Interventions to minimize jet lag after westward and eastward flight

Air travel across several time zones, i.e., transmeridian flight, causes negative effects—some of which occur during flight and some of which occur in the days after flight. Anecdotally, these effects are often referred to collectively as jet lag, but they are actually two separate phenomena—travel fatigue and jet lag—each with their own causes and consequences (Waterhouse et al., 2004). Travel fatigue refers to a collection of symptoms that occur during or immediately after long flights. These symptoms include fatigue, disorientation, and headache (Waterhouse et al., 2004)—primarily caused by the sleep loss, dehydration, hypoxia, and discomfort associated with being in an aircraft with confined space, recline-restricted seats, low air pressure, low humidity, etc., for 8–14 h (Brown et al., 2001; Roach et al., 2018). In contrast, jet lag refers to a collection of symptoms that occur in the days after flight across three or more time zones. These symptoms include headache, irritability, daytime sleepiness, difficulty sleeping at night, poor mental and physical performance, and poor gastrointestinal function (Waterhouse et al., 2004)—primarily caused by the mismatch between the circadian system, or internal body clock, which is synchronized to time cues in the departure time zone, and the desired timing of sleep and wake, which are typically synchronized to time cues in the destination time zone. In August 2020, the Olympic Games will be held in Tokyo, Japan. Athletes will travel from all over the world to compete in the Games, and many will have to travel across several time zones. For example, athletes traveling to Japan from North America and Western Europe will face time zone changes of 8–11 h west and 6–8 h east, respectively. Some athletes will travel to Japan, or nearby countries, weeks before their events, while others will arrive in Japan in the days prior to competition. In either case, athletes will want to adjust to the new time zone as quickly as possible so that they can prepare well and/or compete at the highest level. The purpose of this manuscript is to discuss the causes and consequences of jet lag and to provide examples of how to use judiciously timed light exposure/avoidance and/or exogenous melatonin ingestion to adapt the circadian system to a new time zone after transmeridian flight. These guides could be applied by athletes competing in the Tokyo 2020 Olympic Games, but they could also be applied by athletes traveling to other countries for training or competition, or by non-athletes traveling for business or pleasure.