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Midnight wanderers -

Somnambulism, or sleepwalking, is a sleep disorder that kicks in during deep sleep, causing people to walk or perform complex actions while still mostly asleep. It's more common in kids than adults, and tends to run in families. You're also more likely to take a nighttime stroll if you're sleep-deprived or frequently wake up during the night.

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Sleepwalking woes -

Accidents during sleepwalking episodes can lead to injuries, and it's often linked to poorer sleep and daytime drowsiness. While many individuals don’t require active treatment, frequent or severe episodes sufferers may benefit from various treatment options.

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Parasomnia -

Sleepwalking, a type of sleep disorder classified as a parasomnia, involves abnormal behaviors during sleep. Parasomnias blur the line between sleep and wakefulness, which is why the actions that occur during these episodes can be so unusual.

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Parasomnia -

Parasomnias are categorized by the sleep cycle stage during which they occur. Sleepwalking takes place during non-REM (NREM) sleep, usually in stage 3 of the sleep cycle, also known as deep sleep.

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Parasomnia -

Sleepwalking, along with other parasomnias like sleep talking, confusional arousals, and sleep terrors, is classified as an NREM disorder of arousal.

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Beyond strolling -

Despite its name, sleepwalking isn't limited to just walking. Episodes can involve a range of simple or complex actions, and can last anywhere from a few seconds to half an hour. During this time, a sleepwalker may wake up confused or simply return to bed on their own.

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When sleepwalking gets complicated -

Occasionally, sleepwalking behaviors can be more complex or even violent, such as attempting to drive a car. Episodes might involve walking or running, having open, glassy eyes with a blank expression, minimally responsive or incoherent speech, routine actions like getting dressed or moving furniture, engaging in sexual behavior (sexsomnia), or even urinating in inappropriate places.

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Sleepwalking mysteries -

A main symptom of sleepwalking and other NREM parasomnias is that people almost never remember the episode when they wake up. As a result, they typically learn about their sleepwalking from a family member or housemate.

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The elusive prevalence of sleepwalking -

How common is sleepwalking? It's tough to pinpoint exactly how often sleepwalking happens because those who experience it rarely remember their episodes. Additionally, studies may define sleepwalking differently, adding to the challenge of determining its true prevalence.

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The elusive prevalence of sleepwalking -

To tackle these challenges, a meta-analysis reviewed 51 separate studies and found that 5% of children and 1.5% of adults experienced a sleepwalking episode in the past 12 months.

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The health risks -

Unsurprisingly, sleepwalking can have serious health consequences. Injuries can happen if a sleepwalker trips, falls, or collides with objects while walking or running. Handling sharp objects or trying to drive during an episode can be life-threatening, and, of course, violent behavior can also cause harm to the sleepwalker or others.

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The hidden toll of sleepwalking -

Research shows that sleepwalkers tend to have higher levels of daytime drowsiness and insomnia symptoms. It's unclear whether these issues stem from sleepwalking disturbances or an underlying factor that affects sleep, putting them at risk for both problems.

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Sleepwalking's ripple effect -

Sleepwalking can also affect bed partners, roommates, and housemates. Episodes may disrupt their sleep and negatively impact them due to the sleepwalker's behavior.

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What causes sleepwalking? -

Sleep experts believe sleepwalking occurs when a person is in deep sleep and gets partially awakened, prompting physical activity while still mostly asleep. Various factors can increase the likelihood of this partial awakening.

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Sleepwalking genetics -

Studies show a clear genetic link involving sleepwalking and other NREM parasomnias. About 22% of children with no parental history of sleepwalking will experience it. This rises to 47% if one parent has a history of it, and 61% if both parents do.

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Sleep deprivation -

Lack of sleep has been linked to a higher risk of sleepwalking, likely due to increased time spent in deep sleep following sleep deprivation.

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Sedative medications -

Sedative medications can increase the likelihood of sleepwalking by pushing people into a type of sleep that heightens their chances of having an episode.

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Evening drinks -

No matter how good it feels, drinking alcohol in the evening can disrupt sleep stages, increasing the risk of sleepwalking.

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Fever and sleepwalking -

In children, fever increases the likelihood of sleepwalking, possibly due to more illness-driven arousals during the night.

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Obstructive sleep apnea -

Obstructive sleep apnea (OSA) is a disorder where the airway gets blocked, leading to short lapses in breath during sleep. These pauses, which can happen dozens of times a night, create sleep interruptions that may trigger sleepwalking.

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Restless legs syndrome -

Restless legs syndrome (RLS) is a sleep disorder that causes a strong urge to move the limbs, especially the legs, when lying down. As with sleep apnea, it leads to nighttime arousals that can result in sleepwalking episodes.

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Stress and sleepwalking -

Various types of stress can disrupt sleep, leading to fragmented or disturbed rest and increasing the likelihood of sleepwalking. Stress can be physical, such as from pain, or emotional. It can also come from discomfort or change, like traveling and sleeping in an unfamiliar place.

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Treatment for sleepwalking -

Treatment for sleepwalking depends on the patient’s age, frequency of episodes, and the level of danger or disruption they cause. Often, no active treatment is needed as episodes are rare and pose little risk. Sleepwalking tends to decrease with age, so it may resolve on its own without specific therapy.

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Reducing sleepwalking risks -

To reduce safety risks associated with sleepwalking, consider these precautions: lock away sharp objects and weapons, close and latch doors and windows, remove tripping hazards from the floor, install motion-sensor lights, and, if necessary, use door alarms or a bed alarm that activates when someone gets out of bed.

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Preventing sleepwalking before it starts -

Anticipatory awakening involves waking someone up shortly before a potential sleepwalking episode, and it's particularly effective in helping children. Since sleepwalking is linked to a specific sleep stage and often occurs at the same time each night, this technique can prevent the partial awakening that triggers sleepwalking.

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Sleep hygiene -

Sleep hygiene encompasses a person's sleep environment and habits. Poor sleep hygiene, like inconsistent sleep schedules or consuming caffeine or alcohol close to bedtime, can lead to sleeping problems and sleep deprivation. It's also crucial to choose the best mattress for your needs, considering your sleeping position and body type.

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Medications for sleepwalking -

When other treatments fail, medications such as benzodiazepines and antidepressants may be considered to stop sleepwalking. Early research also suggests that melatonin could be helpful in addressing sleepwalking.

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Managing sleepwalking episodes -

Experts recommend against abruptly waking people during a sleepwalking episode, as they are unaware of their situation. A sudden awakening can provoke fear, confusion, or anger.

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Managing sleepwalking episodes -

If possible, gently guide a sleepwalker away from potential dangers and back to bed using a quiet, soothing voice and a light touch. If you must wake them, do so gently, as they will likely be disoriented upon awakening.

Sources: (American Academy of Sleep Medicine) (Mayo Clinic) (Sleep Foundation)

See also: Sleep habits from around the world

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