Parasomnias: Sleepwalking

What is sleepwalking?

Sleepwalking is a sleep disorder that involves walking while in a deep sleep.

The term can also be used for doing other activities while deep in sleep, such as sitting up in bed, opening the refrigerator, preparing food, or even driving while asleep. But walking around the house while in deep sleep is one of the most common types of sleepwalking.

Sleepwalking can be dangerous not only to the person who is sleepwalking but also to others in the home. Because the person is in deep sleep throughout the episode, they often will not have any memory of the activity.

What causes sleepwalking?

Sleepwalking is much more common in children than in adults. A recent survey found that around 1 in 100 preschool children and 1 in 50 school-aged children sleepwalk occasionally.

But sometimes it happens in adults, as well. Common triggers for sleepwalking include the use of sedative agents like alcohol and some medicines. Also, people who are sleep deprived may sometimes sleepwalk.

Sleep is divided into REM and non-REM sleep. Dreaming happens during REM sleep. Sleepwalking occurs during the deeper states of non-REM sleep. So it's unrelated to dreaming. Deeper states of non-REM sleep are more common in the first third of the night. As a result, sleepwalking is more common in the early part of the night. 

What are the symptoms of sleepwalking?

The symptoms of sleepwalking go beyond just walking while in deep sleep. These are other common symptoms:

• Talking or screaming in sleep
• Unusual behaviors, such as urinating in closets or doorways (more common in children)
• Little to no memory of the event
• Trouble waking the person up from the episode, or even violent reactions from the person when they wake up

How is sleepwalking diagnosed?

If you or a loved one is a sleepwalker, it's generally easy to diagnose. If sleep deprivation is the source of sleepwalking, your healthcare provider may do tests or a physical exam to figure out why you aren't getting enough sleep. Your provider may ask you about stress, medicines you are taking, or other things that might contribute to your sleepwalking.

How is sleepwalking treated?

Sometimes, steps as simple as improving sleep hygiene can help. This can include:

• Going to bed at a consistent time every night
• Creating a relaxing routine before bedtime
• Staying away from light from TVs, tablets, smartphones, laptops, and other electronic devices before bed
• Getting your bedroom at a comfortable temperature that's neither too hot nor too cold

Sometimes medicines, such as sedative-hypnotics or antidepressants, can help.

You’ll want to talk with your healthcare provider about the right strategy for you. Most people who sleepwalk as children stop doing it as they grow older.

Can sleepwalking be prevented?

The best way to prevent sleepwalking is to get a better night’s sleep. In some cases, stress or certain medicines can contribute to sleepwalking. You can try steps to manage your stress, like reading a book or taking a warm bath before bedtime. Regular exercise can also help you sleep better, but it’s best done at least 5 to 6 hours before bedtime.

Living with sleepwalking

Sleepwalking can be dangerous to the sleepwalker. One important step that you can take to make the situation safer for the sleepwalker is to remove any sharp or dangerous objects from the room, such as glass vases or tables with sharp corners. This will help prevent injury.

For children who sleepwalk, it’s a good idea to not use bunk beds. Locking doors and windows is also a strategy to promote safety. It also might be wise to install gates at the top of staircases to prevent dangerous falls.

Alcohol use can sometimes trigger sleepwalking episodes. Not drinking alcohol might help to prevent sleepwalking in some people. Instead, create a relaxing bedtime routine that doesn’t include alcohol.

Key points about sleepwalking

• Sleepwalking is a sleep disorder that involves walking and other behaviors while in a deep sleep.
• Sleepwalking can be dangerous not only to the person sleepwalking but also to others in the home.
• Sleepwalking is much more common in children than in adults.
• Sleep deprivation can be a source of sleepwalking.
• Most children who sleepwalk eventually grow out of it.
• For children who sleepwalk, it’s a good idea to remove sharp or dangerous objects from the room, lock doors and windows, block staircases, and not use bunk beds.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells you.
• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
• Know why a new medicine or treatment is prescribed and how it will help you. Also know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you do not take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your provider if you have questions.