Differentials

Travel-related fatigue

SIGNS / SYMPTOMS
INVESTIGATIONS
SIGNS / SYMPTOMS

Usually symptoms are of shorter duration than jet lag and resolve after a normal night’s sleep.[4]

INVESTIGATIONS

Diagnosis is clinical.

Short-term insomnia disorder

SIGNS / SYMPTOMS
INVESTIGATIONS
SIGNS / SYMPTOMS

To be considered if symptoms persist beyond the episode of jet lag but last less than three months.[1]

INVESTIGATIONS

Sleep history.[1]

Insomnia

Chronic insomnia disorder

SIGNS / SYMPTOMS
INVESTIGATIONS
SIGNS / SYMPTOMS

To be considered if symptoms persist beyond the episode of jet lag and last more than three months.[1]

INVESTIGATIONS

Sleep history.[1]

Dyssomnias in children

Delayed sleep-wake phase disorder

SIGNS / SYMPTOMS
INVESTIGATIONS
SIGNS / SYMPTOMS

To be considered if symptoms persist beyond the episode of jet lag and last more than three months.[1]​ Typically occurs in adolescence, or in extreme 'owls' on the lark-owl scale ('night people').[1]

INVESTIGATIONS

Sleep logs confirm delayed pattern of the habitual sleep period.[1]

Actigraphy confirms diagnosis.[1]

Dyssomnias in children

Shift-work disorder

SIGNS / SYMPTOMS
INVESTIGATIONS
SIGNS / SYMPTOMS

History of work schedule that coincides with the normal sleep period (generally, night-time).

INVESTIGATIONS

Sleep logs confirm a disturbed sleep-wake pattern.[1]​

Actigraphy confirms diagnosis.[1][5]

Advanced sleep-wake phase disorder

SIGNS / SYMPTOMS
INVESTIGATIONS
SIGNS / SYMPTOMS

To be considered if symptoms persist beyond the episode of jet lag and last more than three months.[1]

INVESTIGATIONS

Sleep logs confirm a stable advance in timing of the sleep period.[1]

Actigraphy confirms diagnosis.[1]

Non-24-hour sleep-wake rhythm disorder

SIGNS / SYMPTOMS
INVESTIGATIONS
SIGNS / SYMPTOMS

To be considered if symptoms persist beyond the episode of jet lag and last more than three months.[1]​ There may be a history of blindness.

INVESTIGATIONS

Sleep logs confirm pattern daily progressive change in primary sleep episode.[1]

Actigraphy confirms diagnosis.[1]

Irregular sleep-wake rhythm disorder

SIGNS / SYMPTOMS
INVESTIGATIONS
SIGNS / SYMPTOMS

To be considered if symptoms persist beyond the episode of jet lag and last more than three months.[1]​ There may be a history of neurodegenerative disorders, such as dementia; or in children, developmental disorders.

INVESTIGATIONS

Sleep logs confirm pattern of at least three irregular bouts of sleep with no major sleep period.[1]

Actigraphy confirms diagnosis.[1]

Obstructive sleep apnoea

SIGNS / SYMPTOMS
INVESTIGATIONS
SIGNS / SYMPTOMS

Consider if there are symptoms of excessive daytime sleepiness and unrefreshing sleep pre-dating travel. Patients with obstructive sleep apnoea (or their bed partners) may also report loud snoring, gasping during sleep, and apnoeas.

INVESTIGATIONS

Polysomnography (including electroencephalogram, electro-oculographic recording, air flow assessment, electromyogram, capnography, oesophageal manometry, ECG, and pulse oximetry) demonstrates five or more obstructive respiratory events per hour of sleep.[1]

Obstructive sleep apnoea in adults

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