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Case Report Volume 3 Issue 5
Combined drug therapy for management of jetlag
Andres Endara Bravo,1
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Adam Anglyn2
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1Southeastern Pulmonary and Sleep Clinic, USA
2Department of Medical Education, USA
Correspondence: Andres Endara Bravo, Southeastern Pulmonary and Sleep Clinic, 401 West 27th Street, Lumberton, Tel 910-674-5198, Fax 910-272-7155
Received: July 15, 2016 | Published: September 1, 2016
Citation: Bravo AE, Anglyn A. Combined drug therapy for management of jetlag. J Lung Pulm Respir Res. 2016;3(5):130. DOI: 10.15406/jlprr.2016.03.00095
Abstract
Current therapies for jet lag include melatonin, timed light exposure and modification of sleep schedule. There has not been a study looking at combination therapy to improve both daytime sleepiness and reduce sleep disturbance associated with jet lag. We describe a case where combined drug therapy with modafinil and zolpidem was effective in treating jetlag in a business traveler with 8 hour time zone change.
Report of case
A 38-year-old professional man without any medical history, presented to the sleep clinic prior to a one week business trip from United States to United Arab Emirates. Patient requested medical therapy to help him adjust and perform during his trip in view of 8-hour time zone change. The patient had tried melatonin, timed light exposure and sleep schedule modification on prior occasions without prompt results. Patient was prescribed modafinil 200mg in the morning and zolpidem 10mg at bedtime for the duration of his trip. Upon return to the clinic, patient reported good vigilance during the day and average sleep time of 7hours at night while abroad. The patient reported no adverse effects to the medications. Upon return to the United States, patient discontinued the combined therapy and returned to his usual schedule without major disturbances.
Discussion
Current therapies for jet lag include timed melatonin, timed light exposure, and modification of sleep schedule. The circadian rhythm adjusts in travelers up to one time zone per day for eastward travel and 1.5 time zones per day for westward travel.1 Eastward travel requires persons to advance their circadian rhythm. Current therapy modalities are recommended when traveling more than 6time zones eastward or 12 time zones westward.
The use of armodafinil 150mg has been reported in 427 participants with jet lag disorder after 6hour time zone change.2 Participants reported near normal daytime sleepiness scores with a MSLT >10minutes compared to <5minutes in the placebo group. In another study, zolpidem 10mg was associated with reduced sleep disturbance in patients with jetlag with an increase in total sleep time and a decrease in number of awakenings per night.3
The combination therapy of modafinil and zolpidem has not been previously studied/reported. In our patient, the short term use of combination therapy with modafinil 200mg in the morning and zolpidem 10mg at bedtime was associated with Epworth sleepiness score less than 10 and average total sleep time of 7hours.
Acknowledgements
None.
Conflict of interest
The author declares no conflict of interest.
References
- Aschoff J, Hoffmann K, Pohl H, et al. Re-entrainment of circadian rhythms after phase-shifts of the Zeitgeber. Chronobiologia. 1975;2(1):23–78.
- Rosenberg RP, Bogan RK, Tiller JM, et al. A phase 3, double-blind, randomized, placebo-controlled study of armodafinil for excessive sleepiness associated with jet lag disorder. Mayo Clin Proc. 2010;85(7):630–638.
- Jamieson AO, Zammit GK, Rosenberg RS, et al. Zolpidem reduces the sleep disturbance of jet lag. Sleep Med. 2001;2(5):423–430.
©2016 Bravo, et al. This is an open access article distributed under the terms of the, which permits unrestricted use, distribution, and build upon your work non-commercially.