How to manage travel fatigue and jet lag in athletes? A systematic review of interventions

Abstract

ObjectivesWe investigated the management of travel fatigue and jet lag in athlete populations by evaluating studies that have applied non-pharmacological interventions (exercise, sleep, light and nutrition), and pharmacological interventions (melatonin, sedatives, stimulants, melatonin analogues, glucocorticoids and antihistamines) following long-haul transmeridian travel-based, or laboratory-based circadian system phase-shifts.DesignSystematic reviewEligibility criteriaRandomised controlled trials (RCTs), and non-RCTs including experimental studies and observational studies, exploring interventions to manage travel fatigue and jet lag involving actual travel-based or laboratory-based phase-shifts. Studies included participants who were athletes, except for interventions rendering no athlete studies, then the search was expanded to include studies on healthy populations.Data sourcesElectronic searches in PubMed, MEDLINE, CINAHL, Google Scholar and SPORTDiscus from inception to March 2019. We assessed included articles for risk of bias, methodological quality, level of evidence and quality of evidence.ResultsTwenty-two articles were included: 8 non-RCTs and 14 RCTs. No relevant travel fatigue papers were found. For jet lag, only 12 athlete-specific studies were available (six non-RCTs, six RCTs). In total (athletes and healthy populations), 11 non-pharmacological studies (participants 600; intervention group 290; four non-RCTs, seven RCTs) and 11 pharmacological studies (participants 1202; intervention group 870; four non-RCTs, seven RCTs) were included. For non-pharmacological interventions, seven studies across interventions related to actual travel and four to simulated travel. For pharmacological interventions, eight studies were based on actual travel and three on simulated travel.ConclusionsWe found no literature pertaining to the management of travel fatigue. Evidence for the successful management of jet lag in athletes was of low quality. More field-based studies specifically on athlete populations are required with a multifaceted approach, better design and implementation to draw valid conclusions.PROSPERO registration numberThe protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO: CRD42019126852).

The Thin Line Between Waking and Sleeping in Athletes: A Call for Yoga Nidra in the Sporting Context

“…Moreover, sports professionals can encourage athletes to take a YN "nap" instead of traditional ones (using, for example, taped instructions) while taking advantage of travel time (e.g., van Rensburg et al, 2020). Of note, as recovery is a highly individual process, this strategy should be applied according to individual sleep needs and requirements (Loch et al, 2019).…”

“…For example, because of its effects on sleep latency (Datta et al, 2017;Moszeik et al, 2020), exploring this practice might help athletes with the "sleepability" (the ability to nap on demand) that could be used as a strategic skill to manage sleep challenges and debt (Gupta et al, 2020). These could be due to, for example, travel fatigue and jet lag as athletes are often required to embark on long travel for competition reasons (e.g., van Rensburg et al, 2020). Better sleep would also benefit arousal management; this may reduce stress reactivity, which is caused by the arousal that leaves one overly reactive to stimuli (Park et al, 2020).…”

Up in the Air: Evidence of Dehydration Risk and Long-Haul Flight on Athletic Performance

“…Systematic [36,37] and narrative reviews [2,3,21] aimed to summarize the most recent findings and provide practical guidelines on how to best minimize (handle/tackle) the consequences of the air-travel-induced circadian rhythm desynchronization (e.g., jet lag) on various physical performance indicators. Briefly, crossing multiple time zones via air travel and within a limited time frame is instrumental to inducing the loss of synchronicity among the circadian rhythms, thereby affecting sleep, core temperature, gastrointestinal function, and melatonin release, each of which can translate into impaired physical performance in athletes [3].…”

“…Although the above-mentioned studies have attempted to analyze the effects of long-distance air travel on hydration status, and many studies did evaluate the potential influence of dehydration on physical performance or its associated physiological mechanisms, there is no clear study investigating these effects in a consistent manner. Indeed, the importance of utilizing a proper hydration strategy was recently discussed by van Rensburg et al [36], who examined the effects of jet lag on physical performance in athletes in their systematic review. They looked at a number of factors and concluded that remarkably, there are still no studies looking at the combined effects of hydration status on physical performance of athletes traveling across multiple time zones.…”

Optimisation and Validation of a Nutritional Intervention to Enhance Sleep Quality and Quantity

“…Intake of these factors represents a potential intervention for enhancing natural sleep. A number of recent reviews have highlighted the potential for a number of these ingredients to influence sleep and jetlag [16,19]. However, each of these reviews make mention of the need for additional randomised controlled trials, using objective measures of sleep to enhance the quality of research in the area.…”