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Vol.:(0123456789)
Sports Medicine (2021) 51:2029–2050
https://doi.org/10.1007/s40279-021-01502-0
CONSENSUS STATEMENT
Managing Travel Fatigue andJet Lag inAthletes: AReview
andConsensus Statement
DinaC.JansevanRensburg1,2 · AudreyJansenvanRensburg1 · PeterM.Fowler3 · AmyM.Bender4 ·
DavidStevens5,6 · KieranO.Sullivan7,8 · HughH.K.Fullagar9 · Juan‑ManuelAlonso10 · MichelleBiggins7 ·
AmandaClaassen‑Smithers11 · RobCollins12,13· MichikoDohi14· MatthewW.Driller15 · IanC.Dunican16 ·
LukeGupta17· ShonaL.Halson18 · MicheleLastella19 · KathleenH.Miles20 · MathieuNedelec21 ·
TonyPage22· GregRoach19· CharliSargent19 · MeetaSingh23 · GraceE.Vincent19 · JacopoA.Vitale24 ·
TanitaBotha25
Accepted: 7 June 2021 / Published online: 14 July 2021
© The Author(s), under exclusive licence to Springer Nature Switzerland AG 2021
Abstract
Athletes are increasingly required to travel domestically and internationally, often resulting in travel fatigue and jet lag.
Despite considerable agreement that travel fatigue and jet lag can be a real and impactful issue for athletes regarding perfor-
mance and risk of illness and injury, evidence on optimal assessment and management is lacking. Therefore 26 researchers
and/or clinicians with knowledge in travel fatigue, jet lag and sleep in the sports setting, formed an expert panel to formalise
a review and consensus document. This manuscript includes definitions of terminology commonly used in the field of circa-
dian physiology, outlines basic information on the human circadian system and how it is affected by time-givers, discusses
the causes and consequences of travel fatigue and jet lag, and provides consensus on recommendations for managing travel
fatigue and jet lag in athletes. The lack of evidence restricts the strength of recommendations that are possible but the con-
sensus group identified the fundamental principles and interventions to consider for both the assessment and management
of travel fatigue and jet lag. These are summarised in travel toolboxes including strategies for pre-flight, during flight and
post-flight. The consensus group also outlined specific steps to advance theory and practice in these areas.
* Dina C. Janse van Rensburg
christa.jansevanrensburg@up.ac.za
Extended author information available on the last page of the article
1 Introduction
The modern-day athlete is often required to travel domes-
tically and internationally including high-frequency short
distances (< 3h) and low-frequency long distances (> 3h)
that may involve the crossing of numerous time zones. The
subsequent travel fatigue and jet lag experienced result in
a myriad of shared symptoms, such as daytime fatigue,
decreased concentration and alertness, sleep disruption
and gastrointestinal disturbances [1, 2]. These can lead to
increased illness and injury risk as well as adverse effects
on athletic performance [2–9].
Travel fatigue and jet lag are two distinct entities that
may co-occur when travelling east or west across three or
more time zones [2, 4, 10–12]. Travel fatigue occurs in all
travelling athletes and can be acute following any individual
long journey, or chronic (cumulative) as a consequence of
repetitive travel within a season [4, 10]. It is a multi-domain
disturbance that generally occurs with any travel regard-
less of the direction of travel or the number of time-zones
crossed [2, 4, 10, 13]. It is caused by the demands of travel
itself, such as cramped conditions, prolonged mild hypoxia,
changes in the external environment (trans-latitudinal travel
i.e. winter–summer/summer–winter) and reduced physical
activity [10]. Jet lag is episodic with similar but more severe
and prolonged symptoms compared to travel fatigue and fol-
lows rapid travel across 3 or more time-zones (transmerid-
ian travel i.e. east–west/west–east) [4, 10]. It is typically
characterised by the desynchronisation between the internal
human circadian system and the time at the new destination
[2, 4, 10, 11, 14]. As a result, the circadian rhythm of sev-
eral psychological, physiological and behavioural variables
with a typical early morning nadir and late-afternoon peak is
misaligned with the new local time. Depending on the train-
ing or competition time, this could directly affect athletic
performance [2, 4, 5].
Although the circadian system is well understood and
described in the circadian physiology literature [5, 15–19],
it remains difficult to translate and to apply this knowledge
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