Sleepwalking

Formally known as somnambulism, sleepwalking involves walking during sleep and performing several other complex behaviors. More common in children and in those who are sleep deprived, this disorder occurs during deep sleep and sufferers are therefore difficult to wake during episodes. In the morning most people can’t remember the event.

Thanks to the name, the most obvious symptom of this disorder is walking during sleep, but it could be as simple as sitting up in bed and looking around the room. Others find themselves walking around the house while a small percentage will leave the house and even drive long distances. It is a common misconception that a sleepwalker should not be awakened. The opposite is true, and it can be dangerous not to wake them up. 

Sleepwalking occurs in 1% - 15% of Americans and doesn’t normally suggest a psychological or psychiatric problem. 

There are some common triggers for sleepwalking: 

• certain medications
• febrile illnesses
• sedative agents such as alcohol 
• sleep deprivation.

Sleepwalking is far more common in children and tends to peak between three and seven years of age. It’s even more common when a child suffers from sleep apnea. There is also a higher instance of sleepwalking among children who experience bedwetting and sleep terrors. 

Causes of sleepwalking 

Despite all the improvements in technology these days we’re still unable to highlight the exact cause of sleepwalking. However, we know that alongside night terrors it passes from one generation to the next. If close family members sleepwalk, the next generation is likely to sleepwalk too. 

We also know that there are certain things that make sleepwalking more prevalent: 

• being abruptly awoken from deep sleep (by a touch or noise) 
• waking up abruptly due to the need of the toilet 
• sedatives and other medication
• recreational drugs
• too much alcohol
• infections with a fever (especially in children)
• anxiety and stress
• lack of sleep. 

In other cases it’s another sleep disorder that causes us to suddenly wake up during the night and trigger sleepwalking episodes (such as the restless legs syndrome and obstructive sleep apnea). A doctor will advise patients to reduce these triggers by dealing with stress, getting more sleep, etc. 

Exploring an episode of sleepwalking

In the most basic episodes a sleepwalker might sit up in bed and look around the room while appearing confused. The next level is walking around the home, getting dressed, opening cupboards, and potentially even eating. In less common and extreme cases sleepwalkers might drive a car or perform other complex activities. 

The reason the experience is traumatic for loved ones is that the eyes are open while someone is sleepwalking, but they look straight through people. If you speak to a sleepwalker, they can respond, but the answer won’t make much sense. Sleepwalkers also tend to move well around familiar rooms and objects. 

Although the majority of episodes are over within ten minutes, some can last longer. At the end the sleepwalker either goes back to bed or wakes up. If the former, they can wake up in the morning as if nothing happened. If woken in the middle of an episode, it leads to confusion and lack of memory. 

Dealing with a sleepwalker 

If you live with a sleepwalker, the priority should always be their safety. If you can guide them back to bed, this is the ideal solution; without too much disturbance they will normally drift back to sleep. If you’re worried about a second episode, gently wake them and keep them awake for a couple of minutes (to end the deep sleep cycle) before allowing them to go back to sleep. 

DO NOT: shout or try to shock them in some way. Unless in danger, we also advise against restraining them because they can lash out. 

Preventing accidents: When there’s a sleepwalker in the house, it’s important to clear the common pathways and trip hazards. It’s best to keep them indoors, which is why doctors will tell you to lock the windows and doors. 

If it’s a child, think about everything that could go wrong if they were to sleepwalk, and deal with the potential hazards. If your child sleepwalks, they should never sleep on the top bed of a bunk bed because they could easily fall or jump. It would also be wise to put a safety gate at the top of the stairs to block their path. Whenever somebody else looks after your child, let the minder know the situation and how you deal with the sleepwalking. It's also a good idea to keep windows and doors locked.

Contacting a doctor

If sleepwalking is irregular and causes no harm, medical attention is unnecessary. It doesn’t normally suggest a deeper problem and may get better with time (especially when it comes to children). You SHOULD see a doctor if the following is true: 

• episodes start in adult life 
• you or family members are concerned for your safety
• sleepwalking episodes are becoming frequent. 

Depending on the case, you might be asked to attend a sleep center where you can talk to a sleep specialist. In some cases sleepwalkers take part in sleep studies so that certain medical conditions can be eliminated (including the restless leg syndrome and obstructive sleep apnea). 

Common treatments for sleepwalking 

Rather than a specific medical treatment, dealing with sleepwalking is often about improving one’s lifestyle. For example, we should all try to get sufficient sleep each night and adopt a good bedtime routine. You may find the following advice helpful: 

• read, have a bath, or do something else to relax before bed
• use the toilet before going to sleep
• avoid caffeine in the last couple of hours before bed
• make your bedroom dark and quiet
• stick to a specific bedtime. 

If you’re worried about a child, pay attention to when they sleepwalk and wake them up around 15 minutes before it normally happens. As you alter their normal sleep cycle, this may prevent the problem from occurring. 

What about medications? They aren’t normally offered unless there’s a risk to health and safety. In these cases doctors will offer antidepressants or benzodiazepines since they will encourage sleep and reduce the likelihood of experiencing sleepwalking. A more effective treatment is often found with hypnotherapy or CBT (cognitive behavioral therapy).