Sleepwalking

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at June 21, 2016
StartDiseasesSleepwalking

Sleepwalking is a common behavior found mostly in children to teens that causes the person to move, walk, or perform actions in his or her sleep. The condition is a type of sleep disorder. Sleepwalking is usually referred to by two different terms: somnambulism and noctambulism.

Contents

Definition & Facts

It is common for people who have sleepwalked to remember their experiences though many do not. Though typically harmless, sleepwalking can potentially be harmful; people have been found driving vehicles or performing more dangerous activities in their sleep.

It is shown that some parts of the brain fall into deeper sleep states than others, leaving the person in a state of limbo between consciousness and unconsciousness. Sleepwalking teens usually show signs of falling asleep more rapidly than those who do not sleepwalk.

Symptoms & Complaints

There are several symptoms of sleepwalking. They include:

  • Talking in one's sleep
  • Memory loss of the event
  • Being difficult for others to wake up
  • Glossed-over eyes during an episode

Some sleepwalkers who talk in their sleep may be active in conversation, while others who do so may not be likely to respond. Some children may urinate in inappropriate areas, such as closets, floors, etc. People who sleepwalk may sit up and open their eyes, while some may walk around.

In rare cases, people who sleepwalk will perform sexual acts or engage in sexual activity without prior consent or acknowledgement. In very few episodes, a person may actually hurt or injure himself or herself in activities such as falling out of a window or a flight of stairs.

It is common for those who are awakened in their episode to be somewhat confused and/or disoriented. Those who sleepwalk tend to have difficulty during their waking hours due to sleep disturbances.

Causes

Sleep deprivation is a commonly found link between all sleepwalking cases. Drug use or alcohol use may be a contributing factor in some cases. Medications such as antihistamines used to treat allergies, sleeping aids, anti-psychosis treatments and stimulants may all be contributing factors to a person’s somnambulism. Those who have an irregular sleep schedule are also at risk for episodes of sleepwalking. In rarer cases, conditions such as sleep apnea or narcolepsy can initiate the disorder. Other causes can include:

It's possible that genetic factors and environmental factors may play a role. If one goes to sleep in an environment that he or she is not used to (such as a louder construction area or near a train intersection), it can increase the risk of having a sleepwalking episode.

Diagnosis & Tests

Diagnosis of somnambulism usually begins with a person complaining of bruising or strange markings on his or her body or concerns from a loved one who has witnessed sleepwalking episodes. A person can opt to take what is called a polysomnogram, a multi-part test that checks for most sleep disorders. A sleep specialist will perform the test in one of four different categories:

The diagnostic polysomnogram monitors a person while he or she is asleep. He or she is connected to various sensors that measure:

A daytime test measures how many times a person’s sleep cycle changes. A person will usually go through multiple stages in his or her sleep; one of these stages is the REM or rapid eye movement stage. This is where a person will have the most engaging dreams.

For a two-night evaluation, the patient is tested on the first day using a general diagnostic polysomnogram. If the patient exhibits signs of sleep apnea, then the patient will undergo a second day trial that will pump air into the nasal cavities with a mask to figure out the necessary airway pressure to alleviate the symptoms of sleep apnea.

A split-night titration is similar to the two-night evaluation except occurs over the course of a single night. The first half of the night’s study studies any sleep apnea exhibited by the patient. The second half of the night, a continuous airway pressure device will be used to determine the proper airway pressure necessary to alleviate the symptoms of the apnea.

Treatment & Therapy

Since the majority of cases dealing with somnambulism are typically caused by lack of sleep, sleep schedule disorders or disruptions in sleeping, these cases can be cleared by regulating a sleep schedule. Meditation before falling asleep is recommended as well. For those who take medications, such as sleeping pills, antipsychotics, stimulants and/or allergy drugs, talking to a doctor about changing prescriptions or stopping certain medications may be a step towards reducing one’s sleepwalking.

For the more severe cases caused by underlying sleep disorders, medications may be prescribed to a patient in order to alleviate the somnambulism. Certain medications have proven beneficial for the treatment of sleepwalking – a few of these are:

Prevention & Prophylaxis

For those who are trying to avoid sleepwalking in the future, getting adequate sleep is necessary. Abstaining from alcohol consumption may also prevent sleepwalking. Another prevention method is to limit the amount of stress that comes into one’s life.

For those with more severe cases of sleepwalking disorders, setting up proper boundaries may be necessary to reduce the risk of injury. For those who sleepwalk on an upstairs portion of the house, either place safeguards in place such as window locks, heavy curtains or door locks, or relocate to a downstairs room and blockade the entrances to stairways.

Maintaining keys to vehicles in a safe place away from the bedroom can also prevent sleepwalkers from having an accident, while keeping the door dead-bolted from an area out of reach to the person can help as well.