Sleepwalking – Symptoms and Causes
Overview
Sleepwalking (somnambulism) involves getting up and moving around while still asleep. This condition appears more frequently in children. It typically resolves as they reach adolescence.
Occasional sleepwalking episodes usually don’t require medical attention. However, frequent sleepwalking might indicate an underlying sleep disorder that needs evaluation.
Adults who sleepwalk may experience this behavior as part of other sleep disorders or medical conditions. The symptoms can sometimes be confused with different sleep-related issues, making proper diagnosis important.
Safety is crucial for households with sleepwalkers. Family members should take preventive measures to protect sleepwalkers from potential injuries during episodes.
Key facts about sleepwalking:
- More common in children than adults
- Often resolves naturally by teenage years
- May be linked to other sleep disorders when frequent
- Requires safety precautions to prevent injuries
Signs of Sleepwalking
Sleepwalking typically happens early in the night, usually within 1 to 2 hours after falling asleep. It rarely occurs during naps.
Episodes can last several minutes or longer and may happen occasionally or frequently.
People who sleepwalk might:
- Get out of bed and walk around
- Sit up with eyes open
- Have a blank, glassy-eyed expression
- Be unresponsive when spoken to
- Be difficult to awaken
- Feel confused briefly after waking
- Have no memory of sleepwalking the next day
- Experience daytime fatigue due to disrupted sleep
- Sometimes have sleep terrors with screaming and physical movements
In some cases, sleepwalkers may:
More Complex Behaviors:
- Perform routine activities (dressing, talking, eating)
- Leave their home
- Operate vehicles
- Engage in unusual actions (urinating in inappropriate places)
- Participate in sexual activity unconsciously
- Suffer injuries from falls or dangerous movements
- Show violent behavior when confused after waking
When Medical Help Is Needed
Occasional sleepwalking episodes typically don’t require medical attention and often resolve on their own. Parents can mention a child’s sleepwalking during regular checkups.
However, contact a healthcare provider if sleepwalking:
- Occurs frequently (more than 1-2 times weekly or multiple times nightly)
- Results in dangerous behavior or injuries
- Disrupts the sleep of family members or the sleepwalker
- Causes significant daytime tiredness or interferes with school or work performance
- Persists into adolescence or begins in adulthood
Causes
Sleepwalking belongs to a category of sleep disorders known as parasomnias, which involve unwanted behaviors during sleep. It specifically occurs during N3 sleep, the deepest phase of non-rapid eye movement (NREM) sleep.
This makes it an arousal disorder, sometimes appearing alongside sleep terrors.
Several factors can trigger sleepwalking episodes:
- Sleep deprivation
- High stress levels
- Elevated body temperature
- Disrupted sleep patterns or travel
Certain underlying health conditions may also contribute to sleepwalking behavior:
| Medical Conditions | Substances | Other Factors |
|---|---|---|
| Sleep-disordered breathing (including sleep apnea) | Alcohol | Irregular sleep schedule |
| Restless legs syndrome | Sedatives | Fever |
| Gastroesophageal reflux disease (GERD) | Hypnotics | Travel across time zones |
| Some mental health medications |
The risk of sleepwalking increases when these factors disrupt normal sleep architecture, particularly the deep NREM sleep stage where sleepwalking originates.
Risk Factors
Several factors may increase the chance of sleepwalking:
Genetics plays a significant role. Sleepwalking tends to run in families. Children with one parent who has sleepwalked face a higher risk. The risk becomes even greater when both parents have a history of sleepwalking.
Age is another important factor. Children experience sleepwalking more frequently than adults. When sleepwalking begins during adulthood, it often relates to other health conditions rather than occurring on its own.
Complications
Sleepwalking itself may not be dangerous, but it can lead to several problems.
People who sleepwalk face risks such as:
Physical dangers:
- Injuries from bumping into furniture
- Falls on stairs
- Wandering outside the home
- Attempting to drive
- Eating inappropriate items
Sleepwalkers often experience disrupted sleep patterns that cause daytime tiredness. This fatigue can affect school performance and lead to behavior problems, especially in children.
Many sleepwalkers feel embarrassment about their nighttime activities. They may also disturb the sleep of family members or roommates.
In rare cases, sleepwalkers might accidentally harm others nearby during an episode.
