward travel. Sleep Med. 2010;11(6):525–33.PubMedCrossRefGoogle Scholar
  17. 17.
    Rajaratnam SM, Polymeropoulos MH, Fisher DM, et al. Melatonin agonist tasimelteon (VEC-162) for transient insomnia after sleep-time shift: two randomised controlled multicentre trials. Lancet. 2009;373(9662):482–91.PubMedCrossRefGoogle Scholar
  18. 18.
    Kasper S, Hajak G, Wulff K, et al. Efficacy of the novel antidepressant agomelatine on the circadian rest-activity cycle and depressive and anxiety symptoms in patients with major depressive disorder: a randomized, double-blind comparison with sertraline. J Clin Psychiatry. 2010;71(2):109–20.PubMedCrossRefGoogle Scholar
  19. 19.
    Leproult R, Van Onderbergen A, L’hermite-Balériaux M, et al. Phase-shifts of 24-h rhythms of hormonal release and body temperature following early evening administration of the melatonin agonist agomelatine in healthy older men. Clin Endocrinol (Oxf). 2005;63(3):298–304.CrossRefGoogle Scholar
  20. 20.
    Reilly T, Atkinson G, Budgett R. Effect of low-dose temazepam on physiological variables and performance tests following a westerly flight across five time zones. Int J Sports Med. 2001;22(3):166–74.PubMedCrossRefGoogle Scholar
  21. 21.
    Buxton OM, Copinschi G, Van Onderbergen A, et al. A benzodiazepine hypnotic facilitates adaptation of circadian rhythms and sleep-wake homeostasis to an eight hour delay shift simulating westward jet lag. Sleep. 2000;23(7):915–27.PubMedGoogle Scholar
  22. 22.
    Paul MA, Gray G, Sardana TM, et al. Melatonin and zopiclone as facilitators of early circadian sleep in operational air transport crews. Aviat Space Environ Med. 2004;75(5):439–43.PubMedGoogle Scholar
  23. 23.
    Poulin J, Chouinard S, Pampoulova T. Sleep habits in middle-aged, non-hospitalized men and women with schizophrenia: a comparison with healthy controls. Psychiatry Res. 2010;179(3):274–8.PubMedCrossRefGoogle Scholar
  24. 24.
    Sarkar S, Katshu MZ, Nizamie SH, et al. Slow wave sleep deficits as a trait marker in patients with schizophrenia. Schizophr Res. 2010;124(1–3):127–33.PubMedCrossRefGoogle Scholar
  25. 25.
    Lusignan FA, Godbout R, Dubuc MJ, et al. NonREM sleep mentation in chronically-treated persons with schizophrenia. Conscious Cogn. 2010;19(4):977–85.PubMedCrossRefGoogle Scholar
  26. 26.
    Ferrarelli F, Peterson MJ, Sarasso S, et al. Thalamic dysfunction in schizophrenia suggested by whole-night deficits in slow and fast spindles. Am J Psychiatry. 2010;167(11):1339–48.PubMedCrossRefGoogle Scholar
  27. 27.
    Poulin J, Stip E, Godbout R. REM sleep EEG spectral analysis in patients with first-episode schizophrenia. J Psychiatr Res. 2008;42(13):1086–93.PubMedCrossRefGoogle Scholar
  28. 28.
    Wirz-Justice A, Haug HJ, Cajochen C. Disturbed circadian rest-activity cycles in schizophrenia patients: an effect of drugs. Schizophr Bull. 2001;3:497–502.Google Scholar
  29. 29.
    Bersani G, Mameli M, Garavini A, et al. Reduction of night/day difference in melatonin blood levels as a possible disease-related index in schizophrenia. Neuro Endocrinol Lett. 2003;24(3–4):181–4.PubMedGoogle Scholar
  30. 30.
    Suresh Kumar PN, Andrade C, Bhakta SG, et al. Melatonin in schizophrenic outpatients with insomnia: a double-blind, placebo-controlled study. J Clin Psychiatry. 2004;68(2):237–41.CrossRefGoogle Scholar
  31. 31.
    Trbovic SM. Schizophrenia as a possible dysfunction of the suprachiasmatic nucleus. Med Hypotheses. 2010;74(1):127–31.PubMedCrossRefGoogle Scholar
  32. 32.
    Lamont EW, Coutu DL, Cermakian N, et al. Circadian rhythms and clock genes in psychotic disorders. Isr J Psychiatry Relat Sci. 2010;47(1):27–35.PubMedGoogle Scholar
  33. 33.
    Kishi T, Fukuo Y, Kitajima T, et al. SIRT1 gene, schizophrenia, and bipolar disorder in the Japanese population: An association study. Genes Brain Behav. 2010 Oct 26. Epub ahead of print.Google Scholar
  34. 34.
    Mansour HA, Talkowski ME, Wood J, et al. Association study of 21 circadian genes with bipolar I disorder, schizoaffective disorder, and schizophrenia. Bipolar Disord. 2009;11(7):701–10.PubMedCrossRefGoogle Scholar
  35. 35.
    Shapiro S. Airport wandering as a psychotic symptom. Psychiatr Clin. 1982;15(4):173–6.Google Scholar
  36. 36.
    Jauhar P, Weller M. Psychiatric morbidity and time zone changes: a study of patients from Heathrow airport. Br J Psychiatry. 1982;140(3):231–4.PubMedCrossRefGoogle Scholar
  37. 37.
    Young D. Psychiatric morbidity in travelers to Honolulu, Hawaii. Compr Psychiatry. 1995;36(3):224–8.PubMedCrossRefGoogle Scholar
  38. 38.
    Oyewumi L. Jet lag and relapse of schizoaffective psychosis despite maintenance clozapine treatment. Br J Psychiatry. 1998;173(9):268.PubMedCrossRefGoogle Scholar
  39. 39.
    Katz G, Durst R, Barel Y, et al. De novo jet lag psychosis. Br J Psychiatry. 1999;174(6):558–9.PubMedCrossRefGoogle Scholar
  40. 40.
    Katz G, Durst R, Zislin Y, et al. Psychiatric aspects of jet lag: review and hypothesis. Med Hypothesis. 2001;56(1):20–3.CrossRefGoogle Scholar
  41. 41.
    Katz G, Durst R, Knobler H. Exogenous melatonin, jet lag, and psychosis: preliminary case results. J Clin Psychopharmacol. 2001;21(3):349–51.PubMedCrossRefGoogle Scholar
  42. 42.
    Katz G, Knobler HY, Laibel Z, et al. Time zone change and major psychiatric morbidity: the results of a 6-year study in Jerusalem. Compr Psychiatry. 2002;43(1):37–40.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Emergency Unit, The Jerusalem Mental Health CentreKfar Shaul HospitalJerusalemIsrael

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