Dealing with Sleepwalking: From Symptoms to Treatment

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Also known as “somnambulism”, sleepwalking is Parasomnia, a condition in which undesired instances take place when an affected person is asleep. Sleepwalking is a disorder that causes people to get up and walk while still sleeping. In most cases, it happens when they go from the deep stage of sleep to a lighter stage, or into the awake state. When a person sleepwalks, they cannot respond and will usually not remember the event. They may even talk at times, without making any sense. Although adults can sleepwalk too, sleepwalking in children occurs more commonly, typically among those between the ages of 4 and 8.

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Causes of Sleepwalking

There are a number of factors that can cause sleepwalking in adults and children alike. Firstly, genetic factors may cause the disorder. It has been found that it is ten times more likely for a person to sleepwalk if they have a first-degree relative with a history of sleepwalking. This means that if you have a parent or a sibling who sleepwalks, your chances of manifesting the disorder is ten times higher compared to someone from a family without sleepwalkers. It is also more likely for identical twins to sleepwalk.

A person might also sleepwalk if they are:

  • Sleep-deprived
  • Drunk
  • Stressed
  • On a sleep schedule that is chaotic
  • Taking drugs like:
  • Stimulants – which boost activity
  • Sedative-hypnotics – which promote sleep or relaxation
  • Anti-histamines – which treat symptoms of allergies
  • Neuroleptics – which are prescribed to treat psychosis

There are physiological factors that have been found to be linked to sleep disorders like sleepwalking, including:

  • Fever
  • Arrhythmia
  • Heartburn or acid reflux
  • Conditions like menstruation and pregnancy
  • Nighttime seizures
  • Nighttime asthma
  • Restless leg syndrome
  • Obstructive sleep apnea – this is a condition in which a person stops breathing for a brief moment while sleeping
  • The depth and length of slow-wave sleep – stages III and IV of non-REM sleep. Younger children experience these stages more commonly, and thus, may explain the age differences in how frequently sleepwalking occurs
  • Sleepwalking causes may include certain psychiatric disorders, e.g., panic attacks, post-traumatic stress disorder (PTSD), or dissociative states, like multiple personality disorder.

Symptoms of Sleepwalking

Some examples of symptoms of sleepwalking include –

  • Episodes of sleepwalking range from walking around a room quietly to running agitatedly or attempting to “escape” from a threat that the person imagined or dreamed. The person who is sleepwalking may have a dazed and clumsy appearance in their behavior.
  • Typically, a sleepwalker has their eyes open with a staring, glassy appearance as they quietly walk around the house. However, they do not walk with their arms extended in front of them as you often see in the movies and/or TV shows.
  • When you question a person who is sleepwalking, they will respond slowly with simple thoughts or may not respond at all. Their responses may also contain phraseology that does not make any sense. If the sleepwalker returns to bed without waking up, they usually have no memory of the event.
  • Older children, who may awaken more easily when an episode ends, are often embarrassed by the behavior, especially if it was an inappropriate one. In some cases, children perform certain actions repeatedly, like straightening their pajamas instead of walking. Some children may also wet their beds.
  • According to some studies, sleepwalking children may have slept more restlessly between the ages of 4 and 5, and also more restless with awakenings that occur more frequently during the first year of life.

Treatment for Sleepwalking

For children, sleepwalking treatment is usually not required as the problem tends to go away on its own as they become teenagers.

Sleepwalking may be linked to an underlying medical condition, such as obstructive sleep apnea (OSA), gastroesophageal reflux disease (GERD), seizures, or restless leg syndrome (repetitive leg movements). The underlying medical condition needs to be treated to prevent sleepwalking.

It may be necessary for the person to take medications for treating the disorder in the following situations:

  • When continued behaviors are resulting in family disruption significantly or excessive daytime sleepiness;
  • When there is a real possibility for injury;
  • When other measures have proven to be ineffective.

Certain medications like benzodiazepines or tricyclic antidepressants have been shown to be helpful in treating sleepwalking. Additionally, clonazepam is usually effective when taken in low doses before going to bed and continued for 3 to 6 weeks. You can often discontinue medication after 3 to 5 weeks without the symptoms recurring. The frequency of sleepwalking episodes occasionally increases for a brief period of time after you discontinue the medication you were prescribed.

If you, someone you know, or your child sleepwalks, it is usually not necessary to seek medical attention. However, you should discuss the issue with your healthcare provider if sleepwalking is frequent or persistent, comes with other symptoms, or includes potentially dangerous activities, such as driving. You should visit your doctor if you have a history of sleepwalking or strange behavior while taking any medications for insomnia.

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