Parasomnias are undesirable events that occur during sleep. They can be classified into rapid eye movement
parasomnias and non-rapid eye movement
parasomnias. Those who experience
parasomnias may be anxious about travel for many reasons, including the occurrence of unwanted events during the trip, increased exposure to environmental trigger factors, and the propensity for harm to occur due to unfamiliar surroundings while travelling. There is a paucity of literature examining this area. This review summarizes the relevant literature and the clinical experience of the authors to compile clinical practice recommendations. The clinical features of
parasomnias and how they relate to trans-meridian and long-distance travel are described. Triggers for non-rapid eye movement
parasomnias, particularly the use of
sedative hypnotic drugs, alcohol,
drug withdrawal,
sleep deprivation, emotional stress and environmental stimulations, are described. Management of
parasomnias whilst travelling is reviewed, with a particular focus on trigger minimalization. The role for
clonazepam and
melatonin is outlined. At the pre-travel health consultation, the physician is strongly advised to screen the traveller for co-morbid sleep conditions, which exacerbate
parasomnias. Areas for further research are explored, including the extent to which these
sleep disorders impact on the travel experience.