Sleepwalking (Somnambulism)

By:    Published: October 7, 2012

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Sleepwalking, or somnambulism, generally refers to an individual getting up out of bed during sleep and walking around. There are five different stages that our brain goes through when we are asleep. Put these 5 stages of sleep together, and you have one complete sleeping cycle. A complete cycle occurs for approximately 100 minutes. Most individuals have 4-5 complete sleeping cycles each night. Sleepwalking typically occurs during stages 3 and 4 of the sleep cycle.

What Is It?

In addition to actually walking, the term sleepwalking also refers to other behaviors, such as:

  • Sitting up in bed
  • Talking while asleep
  • Not responding when spoken to
  • Performing repeated motions while asleep, such as rubbing eyes or smoothing hair
  • Inappropriate behaviors such as urinating on the floor

The behaviors that are exhibited during sleepwalking can range from mild and harmless to more serious and potentially dangerous, such as if an individual exits the house and wanders around the streets. It can occur in both children and adults. In children, it is the most common between the ages of 4 and 8.

Symptoms

Specific symptoms of sleepwalking largely depend on the individual. While all people who sleepwalking are asleep, the actual behaviors that they exhibit during sleep vary greatly. Some common sleepwalking symptoms include:

  • Sitting up in bed with eyes open while still asleep
  • Eyes have a glazed appearance
  • Roaming around the house in a daze
  • Turning on and off lights or opening and closing cabinets and doors
  • Getting dressed in the middle of the night
  • Moving around the room clumsily
  • Speaking but not making much sense
  • Screaming
  • Night terrors (see: Night Terrors In Children)
  • Thrashing around in the bed

These episodes generally occur early in the night, shortly after going to bed. They usually begin within two hours of falling asleep. However, they can also occur multiple times throughout the night.

Individuals who sleepwalk do not remember any of their sleepwalking episodes. Sleepwalking episodes in children generally improve or disappear when they reach their teens. This is believed to be a result of them spending less time in deep sleep.

Causes

There are several factors that can lead to sleepwalking. Common causes include:

  • Sleep deprivation
  • An unfamiliar environment when going to bed
  • Stress
  • Fatigue
  • Anxiety
  • Medications
  • Migraines
  • Fever or illness
  • Abnormal breathing patterns during sleep
  • Restless leg syndrome
  • Head injuries
  • Alcohol use
  • Sedative use

[Related: 10 Negative Effects Of Sleep Deprivation]

Risk Factors

Sleepwalking is more common in children under the age of 13 than in older children. It is more likely for children to sleepwalk if they have a parent who is a sleepwalker. If both parents sleepwalk, the risk to the child is even higher. Adults who use alcohol or illegal drugs are more likely to sleepwalk, as are those who take certain medications such as sedatives and antihistamines.

Diagnostic Tests

Most parents are able to recognize sleepwalking in their children. Adults who sleepwalk may not realize they are engaging in the behavior until they see the effects of their episodes. For example, they may wake up in a place other than their bed, or they may wake in their bed and find that the house has been disturbed during the night.

A doctor who is attempting to diagnose sleepwalking will typically perform a physical, first, and then possibly a psychological exam to rule out any other conditions that may be present, such as seizures or panic attacks.

A sleep study, known as polysomnography, may be recommended as well. During a sleep study, patients spend a night in a sleep center where they are closely monitored by the staff. A report is sent to the doctor who can then review the information and make a diagnosis.

Treatment Options

In most cases, treatment is not needed for sleepwalking. Parents should gently try to guide their child back to bed during sleepwalking episodes. Although it is not dangerous to wake a sleepwalker, because they may be disoriented and confused, it can make the event worse. Some adults may even try to attack the individual waking them up.

People who do seek out treatment for sleepwalking often report that hypnosis is effective at decreasing or eliminating episodes. If the sleepwalking occurs as a result of medication use, speak with the doctor about switching to a new medication. If sleepwalking is due to alcohol or drug use, stopping those behaviors can eliminate the condition.

Home Remedies

There are some simple steps that you can take to help with sleepwalking. It is important to make the home as safe as possible. Always keep all windows and doors closed and locked during the night to prevent injury. Use a stairway gate to block off the top and bottom of stairs. Keep electrical cords out of reach and remove objects from the floor that may cause tripping. Never let a child who sleepwalks sleep in a bunk bed and always keep sharp objects entirely out of reach. Additional tips to help with sleepwalking include:

  • Getting more sleep to counteract fatigue
  • Maintaining a regular bedtime routine
  • Perform calming activities before bed such as reading or taking a warm bath
  • Keep a sleep journal
  • Seek out ways to get a handle on stress to reduce anxiety and tension, such as mediation, yoga or other relaxation techniques

When To See A Doctor

Uneventful sleepwalking that only occurs occasionally is not usually a cause for concern. You should contact a doctor if sleepwalking episodes become more frequent or more severe, as well as if they can lead to dangerous behavior. If your child’s sleepwalking does not improve by age 13, contact your pediatrician.

Complications

The act of sleepwalking usually isn’t cause for alarm. Individuals who sleepwalk are at risk for injuries or placing themselves in dangerous situations. The most common complication from sleepwalking is daytime fatigue (see: Excessive Daytime Sleepiness) as a result of disturbed sleep. In children, this can lead to behavior issues and learning problems.

Considerations

When you consult your doctor about sleepwalking episodes, it can be helpful to be prepared for your appointment. Bring a sleep diary with you detailing your sleep ritual, quality of sleep, what you remember in the morning, etc. Make a list of any additional symptoms you are experiencing such as fatigue, headaches, etc.

Include a list of any major stressful events of recent life changes. Be sure to include a list of any medications or vitamin supplements you are taking, even if they are over the counter. Make a list of questions that you have for your doctor so you don’t forget them once you are there.

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