Jet lag: clinical features, validation of a new syndrome-specific scale, and lack of response to melatonin in a randomized, double-blind trial.
OBJECTIVE
The goals of this study were to validate a new rating scale for measuring severity of jet lag and to compare the efficacy of contrasting melatonin regimens to alleviate jet lag.


METHODS
This was a randomized, double-blind trial of placebo and three alternative regimens of melatonin (5.0 mg at bedtime, 0.5 mg at bedtime, and 0.5 mg taken on a shifting schedule) for jet lag. The subjects were 257 Norwegian physicians who had visited New York for 5 days. Jet lag ratings were made on the day of travel from New York back to Oslo (6 hours eastward) and for the next 6 days in Norway. The main outcome measures were scale and item scores from a new, syndrome-specific instrument, the Columbia Jet Lag Scale, that identifies prominent daytime symptoms of jet lag distress.


RESULTS
There was a marked increase in total jet lag score in all four treatment groups on the first day at home, followed by progressive improvement over the next 5 days. However, there were no significant group differences or group-by-time interactions. In addition, there was no group effect for sleep onset, time of awakening, hours slept, or hours napping. Ratings on a summary jet lag item were highly correlated with total jet lag scores (from a low of r = 0.54 on the day of travel to a high of r = 0.80 on day 3). The internal consistency of the total jet lag score was high on each day of the study.


CONCLUSIONS
The use of melatonin for preventing jet lag needs further study.
Spitzer
R L
RL
New York State Psychiatric Institute, NY 10032, USA. rls8@columbia.edu
Terman
M
M
Williams
J B
JB
Terman
J S
JS
Malt
U F
UF
Singer
F
F
Lewy
A J
AJ
D000337:Aerospace Medicine; D002940:Circadian Rhythm / Q000187:drug effects / Q000502:physiology*; D004311:Double-Blind Method; D006304:Health Status; D006801:Humans; D008550:Melatonin / Q000494:pharmacology / Q000627:therapeutic use*; D010919:Placebos; D012720:Severity of Illness Index; D012892:Sleep Deprivation / Q000502:physiology; D012893:Sleep Wake Disorders / Q000175:diagnosis* / Q000188:drug therapy* / Q000209:etiology; D011795:Surveys and Questionnaires; D014195:Travel; D016896:Treatment Outcome
D010919:Placebos; D008550:Melatonin