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Westbound vs. Eastbound Travel – Symptoms – Treatment – Prevention – Melatonin – Light Exposure – Modafinil
Jet-lag disorder is caused by mismatch between the internal clocks and the local time while traveling across multiple time zones.
Level of alertness, body temperature, blood pressure, hormone levels, pain perception, and other numerous functions are circadian rhythm dependent and are normally synchronized with sleep-wake cycle. Sudden change in sleep schedule causes desynchronization between sleep-wake cycle and other circadian rhythms.
Most people have internal clocks set to 25 hour cycle, which means that in the absence of any astronomical time cues the body will shift from 24 hour to 25 hour cycle. External factors, mostly day/night cycle, keep the body clock in tune with astronomical time.
Fast travel across multiple time zones puts internal clocks and external (astronomical, social) clocks out of sync.
Common symptoms of jet-lag disorder are daytime sleepiness, difficulty falling asleep and staying asleep at night, early morning awakenings, malaise, depressed mood and anxiety. Not all travelers experience jet-lag disorder but most do experience some level of discomfort.
Longer than 24 hour internal clock cycle is the reason for a different speed of adaptation in westbound vs. eastbound travel. Westward travel is better tolerated because sleep time delay is easier to accomplish than sleep time advance. An average rate of adaptation is 1.5 hours per day for the westbound travelers and 1 hour per day for the eastbound ones.
The treatment of jet-lag disorder is travel direction dependent. The goal of treatment is to speed up the internal clock reset process and to alleviate the symptoms of jet-lag.
Jet-Lag Disorder Treatment for Eastbound Travelers
Eastbound travelers experience difficulty falling asleep and waking up in the morning on the following day. In case of eastbound travel circadian rhythm has to be advanced.
- Avoid exposure to bright light early in the morning. Sunglasses might do the trick.
- Recommended exposure to bright light in the late morning and in the afternoon.
- Melatonin 0.3 mg to 0.5 mg in the early evening hours a few days prior to eastbound travel followed by the same dose of Melatonin at bedtime at the destination is proven to reduce the symptoms of jet-lag.
- Short acting sleeping pills at bed time is an option as well.
Jet-Lag Disorder Treatment for Westbound Travelers
Traveling west causes early evening drowsiness and early awakenings. In westbound travel the circadian rhythm has to be delayed.
- Avoid naps during the daytime
- Recommended maximum light exposure in the afternoon and in the evening
- Caffeine may decrease sleepiness during the day.
- Modafinil (Provigil) 150 mg (wake promoting agent) improved jet-lag symptoms in one study.