Question: Why do people feel so crummy when they move across time zones?

Answer: Jet lag. It is a disruption of the circadian rhythms. It happens when the body’s clock and the destination’s clock are out of sync.

Question: Then jet lag is more than a lack of sleep?

Answer: It’s definitely more than a lack of sleep. You can take a flight across the time zones, and even if you sleep you can still experience symptoms of jet lag.

Question: What causes these disruptions in the body’s rhythms?

Answer: Light primarily drives the brain clock. Because the brain’s clock receives light information about the new time zone directly from your eyes, it actually shifts faster than the clocks in the rest of the body. Bodily tissues have their own clocks – liver, kidney, stomach, intestines, etc. Part of jet lag may be a misalignment of the brain’s clock and these peripheral clocks.

Question: What are the symptoms?

Answer: The symptoms are fatigue, insomnia, gastrointestinal upset, headache, trouble focusing and generally feeling “out of whack.”

Question: How long do symptoms last?

Answer: It really varies by individual, but there is a general rule of thumb that you can figure on about a day to shift per every time zone you travel through.

Question: How do people who travel regularly cope with this?

Answer: Really, the people who are successful are those who try to stay in their own time zones behaviorally. If you fly to the West Coast and try to get up early like you’re still on East Coast time, you’ll experience fewer symptoms. The worst is when you are flying to China, which is 13 hours off.

Question: Is jet lag worse going west to east or east to west?

Answer: Most people say going to the east is harder. The reason for that is most people find it harder to get up earlier.

Question: Is there anything you can do to reduce the symptoms of jet lag?

Answer: There is some controversy about that because every person is different. Some people try to preshift to the other time zone. If you are going to be gone for a long time, it makes sense to preshift. If you are on a short trip, it makes sense to stay in the current time zone. Other people try other things: bright lights, pharmaceuticals such as melatonin or Provigil, caffeine or naps. Directly or indirectly, these things are ultimately going to affect the brain’s clock.

Question: What do you advocate?

Answer: I try to stay in my own time zone when traveling within the U.S. My advice is work with your natural rhythm. There’s a second thing I do. If you’re going to travel to Europe, get up, start your sightseeing and engage in vigorous activity. Also, eat multiple small meals throughout the day. I feel less nauseated and more alert.

Question: Do certain kinds of food help?

Answer: There is anecdotal evidence that carbohydrate-rich foods will help, but it may be that they just make your brain feel good. One of the things we need to realize about circadian rhythms is that there is a genetic component to them, and there is a tremendous variability of what will work for each person.

http://www.dallasnews.com

Frequent travelers know that one of the biggest annoyances they have to face each time they land is jet lag.

Until not long ago, it was believed that jet lag was nothing more than just an upsetting occurrence that no one could do anything about, other than bear with it until it went away.

Since research has shown that it’s actually a disorder, Cephalon has already come up with a cure for it in the form of Nuvigil, which is poised to become the first drug for jet lag.

“The efficacy and safety of Nuvigil as a potential treatment for acute excessive sleepiness associated with jet lag disorder were evaluated over the course of three days in a randomized, double-blind, placebo-controlled study of 427 healthy adults who had experienced jet lag symptoms during the previous five years.

Participants in the study traveled eastbound from the United States to France where they were then examined at a sleep facility.

Clinical efficacy was evaluated using two primary endpoints: an objective assessment – the Multiple Sleep Latency Test (MSLT), and a subjective assessment – the Patient Global Impression of Severity (PGI-S).” a statement from the company says.

At the same time, the statement adds that the exact, detailed results of the study have not yet been submitted for presentation.

Yet, the initial numbers indicate that Nuvigil could be effectively used to treat jet lag in all sufferers, which would virtually put an end to this acute, circadian rhythm sleep disorder, as Cephalon classifies it.

Next up on the company’s to-do list is submitting the drug for approval with the FDA, after wrapping up the studies and drawing the line as to its efficiency with jet lag symptoms.

However, as Goldman Sachs analyst Shibani Malhotra wrote in a note to investors, getting this approval for jet lag would mean Cephalon would be able to market Nuvigil to a broad range of doctors, which, in turn, might make “this indication be viewed as ‘lifestyle’ (less severe) and would enable use of the drug in a broader population.”

Cephalon spokeswoman Candace Steele is optimistic that Nuvigil will get approval for jet lag, since this is not a condition that should be disregarded just because it goes away, as she tells in a statement to the Health Blog.

“We do acknowledge that this is an acute condition that does resolve itself once someone does adjust to a local time zone. [Still,] there is a functional impairment for people who have jet lag disorder.” Steele underlines.

If all goes according to plan, Cephalon intends to start marketing Nuvigil for jet-lag use in the latter part of 2009.

http://news.softpedia.com

The drug, called Nuvigil, is licensed in some countries, such as the U.S., to help shift-workers keep alert through the night.

Now the results of a new clinical trial suggest it could also be beneficial for passengers coping with the exhausting effects of long-distance flights.

Tests on more than 400 volunteers who flew from the U.S. to France showed those who took one pill shortly before boarding the plane were considerably less drowsy and more alert on arrival than those who did not.

The U.S. company that makes the drug is applying for permission to market it as the world’s first jet lag pill.

If successful, it could be on sale in the U.S. and Europe by the end of this year or early 2010.

Jet lag is a common condition that usually occurs only when flying long distances. As the body crosses different time zones, its circadian rhythm – or internal biological clock – becomes disrupted.

This is the mechanism that tells you when to sleep and when to wake up.

The circadian system also affects hunger, digestion, urine production, body temperature and blood pressure.

For example, it is normally in tune with local time, so we feel hungry in the morning and sleepy at night. Major time changes upset this rhythm, often leaving travellers sleepy in the day and wide awake at night.

It’s not clear why, but jet lag is more common in those over 50; children and babies rarely suffer from it.

Sleep experts say the worst of the symptoms can be avoided by taking simple measures, such as adjusting your sleeping routine a few days before travelling. If travelling east, it’s best to go to bed an hour earlier than usual. If west, make it an hour later.

Other measures include spending as much time outdoors as possible on arrival. Natural sunlight helps the body adjust to its new routine.

But a quick fix has obvious appeal. U.S. pharmacies already sell melatonin, a pill based on the body’s sleep-regulating hormone. But the drug is not licensed for sale in Britain.

The latest remedy, however, is based on Provigil, a medicine approved for use in this country for the treatment of narcolepsy, the condition that triggers frequent bouts of daytime sleep.

It works by stimulating activity in the central nervous system – in other words, the brain and spinal cord. Exactly how it increases wakefulness is not fully understood.

Nuvigil, from Cephalon Inc of Pennsylvania, is a longacting form of this drug and is designed to help those who need to stay awake for longer.

Researchers recruited 427 travellers who complained of severe jet lag in the past.

Half were given 150 milligrammes of Nuvigil to take shortly before boardinga transatlantic flight.

On arrival, all the travellers were given tests to measure their drowsiness.

The results, which have yet to be published in a medical journal, showed those on the jet lag pill suffered significantly fewer symptoms.

However, some reported side-effects included headaches, anxiety, nausea and heart palpitations.

Sleep expert Dr Neil Stanley, from Norfolk and Norwich University Hospital, said he was concerned the drug would help to medicalise a normal reaction to time change.

‘Jet lag is not an illness, it’s simply a consequence of long-distance travel,’ he says.

‘You get jet lag because it’s light or dark when, as far as your body is concerned, it should not be.

‘Now it seems it is being treated as a reason to take medicine. I can understand someone on a business trip wanting to feel their best when they arrive. But you could probably get the same effect by drinking coffee or going out in daylight.

‘It takes only four minutes of exposure to sunlight to tell your body clock that it’s daytime.’

http://www.dailymail.co.uk

Cephalon made the announcement after releasing positive results from a Phase III clinical study of the drug for that indication. Nuvigil is already on the market to treat sleepiness associated with narcolepsy, sleep apnea and night shift work.

http://www.marketwatch.com