Jet lag disorder

Sleep disorder with daytime sleepiness, night-time insomnia, and impaired concentration after rapid travel across multiple time zones (3 or more). Caused by misalignment of circadian rhythm with local time. Self-resolves over 1–2 days per time zone crossed.

ICD-10 G47.252 drugs

Also known as: Jet lag, Time zone change syndrome

Drugs used for this condition

AMelatoninFirst line · Hypnotics. Melatonin receptor agonistsMelatonin is first-line for jet lag treatment and prevention. The 2002 Cochrane review (10 RCTs) showed a 50% reduction in jet lag symptoms when crossing 5 or more time zones. Dose: 0.5–5 mg 30 minutes before desired sleep in local time, for 2–5 days after arrival. AASM 2015 recommends melatonin for jet lag with “strong” evidence. Effect is more pronounced with eastward travel.

Marketing claims without evidence base

The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.

DZolpidemNot recommended · Non-benzodiazepine hypnotic (Z-drug), imidazopyridineZolpidem is sometimes prescribed for jet lag «to help fall asleep in the new time zone». AEMPS does not authorise this indication. Zolpidem has a short half-life and helps sleep onset but does not shift the circadian rhythm – sleep architecture does not normalise the next day. For jet lag, AASM 2020 recommends melatonin 0.5–5 mg 30 minutes before the desired sleep (stronger evidence) and behavioural strategies (morning light in the new time zone, avoiding caffeine and alcohol on the flight). Zolpidem use on planes is associated with complex sleep behaviours (walking, eating without recall). If zolpidem was prescribed solely for jet lag, consider seeking a second opinion.

How to read tiers A–F

Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.

AStrong evidence – first or second line in international guidelines
BRecommended in selected cases
CStudy data contradict each other
DBenefit not proven, no documented harm
FDocumented harm, or risk without benefit