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
  • talking
  • 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:

Diagnosis

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.

Treatment Options

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.

Anticipatory Awakenings

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.

Self-Hypnosis

This treatment uses relaxation techniques and positive suggestions to help control sleepwalking. It works well with people who are receptive to hypnosis.

Therapy

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.

Medication

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.

Takeaway

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.


Sources

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Mayo Clinic. (2017). Sleepwalking: Diagnosis & treatment. https://www.mayoclinic.org/diseases-conditions/sleepwalking/diagnosis-treatment/drc-20353511

Mayo Clinic. (2017). Sleepwalking: Symptoms & causes. https://www.mayoclinic.org/diseases-conditions/sleepwalking/symptoms-causes/syc-20353506

Schredl M, et al. (2020). Fever Dreams: An Online Study. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6997236/

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