Everything to Know About Sleepwalking
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When you go to bed, you expect to drift off into a blissful slumber. But for people who struggle with sleepwalking, rest is anything but restful.
Sleepwalkers carry out complex activities like making a snack or even driving a car, and even though their eyes are open, they’re totally asleep. The next day, they often have zero recollection of what happened.
For most people, sleepwalking is nothing more than an occasional nuisance. But for others, it can be a constant safety hazard that could point to an underlying sleep disorder.
What is Sleepwalking?
Sleepwalking (also known as somnambulism) is a disorder characterized by walking or performing other complex behaviors while asleep. It’s a type of parasomnia—an undesirable physical or mental event that occurs during sleep—that happens in the deeper, non-rapid-eye-movement (REM) stages around one to two hours after falling asleep.
Most sleepwalking episodes last less than 10 minutes, but there are cases where they last longer. What a person does during an episode varies, too. Activities can include:
- sitting up in bed
- getting out of bed
- walking around
- eating or preparing food
- getting dressed
- leaving the house
Sometimes, sleepwalkers may engage in unusual and even aggressive or violent behaviors like urinating somewhere other than the toilet, engaging in sexual activity, or fighting. After the episode is complete, the person usually returns to bed and falls asleep—often without any recollection of what they did.
While about 6.9 percent of the population has had at least one sleepwalking episode, the American Psychiatric Association doesn’t consider sleepwalking to be a disorder unless it happens frequently enough to interfere with daytime functioning or cause distress.
Symptoms of Sleepwalking
It’s pretty easy to tell when someone is sleepwalking. However, there are a few signs and symptoms you can look out for:
- a glassy-eyed or vacant stare
- talking but not responding
- wandering aimlessly
- confusion or disorientation
- being difficult or impossible to wake up
- not remembering what happened after waking up
- feeling tired or fatigued the following day
- having sleep terrors
Causes and Risk Factors of Sleepwalking
There’s no single root cause for sleepwalking. Everything from stress to genetics to underlying health conditions can contribute to the development of a sleepwalking disorder. And while children are more likely to sleepwalk than adults, it can happen at any age. In fact, about 1.5 percent of adults have experienced an episode well after their childhood.
Here are the most common causes of sleepwalking:
- Stress: Experiencing a stressful trigger during the day can trigger a sleepwalking episode at night, according to a 2016 study.
- Sleep deprivation: Science has found from studying MRI brain scans of sleepwalkers that a lack of sleep can increase the number of sleepwalking episodes.
- Fever: Running a high fever can result in fever dreams, which may increase the likelihood of sleepwalking, especially in children.
- Migraine episodes: Researchers have found an association between migraine episodes and sleepwalking.
- Parkinson’s disease: Because Parkinson’s disease can prevent the natural sleep paralysis that happens during REM sleep, people with the condition may be at an increased risk of sleepwalking.
- Restless leg syndrome: the jury is still out on this one, but some research suggests that the medication used to treat restless leg syndrome may actually increase the risk of sleepwalking.
- Genetics: Sleepwalking seems to run in families, which suggests that genetics may be a factor.
- Medications: Antidepressants, antipsychotics, beta-blockers, benzodiazepine receptor agonists, and sodium oxybate that’s used to treat narcolepsy have all been linked to sleepwalking.
If you’re concerned about your sleepwalking or that of a loved one, the first step is to talk with your doctor. Sleepwalking is usually diagnosed by a sleep specialist after a full evaluation.
During the appointment, your doctor will ask about your medical history and any medications you’re taking. They may also ask about your sleep habits, including how often you sleepwalk and what you do during an episode.
The doctor may also order a sleep study to rule out other sleep disorders that could be causing sleepwalking. Sleep studies are conducted overnight in a sleep lab and involve monitoring brain activity, heart rate, and breathing while you sleep.
For most people, sleepwalking is an occasional and relatively harmless event. However, if it’s frequent or causing problems, there are treatment options available.
Treating the Underlying Condition
If an underlying health condition is causing sleepwalking episodes, treating the condition can help reduce or eliminate the episodes.
This treatment involves setting an alarm for a few minutes before the estimated time of the sleepwalking episode. The goal is to wake the person up before they start sleepwalking and stay awake with them until they’re no longer at risk.
This treatment uses relaxation techniques and positive suggestions to help control sleepwalking. It works well with people who are receptive to hypnosis.
If stress or anxiety is the underlying cause of sleepwalking, talking to a therapist can help. They can teach you stress-reduction techniques and help you manage any underlying mental health conditions.
Benzodiazepines or even some antidepressants may be used to help control sleepwalking. However, because of the risk of addiction and other side effects, medications are usually only used as a last resort.
Living with Sleepwalking
Unfortunately, it takes time to find the right treatment for sleepwalking, and there is no single cure. However, there are things you can do to help manage the condition and keep yourself or your loved one safe.
Here are a few tips:
- Eliminate safety hazards. Close and lock any windows and doors. Block stairways or other areas that could be dangerous. Remove any sharp objects or tripping hazards.
- Get enough sleep. Reduce sleep deprivation by getting seven to eight hours of sleep each night.
- Manage stress and anxiety. Try relaxation techniques such as yoga or meditation. Get regular exercise. Avoid caffeine and alcohol.
- Look for patterns. Something is triggering the sleepwalking episodes. Try to identify any triggers and avoid them if possible.
Sleepwalking can be a harmless occasional event for most people. However, if it’s frequent or causing problems, there are treatment options available.
If you’re concerned about sleepwalking, talk with your doctor. They can help diagnose the condition and recommend a treatment plan. With the right treatment, you can manage sleepwalking and keep yourself or your loved one safe.
American Psychological Association. (2022). Sleepwalking disorder. https://dictionary.apa.org/sleepwalking-disorder
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