Jet Lag Disorder

When a person travels to a different time zone, the time vicissitude causes misalignment of the body’s internal circadian clock with the external time cues.

The circadian clock is the body’s internal time sensing system which helps a person to coordinate with the external environment and send signals to the body to remain awake or to sleep.

The inability to coordinate with the new time system causes disturbances in the body’s normal sleep-wake schedule and the person suffers from the jet lag disorder.

Usually, there is no need for medical assistance and the person can adapt to the new environment by taking some pre-travelling and post travelling measures. But in some cases where the treatment is needed, melatonin could be prescribed along with light therapy. 

The symptoms of jet lag are uncommon and vary with a person.

At a time one can experience one symptom or multiple, which may include:

• Difficulty in sleeping
• Daytime fatigue
• Sleepwalking
• Diarrhoea or
• Constipation

Immediate circadian adaptation is virtually impossible for anyone and thus when a person travels to a different time zone, he suffers from jet lag.

Things worsen with the frequency of travelling and the number of time zones crossed.

Jet lag disorder is caused by a disruption in normal brain activity.

A group of nerve cells in the hypothalamus (master clock) controls the physical, mental and behavioural changes in the body, known as circadian rhythm. The circadian rhythms follow a 24-hour cycle and are mainly affected by exposure to the light.

During day eyes sense the presence or absence of incoming light and relays the information to the hypothalamus. In the presence of bright light like at day, the hypothalamus signals the pineal gland to inhibit production of melatonin whereas when the levels of light are low, the hypothalamus signals for increasing melatonin production thus making a person feel sleepy.

When a person travels across different time zones the coordination between the biological or circadian clock and external time gets disrupted and the body starts suffering for the adjustment to the new environment resulting in jet lag disorder.

There is no specific test to diagnose the jet lag disorder. It could be simply diagnosed by looking at the symptoms.

Although the body normalizes in two to three days itself, in severe cases proper treatment for jet lag is required.

Medicines:

Drugs non-benzodiazepines, such as zolpidem (Ambien), eszopiclone (Lunesta) and zaleplon (Sonata) benzodiazepines, such as triazolam (Halcion) have been proved to be efficient in combating fatigue and reduced alertness associated with jet lag.

Although these medicines, also called sleeping pills are effective in inducing sleep, they could not treat daytime symptoms and may also possess some uncommon side effects like nausea, vomiting, amnesia, sleepwalking, confusion, and morning sleepiness.

Thus, these sleeping pills are only recommended when other therapies do not work. Melatonin, which is normally produced in almost all organisms, could also be administered in jet lag patients to induce sleep and is comparatively safer choice than sleeping pills. Alcohol consumption is strictly prohibited during melatonin intake.

Light therapy:

Light therapy is suggested alone or with the above-mentioned medicines for the treatment of jet lag. Body's internal clock or circadian rhythms are influenced by exposure to sunlight, among other factors.

When a person travels across time zones, the body must adjust to a new daylight schedule and reset allow the person to fall asleep and be awake at the appropriate times. Light therapy can help ease this transition. It involves exposing patient’s eyes to an artificial bright light or lamp that simulates sunlight for a specific and regular amount of time during the time when you're meant to be awake.

This is very useful for frequent business travellers and for the persons who are often away from natural sunlight during the day in a new time zone. Light therapy comes in a variety of forms including a light box that sits on a table, a desk lamp that may blend in better in an office setting or a light visor that you wear on your head.

Some preventive measures can help prevent jet lag or reduce its effects:

Pre-travelling measures:

• In a case of an important meeting or another event, try to arrive a few days early to give your body a chance to adjust to the new time schedule so that you can perform at your best.
• Get plenty of rest before your trip and gradually adjust your schedule according to the schedule of the destination.
• Regulate exposure to light according to your destination. In general, exposure to light in the evening helps you adjust to a later than usual time zone (travelling westward) while exposure to morning light can help you adapt to an earlier time zone faster (travelling eastward)

While travelling:

• Try to sleep on the plane if it's night at your destination. Earplugs, headphones and eye masks can help blocking noise and light.
• Drink plenty of water before, during and after your flight to counteract the dehydrating effects of dry cabin air as dehydration can make jet lag symptoms worse.

Post Travelling:

• After arriving at the new place, sleep and eat in accordance with the local time, no matter how hard it may seem.

Regulate exposure to the light:

• Expose your eyes to the light in the evening if you have travelled westwards and expose your eyes to morning light if you have travelled eastwards.
• If you have travelled across more than eight time zones the early morning could be mistaken by your body as dusk and evening light might be interpreted as dawn. So, if you've travelled more than eight time zones to the east, wear sunglasses and avoid bright light in the morning, and then allow as much sunlight as possible in the late afternoon for the first few days in your new location. Whereas, if you have travelled west by more than eight time zones, avoid sunlight a few hours before dark for the first few days to adjust to the local time.
• Try to follow the schedule of the new place and avoid sleeping until the local night-time, no matter how tired you are.
• Try to time your meals with local mealtimes too and stay hydrated.
• Avoid alcohol and caffeine, as these, can dehydrate you and affect your sleep. Try to sleep on the plane if it's night-time at your destination.

Simple lifestyle change is the best homeopathic remedy for jet lag disorder.

Regulate exposure to light appropriately to adapt to the new time schedule and try to follow the new time schedule.

Lifestyle modifications are necessary in order to cope with jet lag disorder:

• Use sunlight to reset your internal clock. It's the most powerful natural tool for regulating the sleep-wake cycle.
• Plan ahead to determine the best times for light exposure based on your departure and destination points and overall sleep habits.
• Combining light exposure with exercises such as walking or jogging may help a person adapt to the new time even faster.
• Avoiding light at certain times is important too. For example, someone travelling west should avoid light in the morning on the first few days. During a day, dark glasses can help block light. At night, draw the blinds or drapes in your hotel room or use a sleep mask.
• Caffeine beverages such as coffee, espresso, and soft drinks may help offset daytime sleepiness but drink them judiciously and avoid after midday.

There are several risks associated with jet lag disorder:

• An older person may find handling jet lag very difficult and need more time to overcome.
• It may result in poor performance at an important event.

As you cross more time zones the situation becomes worst.