Travel, insomnia

Weakness, dizziness, insomnia, headache, and nausea can occur in mountain travelers who rapidly ascend above 3000 m. The symptoms are usually mild and last for a few days. In more serious cases, rapidly progressing pulmonary or cerebral edema can be life-threatening. By decreasing cerebrospinal fluid formation and by decreasing the pH of the cerebrospinal fluid and brain, acetazolamide can increase ventilation and diminish symptoms of mountain sickness. 

Insomnia may also be classified according to its duration as a symptom. Thus, transient insomnia occurs in normal sleepers who have traveled to another time zone (jet lag), who are sleeping in an unfamiliar surrounding, or who are under acute situational stress. Often treatment is not required, and insomnia is reversed with time alone. Short-term insomnia can be experienced by one who is generally a normal sleeper but is under a stress that does not resolve within a few days, such as divorce, bankruptcy, or a lawsuit. Such individuals may not meet the criteria for a psychiatric disorder other than an adjustment disorder and yet may require short-term symptomatic relief of their insomnia in order to function optimally. 

Jet lag is especially common among frequent travelers and airplane cabin crews. Typical symptoms of jet lag may include daytime drowsiness, insomnia, frequent awakenings, and gastrointestinal upset. Clinical studies with administration of melatonin have reported subjective reduction in daytime fatigue, improved mood, and a quicker recovery time (return to normal sleep patterns,... 

Transient insomnia. This occurs in normal sleepers who experience an acute stress or stressful situation lasting for a few days, for example, air travel to a different time zone or hospitalization. 

In five comparisons of mefloquine with other chemoprophylaxis regimens, there was no difference in tolerability. The only consistent adverse effects consistently specific to mefloquine in the controlled trials were insomnia and fatigue, but there were also 516 reports of adverse effects of mefloquine, 63% of which were in tourists and travellers. Four deaths were attributed to mefloquine. 

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