Sleepwalking

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What is Sleepwalking?

Sleepwalking, or somnambulism, involves sitting up in bed, standing, and walking during deep, NREM slumber, usually earlier in the night after one or two hours of sleep. This disorder is one of the most striking parasomnias, if only because it can scare other members of the household.

Because sleepwalkers may injure themselves or cause damage to their environments, it is also one of the more dangerous sleep disorders. Sleepwalkers sometimes urinate, trip, and fall during sleepwalking episodes, which generally last 5 to 10 minutes.

How Common is Sleepwalking?

An estimated 10 percent of all people sleepwalk at some point. Per a recent Stanford study, 3.6 percent of adults experienced sleepwalking in the past year. Like many parasomnias, sleepwalking is more common in children; most often boys ages 6 to 12. Sleepwalking is more common in children who also experience night terrors, leading some researchers to believe the two are connected.

Symptoms of Sleepwalking

  • Sitting up in bed and making repeated fine motor movements (small hand movements)
  • Gazing with open eyes with blank expression
  • Inappropriate responses to people and things in the room
  • Non-responsive and difficult to wake
  • Urinating in inappropriate places
  • No memory of the episode afterward

What Causes Sleepwalking?

For centuries, sleepwalking was mistakenly associated with hysteria, psychological problems, or a guilty conscience. A famous sleepwalking depiction appears in Shakespeare’s MacBeth, Act 5, Scene 1, when Lady MacBeth plays out actions related to her own guilt.

Today, science has disproved these myths. Sleepwalking is thought to be aggravated by stress, fatigue, sleep deprivation and some medications. Sleepwalking most often occurs during deep sleep early in the night, and therefore is more common in people who spend more time in these deeper sleep stages.

Alcohol and medications that promote deep, NREM sleep can trigger sleepwalking episodes. Some people report so-called “drunk sleepwalking,” or sleepwalking behavior while intoxicated.

Other causes of sleepwalking include:

  • Heredity
  • Sleep deprivation
  • Poor sleep hygiene
  • Sleeping with a full bladder

Diagnosis

Doctors generally don’t perform tests or overnight sleep studies to diagnose sleepwalking. Your physician may take a detailed health history to check for an underlying sleep disorder and ask about your sleep patterns and sleep habits.

Treatment

The urban myth to never wake a sleepwalker is just that: a myth. When your partner or child sleepwalks, attempt to wake him or her or gently guide the sleepwalker back to bed.

Generally, children outgrow sleepwalking, so treatment is not necessary. Sleepwalking is usually managed with lifestyle modifications. These include:

  • Improving sleep hygiene to minimize fatigue
  • Avoiding stress and anxiety
  • Modifying the sleep environment to reduce tripping hazards
  • Emptying the bladder before sleep

In some cases, hypnosis may help alleviate stress and anxiety contributing the sleepwalking.

Rarely, benzodiazepine medications are prescribed for sleepwalking.

Additional resources:
National Library of Medicine Sleepwalking Facts
Night Terrors
NREM Parasomnias

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