Prevention and Treatment of Jet Lag: What Works?

Abstract

Melatonin and Z-drug sleep medications are clearly helpful in reducing the sleep disruption that occurs following long-haul flights, especially those in an eastbound direction. Most of the evidence is based on treatment during the first 3–4 days after arrival at the flight destination; the evidence base is very thin regarding the use of these medications preventively before or during the flight. Most studies of bright light exposure after arrival have been too small to show significant benefits, although the encouraging results of one trial and the known effects of bright light on inhibiting endogenous melatonin secretion suggest that walking or other outdoor physical activity during the “droopy” afternoons in the first few days after landing may be beneficial; they are almost certainly harmless. Extra fluid, alteration of mealtimes, and consumption of specific foods have been inadequately studied, either as prevention before or during the light or as treatment after arrival. The field would greatly benefit from large, placebo-controlled trials of these interventions.