Sleepwalking
DEFINITION
Sleepwalking — also known as somnambulism — involves getting up and walking around while in a state of sleep. More common in children than adults, sleepwalking is usually outgrown by the teen years. Isolated incidents of sleepwalking often don’t signal any serious problems or require treatment. However, recurrent sleepwalking may suggest an underlying sleep disorder.
Sleepwalking is less common in adults and has a higher chance of being confused with or coexisting with other sleep disorders as well as medical and mental health conditions.
If anyone in your household sleepwalks, it’s important to protect him or her from sleepwalking-related injuries.
CAUSES
Many factors can contribute to sleepwalking, including:
- Sleep deprivation
- Fatigue
- Stress
- Depression
- Anxiety, such as separation anxiety in children
- Fever
- Sleep schedule disruptions
- Some medications and substances, such as short-acting hypnotics, sedatives or combinations of different drugs prescribed for psychiatric illnesses, as well as alcohol
Sometimes sleepwalking can by triggered by underlying conditions that interfere with sleep, such as:
- Sleep-disordered breathing — a group of disorders characterized by abnormal breathing patterns during sleep (for example, obstructive sleep apnea)
- Narcolepsy
- Restless legs syndrome
- Gastroesophageal reflux disease (GERD)
- Migraines
- Medical conditions such as hyperthyroidism, head injury or stroke
- Travel
SYMPTOMS
Sleepwalking is classified as a parasomnia — an undesirable behavior or experience during sleep. Sleepwalking is a disorder of arousal, meaning it occurs during slow wave sleep, the deepest stage of dreamless (non-rapid eye movement, or NREM) sleep. Another NREM disorder is sleep terrors, which can occur together with sleepwalking.
Sleepwalking usually occurs early in the night — often one to two hours after falling asleep. It’s unlikely to occur during naps. A sleepwalking episode can occur rarely or often, and an episode generally lasts several minutes, but can last longer.
Someone who is sleepwalking may:
- Get out of bed and walk around
- Sit up in bed and open his or her eyes
- Have a glazed, glassy-eyed expression
- Do routine activities, such as getting dressed, talking or making a snack
- Not respond or communicate with others
- Be difficult to wake up during an episode
- Be disoriented or confused for a short time after being awakened
- Quickly return to sleep
- Not remember the episode in the morning
- Sometimes have problems functioning during the day because of disturbed sleep
- Have sleep terrors in addition to sleepwalking
Rarely, a person who is sleepwalking will:
- Leave the house
- Drive a car
- Engage in unusual behavior, such as urinating in a closet
- Engage in sexual activity without awareness
- Get injured, for example, by falling down the stairs or jumping out a window
- Become violent during the confused period after awakening or, occasionally, during the event
When to see a doctor
Occasional episodes of sleepwalking aren’t usually a cause for concern. You can simply mention the sleepwalking at a routine physical or well-child exam. However, consult your doctor if the sleepwalking episodes:
- Occur often — for example, more than one to two times a week
- Lead to dangerous behavior or injury to the person who sleepwalks (which may occur, for example, after leaving the house) or to others
- Cause significant sleep disruption to household members or embarrassment to the person who sleepwalks
- Start for the first time in an adult
- Continue into your child’s teen years
