Sleepwalking, also known as somnambulism or parasomnia, is an abnormal behavior that occurs during sleep. It involves getting up and walking around while still in a state of sleep. The actions that occur during an episode of sleepwalking are considered abnormal due the state of being between sleep and wakefulness.
Signs and Symptoms
Typically, sleepwalking will occur during non-REM sleep (NREM), which is usually stage three of the sleep cycle and is associated with deep sleep. While it may be difficult to diagnose yourself with sleepwalking if you sleep or live alone, there are some common behaviors and actions that take place while sleepwalking. Some common symptoms and effects of sleepwalking to look out for can include:
- Getting out of bed and walking around
- Sitting up in bed and opening eyes
- Glazed or glassy eyes
- Difficulty waking up
- Disorientation or confusion
- Not remembering the episode in the morning
- Daytime exhaustion and fatigue
- Sleep terrors
According to experts, sleepwalking typically occurs during late-stage sleep and whenever a person is partially awakened. This partial awakening triggers physical or wakeful activity but while remaining in state of sleep. Essentially, any condition or factor which can disrupt sleep should be looked into as a possible cause for sleepwalking.
Some key factors that can increase the likelihood someone will experience sleepwalking can include:
- Sleep deprivation: A lack of sleep is correlated with a higher risk of sleepwalking; this may be due to more time spent in deep sleep after a period of sleep deprivation.
- Obstructive sleep apnea (OSA): OSA is a sleep disorder in which the airway gets blocked, causing short lapses in breath during sleep. These pauses in breathing, which can occur dozens of times per night, create sleep interruptions that can lead to sleepwalking.
- Restless Leg Syndrome (RLS): RLS is a type of sleep disorder that causes a powerful urge to move the limbs, such as the legs, when lying down. It can cause nighttime arousals from which a person may enter a sleepwalking episode.
- Stress: Different types of stress can affect sleep, including causing disjointed or disrupted sleep that can increase the propensity for sleepwalking. Stress can be both physical and emotional. Some types of stress may be related to discomfort or change such as when traveling and sleeping in an unfamiliar place, or simply stress from day-to-day activities and life.
- Genetics and family history: About 22% of children whose parents have no history of sleepwalking will experience this sleepwalking; however, 47% of children sleepwalk if one parent has a history of it, and 61% of children sleepwalk if both parents do.
- Medications: Some medications with a sedative effect can put people into a type of sleep that increases their chances of having a sleepwalking episode.
- Alcohol: Drinking alcohol before bed can create instability in a person’s sleep stages and may increase the risk of sleepwalking.
A lack of sleep is correlated with a higher risk of sleepwalking; this may be due to more time spent in deep sleep after a period of sleep deprivation.
Prevention and Treatment
If you learn you or someone else you know experiences sleepwalking, you might be wondering how to effectively stop sleepwalking. In most cases, sleepwalking doesn’t require active treatment due to the rarity of episodes or posing little risk to the sleepwalker and those around them. Episodes of sleepwalking a more common at a younger age and are likely to be less frequent as a person ages. However, if the episodes of sleepwalking are serious enough, there are some useful active approaches that can be used for a treatment plan.
Improved Sleep Environment
Also, sometimes known as sleep hygiene, it is important to have a good sleeping environment for someone who is predisposed to episodes of sleepwalking. Since sleepwalking can be triggered by a partial disturbance that triggers the event, it can be a good idea to invest in making that person’s sleeping space or bedtime routine is consistent and conducive to sleep. This can include avoiding alcohol, caffeine, or other substances close to bedtime. Other aspects of improving “sleep hygiene” might be as simple as making sure the mattress a sleepwalking prone person uses. If the mattress is uncomfortable it might lead to pressure points and physical stresses on the body, possibly causing partial wakefulness, and even triggering an episode of sleepwalking.
When other treatments are not entirely effective, medications may be considered to try to stop sleepwalking. Examples include benzodiazepines and antidepressants. Melatonin is also often used to help prevent sleepwalking episodes. Your body naturally creates melatonin to induce sleep, but additional dosage of it might be required to prevent periods of disrupted sleep.
Any medication, whether prescription or over the counter, has potential benefits and risks, and a doctor should determine whether it is appropriate for a given individual.
Cognitive Behavioral Therapy
Cognitive behavioral therapy (CBT) is a form of therapy that counteracts negative thoughts and actions. CBT can be used to retrain how someone approaches sleep, possibly leading to less disruptions and wakefulness during periods that they should be in deep sleep. CBT is often used for stress and anxiety, and by using CBT methods such as including relaxation techniques, it may help prevent stress-related episodes of sleepwalking.
Harm reduction in an important consideration for those who sleepwalk due to possible safety risks and chances of injury. For instance, it is important to keep sharp objects as well as weapons secured or locked away as a sleepwalking person could potentially harm themselves or others unintentionally. It is also a good idea to close latching doors and windows, remove tripping hazards, or possibly even install lights with motion sensors or alarms that go off when a sleepwalking person gets out of bed.
Overall, unless the episodes of sleepwalking you or a loved one is experiencing are severe and dangerous, it is likely that a combination of these prevention and treatment methods can greatly reduce the likelihood of sleepwalking incidents.