Sleepwalking — technically known as somnambulism — is a sleep disorder characterized by walking, sitting up in bed, and performing other movements while asleep. Sleepwalking is considered a parasomnia, a sleep disorder that involves abnormal or disruptive movements or behaviors. In addition to sleepwalking, parasomnias include sleep-eating, talking while asleep, sleep paralysis, night terrors, and hypnagogic hallucinations.
Note: The content on Sleepopolis is meant to be informative in nature, but it shouldn’t take the place of medical advice and supervision from a trained professional. If you feel you may be suffering from any sleep disorder or medical condition, please see your healthcare provider immediately.
Symptoms of Sleepwalking
Sleepwalking is most common in children, but does occur in adults. (1) Sleepwalking usually occurs during deep sleep but can also take place during the lighter sleep stages. Symptoms of sleepwalking can involve more than just walking during sleep, and may include:
- Sitting up in bed
- Lack of responsiveness to a voice or touch
- Leaving the home
- Trying to drive
- Appearing dazed
- Repeating certain movements such as rubbing the eyes
Children who sleepwalk may experience other parasomnias, as well, including bedwetting, night terrors, and talking in their sleep. (2) Common effects of sleepwalking in children include daytime sleepiness, behavioral issues at home or school, and symptoms typically associated with ADHD, such as difficulty concentrating and hyperactivity.
The Dangers of Sleepwalking
Sleepwalking occurs during the deepest stage of sleep, also known as N3 or slow wave sleep. Blood flow to the brain decreases during N3 sleep and is redirected to other parts of the body for tissue repair and maintenance of the immune system. Lack of cerebral blood flow makes waking up during N3 sleep difficult, even when sleep is disturbed.
Sleepwalking is a disorder of “partial arousal,” which means that it takes place during N3 sleep when the sleeper is not fully awake and alert. (3) Sleepwalking, sleep-eating, talking during sleep, and other activities can occur as a result.
Sleepwalking can become dangerous when the sufferer attempts to engage in activities that require full consciousness and coordination. These may include:
- Leaving the home
- Using stairs
- Using sharp or heavy objects
- Attempting complex tasks
Sleepwalkers may also open or try to leave the home through a window, rearrange furniture, or run, jump, or climb. Sleepwalking sufferers may have no memory of the incidents, or may be able to remember them in detail. Waking a sleepwalker may be difficult, but can help keep them from injuring themselves. To protect children and adults who sleepwalk, try the following tips:
- Make sure front and back doors are locked at night
- Install childproof locks on windows
- Don’t allow a child who sleepwalks to sleep in a top bunk bed
- Put heavy, sharp, or dangerous objects out of reach
- Hide keys if the sleepwalker has ever attempted to drive
- To prevent falls, install gates on stairways
- If episodes continue, see your healthcare provider for professional diagnosis and advice
What Causes Sleepwalking?
Sleepwalking occurs more often in children whose parents sleepwalked as children, indicating a possible genetic link. (4) The sleep and wake system is less mature in children, which may contribute to sleepwalking episodes. Other potential causes include:
- Sleep deprivation
- Fever or illness
- Jet lag or other disruptions to the circadian rhythm
- Gastroesophageal reflux disease (GERD)
- Other sleep disorders, such as restless legs syndrome and obstructive sleep apnea (5)
- Use of alcohol, recreational drugs, and certain medications, particularly prescription sleep medications and sedatives
Many cases of sleepwalking have no clear cause, particularly in children. Sleepwalking typically appears in childhood, but in most cases resolves without treatment by adolescence.
How to Prevent Sleepwalking
Not all cases of sleepwalking are preventable, but some may be helped by promoting healthy sleep and basic sleep hygiene. Sleep hygiene essentials include:
- Consistent sleep and wake times
- Turning off electronics such as phones, televisions, and video games at least an hour before bed
- Eliminating consumption of caffeine and alcohol at night
- Reducing stress to help deactivate the nervous system
- Practicing mindfulness, meditation, and/or yoga to help decrease anxiety
- Keep the bedroom dark, cool, and quiet
- Have other sleep disorders such as insomnia and sleep apnea treated to help avoid disturbed sleep that might lead to sleepwalking
If sleepwalking and the risk of injury persist, see your healthcare provider to discuss treatment options. Treatments may include a short-term course of medication or scheduled awakenings to prevent sleepwalking episodes. (6)
Last Word From Sleepopolis
Sleepwalking is a potentially dangerous sleep disorder that can result in injury, daytime sleepiness, and behavioral issues. Though sleepwalking often occurs only occasionally and resolves on its own, it can pose a risk of injury or death.
Addressing underlying disorders that may contribute to sleepwalking can help reduce episodes of sleepwalking. People with a family or personal history of leaving the home or putting themselves in jeopardy may lower the chance of injury by maintaining healthy sleep habits and seeking treatment from a medical professional.
Can sleepwalking be fatal?
Rarely, but yes. There have been cases of sleepwalkers jumping from windows, being hit by vehicles, and climbing tall objects. While most sleepwalkers do not put themselves in significant danger, fatal injury is possible for those who do.
How long do sleepwalking episodes usually last?
Most episodes of sleepwalking last for ten minutes or less, though they may last from a few seconds to thirty minutes or longer.
How old is the typical sleepwalker?
Between four and eight years old.
- Antonio Zadra, Somnambulism: clinical aspects and pathophysiological hypotheses, The Lancet Neurology, March 1, 2013
- Fleetham JA, Fleming JA., Parasomnias, Canadian Medical Association Journal, May 2014
- Robyn Mehlenbeck, The clinical presentation of childhood partial arousal parasomnias, Sleep Medicine, October 2000
- Dominique Petit, Childhood Sleepwalking and Sleep Terrors: A Longitudinal Study of Prevalence and Familial Aggregation, JAMA Pediatrics, July 1, 2015
- Helen M Stallman, Assessment and treatment of sleepwalking in clinical practice, Australian Family Physician, Chronic Illness in Adolescents, 2017
- Drakatos P, Marples L, Muza R, Higgins S, Gildeh N, Macavei R, Dongol EM, Nesbitt A, Rosenzweig I, Lyons E, d’Ancona G, Steier J, Williams AJ, Kent BD, Leschziner G., NREM parasomnias: a treatment approach based upon a retrospective case series of 512 patients, Sleep Medicine, January 2019
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