Clinical management of jet lag: What can be proposed when performance is critical?

SummaryJet lag, which appears after a long lasting transmeridian flight, is generally considered as a consequence of a desynchronization of circadian rhythms. After a recall of the circadian physiology, a modern view of the physiopathology is proposed. The major idea that emerges from these data is that only the wake–sleep rhythm may adapt itself quickly during jet lag and therefore it constitutes a good therapeutic target for physicians. We focus on the modalities of a light pharmacological aid to counteract jet lag. This punctual aid should help passengers to restore an adapted wake–sleep rhythm as quickly as possible. From this point of view, hypnotics may constitute a good indication. Finally, we suggest that the use of psychostimulants could also be interesting in very exceptional circumstances.