Intervention Review

Melatonin for the prevention and treatment of jet lag

  1. Andrew Herxheimer1,*,
  2. Keith J Petrie2

Editorial Group: Cochrane Common Mental Disorders Group

Published Online: 22 APR 2002

Assessed as up-to-date: 11 FEB 2008

DOI: 10.1002/14651858.CD001520


How to Cite

Herxheimer A, Petrie KJ. Melatonin for the prevention and treatment of jet lag. Cochrane Database of Systematic Reviews 2002, Issue 2. Art. No.: CD001520. DOI: 10.1002/14651858.CD001520.

Author Information

  1. 1

    London, UK

  2. 2

    University of Auckland, Psychiatry & Behavioural Sciences, Auckland, New Zealand

*Andrew Herxheimer, 9 Park Crescent, London, N3 2NL, UK. a.herxheimer@ntlworld.com.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 22 APR 2002

SEARCH

 

Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要
  5. Laički sažetak

Background

Jet lag commonly affects air travellers who cross several time zones. It results from the body's internal rhythms being out of step with the day-night cycle at the destination. Melatonin is a pineal hormone that plays a central part in regulating bodily rhythms and has been used as a drug to re-align them with the outside world.

Objectives

To assess the effectiveness of oral melatonin taken in different dosage regimens for alleviating jet lag after air travel across several time zones.

Search methods

We searched the Cochrane Controlled Trials Register, MEDLINE, EMBASE, PsychLit and Science Citation Index electronically, and the journals 'Aviation, Space and Environmental Medicine' and 'Sleep' by hand. We searched citation lists of relevant studies for other relevant trials. We asked principal authors of relevant studies to tell us about unpublished trials. Reports of adverse events linked to melatonin use outside randomised trials were searched for systematically in 'Side Effects of Drugs' (SED) and SED Annuals, 'Reactions Weekly', MEDLINE, and the adverse drug reactions databases of the WHO Uppsala Monitoring Centre (UMC) and the US Food & Drug Administration. An updating search was carried out on 12/2/2008 but no new studies were identified.

Selection criteria

Randomised trials in airline passengers, airline staff or military personnel given oral melatonin, compared with placebo or other medication. Outcome measures should consist of subjective rating of jet lag or related components, such as subjective well being, daytime tiredness, onset and quality of sleep, psychological functioning, duration of return to normal, or indicators of circadian rhythms.

Data collection and analysis

Ten trials met the inclusion criteria. All compared melatonin with placebo; one in addition compared it with a hypnotic, zolpidem. Nine of the trials were of adequate quality to contribute to the assessment, one had a design fault and could not be used in the assessment.
Reports of adverse events outside trials were found through MEDLINE, 'Reactions Weekly', and in the WHO UMC database.

Main results

Eight of the ten trials found that melatonin, taken close to the target bedtime at the destination (10pm to midnight), decreased jet-lag from flights crossing five or more time zones. Daily doses of melatonin between 0.5 and 5mg are similarly effective, except that people fall asleep faster and sleep better after 5mg than 0.5mg. Doses above 5mg appear to be no more effective. The relative ineffectiveness of 2mg slow-release melatonin suggests that a short-lived higher peak concentration of melatonin works better. The estimated number needed to treat (NNT) is 2, based on the only two trials that gave the necessary data. The benefit is likely to be greater the more time zones are crossed, and less for westward flights.

The timing of the melatonin dose is important: if it is taken at the wrong time, early in the day, it is liable to cause sleepiness and delay adaptation to local time. The incidence of other side effects is low. Case reports suggest that people with epilepsy, and patients taking warfarin may come to harm from melatonin.

Authors' conclusions

Melatonin is remarkably effective in preventing or reducing jet lag, and occasional short-term use appears to be safe. It should be recommended to adult travellers flying across five or more time zones, particularly in an easterly direction, and especially if they have experienced jet lag on previous journeys. Travellers crossing 2-4 time zones can also use it if need be.

The pharmacology and toxicology of melatonin needs systematic study, and routine pharmaceutical quality control of melatonin products must be established.

The effects of melatonin in people with epilepsy, and a possible interaction with warfarin, need investigation.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要
  5. Laički sažetak

Melatonin for the prevention and treatment of jet lag

Jet lag commonly affects air travellers who cross several time zones. It results from the body's internal rhythms being out of step with the day-night cycle at the destination. Melatonin is a pineal hormone that plays a central part in regulating bodily rhythms and has been used as a drug to re-align them with the outside world. Melatonin is remarkably effective in preventing or reducing jet lag, and occasional short-term use appears to be safe. It should be recommended to adult travellers flying across five or more time zones, particularly in an easterly direction, and especially if they have experienced jet lag on previous journeys. Travellers crossing 2-4 time zones can also use it if need be.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要
  5. Laički sažetak

背景

Melatonin用於預防和治療時差

搭飛機經過數個時區的旅客常有時差.身體時鐘節奏與目的地的日夜時間不和. Melatonin是松果體激素,調控身理時鐘,已經被當成藥物調整生理時鐘,使與外界環境一致

目標

評估口服不同劑量的Melatonin,對舒緩經過數個時區旅客時差的效果

搜尋策略

電子搜尋Cochrane Controlled Trials Register, MEDLINE, EMBASE, PsychLit and Science Citation Index,手動搜尋 journals ‘Aviation, Space and Environmental Medicine’和 ‘Sleep’ 搜尋相關研究的文獻是否有其他相關試驗.像主要作者詢問是否有未發布試驗資料.隨機試驗外的melatonin相關的副作用採系統竟搜索‘Side Effects of Drugs’ (SED)和SED Annuals, ‘Reactions Weekly’, MEDLINE, the WHO Uppsala Monitoring Centre (UMC)和美國食品藥品管理局的副作用資料庫

選擇標準

有隨機試驗,比較搭飛機乘客,航空公司員工,軍方人士,使用口服Melatonin和安慰劑或其他藥物.結果變項應包含主觀時差評分或相關評分,如主觀舒適度,白天疲勞程度,睡眠開始和品質,心理功能,復原需耗時間或生理時鐘指標.

資料收集與分析

10個試驗符合那如條件.都比較melatonin 和安慰劑.其中一個還有與安眠藥zolpidem比較.有九個試驗品質合格,納入評估,另一個有設計缺失,不能納入. MEDLINE, 搜索‘Reactions Weekly’,和世界衛生組織UMC資料庫,已取得試驗外的melatonin相關的副作用

主要結論

10個試驗中有八個發現, 在目的地預定睡覺時間(晚上10 – 12點)左右服用melatonin,可減少穿越5個以上時區後產生的時差. 每日melatonin 劑量介於0.5 – 5毫克的療效相當,但比起使用0.5毫克的受試者,使用5毫克的受試者較快入睡且睡眠品質較好. 使用5毫克以上療效更大. 2毫克緩釋melatonin相對較無療效,顯示快速達到最大血清藥量的melatonin療效較佳.只有兩個試驗提供的資料可估計益一需治數,估計值為 2, 經過時區越多,治療益處越大,西向航班益處較少.服用melatonin 的時間很重要.服藥時間不對,例如在一大早服用,會讓人想睡且延長適應時間.其他副作用發生率低. Melatonin可能有害於癲癇或使用warfarin的患者

作者結論

Melatonin對預防和治療時差療效卓越,偶爾短期使用是安全的.應建議飛行經過五個以上時區的成人旅客使用,尤其是一大早到目的地的班機或之前有時差的旅客. 經過2 – 4個時區的旅客也可使用.需系統性研究探討melatonin的藥理學和毒性,也需對melatonin藥品有常規的品質檢測. Melatonin對癲癇患者的影響或可能與warfarin產生的交互作用,都有待研究

翻譯人

本摘要由成功大學附設醫院尹子真翻譯

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌

總結

沒有英文總結可供翻譯

 

Laički sažetak

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要
  5. Laički sažetak

Melatonin za prevenciju i liječenje jet laga

Jet lag najčešće pogađa zrakoplovne putnike koji prolaze nekoliko vremenskih zona. Proizlazi iz činjenice da unutarnji ritam tijela gubi korak s dnevnim ciklusom (dan-noć) dolaskom na odredište. Melatonin je hormon epifize koji ima središnju ulogu u regulaciji tjelesnih ritmova i koristi se kao lijek koji ponovno uskladi tjelesne ritmove s vanjskim svijetom. Neprocjenjiva je njegova korisnost u sprječavanju ili smanjenju jet laga i povremeno korištenje se pokazalo sigurnim. Preporuča se odraslim putnicima koji lete kroz pet ili više vremenskih zona, pogotovo u smjeru istoka i još više ako su iskusili jet lag na prethodnim putovanjima. Ako je potrebno, melatonin mogu koristiti i putnici koji lete kroz dvije do četiri vremenske zone.

Bilješke prijevoda

Hrvatski Cochrane ogranak.
Prevela: Ivana Miošić