Sleepwalking

by Krisha McCoy, MS

Definition

Sleepwalking is a sleep disorder in which a person partially awakens during the night, and walks or performs other complex behaviors while still technically asleep.

Causes

Some causes of sleepwalking include:

• Genetic
• Stress
• Magnesium deficiency
• Sleep deprivation
• Febrile illnesses
• Certain medications (antidepressants, tranquilizers, anticonvulsants, and antihistamines)
• Medical illness: migraine, asthma, arrhythmia, heartburn, sleep apnea

Risk Factors

The following factors increase your chances of sleepwalking. If you have any of these risk factors, tell your doctor:

• Being a child reaching a peak at age 11-12 years old
• Hyperthyroidism
• Psychiatric disorders such as a panic attack or post-traumatic stress syndrome
• Being sleep deprived
• Having sleep apnea
• Wetting the bed (in children)

Hyperthyroidism

Hyperthyroidism is an abnormal condition of the thyroid that can affect many of the body's systems including glands in the brain that can interfere with proper sleep.

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Symptoms

If you experience any of these symptoms do not assume they are due to sleepwalking. These symptoms may be caused by other health conditions. If you experience any one of them, see your physician.

• Walking during deep sleep
• Sitting up in bed and repeating certain movements (eg, rubbing eyes, fumbling with clothes)
• Sleep-talking
• Difficulty arousing during a sleepwalking episode
• Inappropriate behavior during a sleepwalking episode (eg, urinating in closets)
• Screaming during sleepwalking episodes
• Violent attacks on the person trying to awaken the sleepwalker

Diagnosis

Your doctor will ask about your symptoms and medical history, and perform a physical exam. He or she may ask you about any factors, such as family history, fatigue, medication, underlying illness, or stress, which may trigger sleepwalking symptoms. Your doctor may refer you to a sleep specialist.

Treatment

There is no specific treatment for sleepwalking. Talk with your doctor about the best treatment plan for you. Treatment options include the following:

Strategies to Prevent Injury

Your doctor or sleep specialist will help you prevent injury during sleepwalking episodes by recommending that you remove dangerous objects and keep doors and windows closed and locked.

Hypnosis

Some cases of sleepwalking can be treated with hypnosis alone.

Medications

Sedative-hypnotics, tranquilizers, or antidepressants may be helpful in reducing the incidence of sleepwalking.

Prevention

To help reduce the chances of sleepwalking, take the following steps:

• Increase the amount of time scheduled for sleep.
• Avoid alcohol and certain medications that may trigger sleepwalking.
• Establish a regular bedtime routine.

RESOURCES:

American Academy of Family Physicians
http://www.familydoctor.org

National Sleep Foundation
http://www.sleepfoundation.org

CANADIAN RESOURCES:

About Kids Health
http://www.aboutkidshealth.ca

Better Sleep Council Canada
http://www.bettersleep.ca

References:

Guilleminault C, Kirisoglu C, Bao, G, Arias V, et al. Adult chronic sleepwalking and its treatment based on polysomnography. Brain. 2005; 128:1062-69.

Guilleminault C, Palombini L, Pelayo R, Chervin RD. Sleepwalking and sleep terrors in prepubertal children: what triggers them?. Peditrics. 2003; 111: 17-25.

Pressman MR: Factors that predispose, prime and precipitate NREM parasomnias in adults: clinical and forensic implications. Sleep Med Rev. 2007:11: 5-30

Sleepwalking. National Sleep Foundation website. Available at: http://www.sleepfoundation.org/sleeptionary/index.php?id=22&subsection=basics.Accessed September 26, 2006.

Sleepwalking in children. American Academy of Family Physicians website. Available at: http://familydoctor.org/160.xml. . Accessed September 26, 2006.

Somnambulism (Sleepwalking). eMedicine website. Accessed January 3, 2006.