Have you ever gone to sleep in your bed but woken up in the kitchen or living room? Or did you ever wake up surrounded by mysterious crumbs sprinkled all over your bedroom with no memories of having a midnight snack? If so, you might be one of the 6.9 percent of the world population who experience sleepwalking at least once in their lifetime.
Despite being more predominant in children, approximately 1.5 percent of adults also experience this unique disorder past their childhood years. Also known as somnambulism, sleepwalking is a multifactorial problem with medications, health conditions, genetics, and other factors contributing to its development.
What is sleepwalking?
Sleep walking is a common condition in kids; however, most of them get over it as they grow up. It typically happens within one to two hours of falling asleep and may cause the patient to walk around. A single episode of sleepwalking may continue for a few seconds to thirty minutes. It can be extremely difficult to wake someone up in the middle of their sleep walking episode, and doing so can make them disoriented and groggy for a few minutes.
Also known as somnambulism, sleep walking may involve many other behaviors apart from walking, such as the following:
- Harmless behaviors, such as sitting up
- Inappropriate behaviors, such as opening the wardrobe and peeing inside
- Potentially dangerous behaviors, such as leaving the house and wandering in the streets
No matter what a person does during their sleep walking episodes, it is unlikely that they will remember any of it when they wake up.
What Causes Sleep Walking?
Sleep walking is primarily a disease of childhood, and many children outgrow it by the time they enter adulthood. However, not everyone may completely drop this habit. Very rarely, the problem may start occurring in people who have already entered adulthood. So far, experts have identified several potential factors that might be contributing to sleepwalking episodes. This issue can also be inherited as the problem runs in families.
Following are some potential sleep walking causes in adults and children.
Family history and genetics
Studies have demonstrated a clear pattern in which some people have a genetic predisposition to sleep walking and other associated disorders. Up to 47 percent of children will sleep walk if one of their parents has a history of it. The risk increases up to 61 percent in children whose both parents have similar issues.
A lack of sleep can also increase the risk of sleepwalking since a sleep-deprived person is more likely to spend time in deep sleep.
Drinking alcohol during the late hours of the evening can cause disruptions in specific sleep stages of a person while heightening their risk of sleep walking.
Certain conditions that affect the brain, such as brain swelling in encephalitis, can also trigger sleepwalking.
In children, fever has been an essential factor in determining their risk of sleepwalking. This is because fever often leads to frequent arousal during the night.
Obstructive sleep apnea
Also known as OSA, obstructive sleep apnea is a sleep disorder that causes the airway to get blocked, leading to short lapses or pauses in breathing. These pauses may occur in dozens per night, disrupting sleep and increasing the likelihood of sleepwalking.
Different types of stress can negatively affect sleep, often causing fragmentation of the sleep or disrupting it while raising the risk of sleepwalking. This stress can either be physical, such as coming from pain, or emotional. Sometimes, stress may arise due to a change or discomfort, such as sleeping in an unfamiliar environment.
Restless Leg Syndrome
Also known as RLS, restless leg syndrome is a kind of sleep disorder where a patient has a strong urge to move their legs to avoid discomfort or numbness constantly. RLS can lead to frequent nighttime arousals, which increase their risk of sleepwalking.
Some sleep medications can cause users to sleep walk, such as zolpidem. Other such medications may include sodium oxybate used to manage narcolepsy, benzodiazepine receptor agonists, beta-blockers, antipsychotics, and antidepressant medicines.
Somnambulism Symptoms To Remember
It is imperative to remember that despite being called sleep walking, the issue does not limit itself to walking only. In reality, episodes of sleepwalking may involve simple and complex actions lasting up to thirty minutes at one time. Sometimes, a person may wake up in the middle of a sleepwalking episode and return to bed on their own in a confused state. In other cases, the behavior may be more complex, involving the following:
- Open, glassy eyes with blank expressions
- Running or walking
- Urinating at inappropriate places
- Engaging in sexual behaviors
- Minimal responsiveness
- Incoherent speech
- Routine actions involving moving furniture or getting dressed
A major symptom of all NREM parasomnias, including sleep walking, is that a person never has any recollection of what happened during the night when they wake up. For this reason, they usually learn about their incident from someone who lives with them. Most sleepwalking incidents occur during the first half of the night when a person is in deep NREM sleep stages.
Dangers of Sleepwalking: What to Remember
Sleepwalking can often lead to serious health consequences. For instance, if a person trips and falls during an episode or collides with something while running or walking, they may acquire significant damage. Additionally, they may mishandle a sharp object, such as a knife, without knowing the risks, leading to life-threatening issues. Some people may engage in violent behaviors, putting themselves in harm’s way.
Sometimes, actions performed during sleepwalking episodes may become a source of embarrassment for some people. For instance, a person may feel ashamed of the sexually explicit behavior or urinate in the wrong place during a sleepwalking episode. Studies have indicated that people who sleepwalk experience a higher level of daytime sleepiness in addition to other symptoms of insomnia. Experts are not sure whether these problems occur due to sleepwalking and the disturbances it causes or any other underlying factor that potentially disturb their sleep, putting them at risk of sleepwalking.
Lastly, sleepwalking can also bring negative consequences for a bed partner, housemate, or roommate. These people may also experience frequent sleep disruptions or be negatively affected by another person’s behavior or actions during an episode.
Treatment for sleepwalking can vary depending on the patient’s age, the frequency of the issue, and how dangerous these episodes are. For adults and children, it is best to speak with a doctor and let them analyze the situation so that they can come up with a tailored program. In most cases, sleepwalking does not need any active treatment as the episodes occur very rarely and involve little to no risk to the victim and others around them. Many people also outgrow the issue independently without receiving therapy or medication.
The following tips and tricks can help children and adults prevent sleep walking as much as possible.
Eliminate Safety Risks
Harm reduction is the most important thing to remember for people who sleep walk. For this reason, keep the following tips in mind:
- Close and latch all windows and doors
- Keep all sharp weapons and objects locked away
- Install lights with motion sensors
- Remove all tripping hazards from the floor
Treat Underlying Causes
If sleepwalking in a person is due to a cause, such as restless leg syndrome or obstructive sleep apnea, treating it is likely to resolve the problem. Similarly, if a medication is causing the attacks, stopping it or swapping it with a safer alternative with the help of a doctor can help.
Anticipated awakening means waking up a person shortly before they are likely to start sleep walking. Since sleepwalking is often connected to a certain stage of sleep, it is easy to predict the time when it is most likely to happen. Most people also engage in sleepwalking episodes at the same time every night, and waking them up before it happens can prevent them from undergoing it. According to experts, anticipated awakenings have helped many children overcome their sleepwalking issues; however, its efficiency in adults is still under research.
Improve Sleep Hygiene
Sleep hygiene involves the sleep-related habits and environment surrounding a person. Poor sleep hygiene, such as using alcohol or caffeine close to bedtime, having an inconsistent time for sleep, and sleeping in a bedroom with too much light, noise, or a high level of discomfort, can make it difficult for a person to sleep. As a result, they are more likely to sleep walk every night. Hence, aim to improve your sleep hygiene by making your bedroom as quiet, dark, and comfortable as possible. Invest in a good mattress, use white light to mask any noise, and keep the temperature toward a cooler side for easier sleep. These tips will improve the quality of sleep and make it more stable while reducing the risk of sleep deprivation and consequent sleepwalking episodes.
Cognitive Behavioral Therapy
Cognitive behavioral therapy, or CBT, is a type of talk therapy that helps people counteract their negative actions and thoughts. A subtype of this therapy, known as CBT-I, has been particularly effective in improving sleep by reframing their thoughts about sleep. This therapy and other relaxation techniques can help people successfully avoid episodes of sleepwalking triggered by stress.
When all other holistic treatments and therapies fail, an expert may prescribe medications to help people stop sleepwalking. Some examples of medications used in this context include antidepressants and benzodiazepines. Early research also indicates the role of melatonin in preventing these episodes. Remember that every medication, whether prescription-based or over-the-counter, has pros and cons. A doctor may evaluate each case individually and determine if there is a need to use the medication.
How common is sleepwalking in adults?
Sleepwalking is more common in children than adults. Most long-term studies have indicated that up to 29 percent of children between the ages of 2 to 13 years suffer from sleepwalking. The problem peaks in children between the ages of 10 to 13 years. In adults, the prevalence of this disorder is up to 4 percent. The fact that most people who sleepwalk do not remember these episodes makes it difficult for experts to determine how common it is and how frequently it occurs. Moreover, different studies may define sleepwalking in different ways, making it challenging to understand its prevalence.
Is it safe if I wake up a person who is sleep walking?
Most experts do not recommend waking up a person in the middle of a sleepwalking episode as they may not be aware of their surroundings. Waking them up in such circumstances may trigger confusion, fear, or even anger. If you feel like the person is putting themselves into a dangerous position, try lightly guiding them away from these dangers and help them get back to bed. Ensure to use a soothing voice and a gentle, light touch to direct them. If it is critical to wake a sleepwalking person, try doing it as gently as possible and remember that they are likely to be disoriented upon waking up.
Is sleepwalking a sleep disorder?
Sleepwalking comes under an umbrella term called parasomnia. Parasomnia includes a collection of abnormal behaviors people experience during sleep. In most cases, these disorders straddle a border between wakefulness and sleep which is why the actions they lead to are abnormal. In general, parasomnias are categorized into different types of sleep disorders based on the part of the sleep cycle they affect. Sleep walking, for instance, occurs during the non-REM stage of sleep, which is also known as deep sleep. Some other types of parasomnias that occur in a similar stage of sleep include sleep terrors, confusional arousals, and sleep talking.