Sleepwalking is one of the various types of sleep disorder called parasomnia. The other name for sleepwalking is somnambulism. Parasomnia is an undesirable abnormal behaviour that disrupts the sleep of a person who is experiencing it. Sleepwalk is also one of them. In parasomnia, a person can have abnormal movements, express emotions, talk or do unusual things. Parasomnia events occur at a higher rate during the early part of the night. A parasomnia may also occur during sleep or arousal from sleep or before sleep. Sleep experts believe that sleepwalking usually happens when an individual is in a stage of deep sleep and partially awoken in a way that activates physical activity while remaining mostly asleep.
No one should confuse with the term sleepwalking and think that it is only a walking habit in a person while asleep. However, it is important to know that sleepwalking is not limited to walk-in sleep. It can lead to a series of complex actions. Examples of signs other than walking include running, routine activities like getting dressed, engaging in sexual behaviour called sexsomnia, moving furniture, or urinating in unsuitable places. Behaviours may be violent or more complex, such as trying to drive a car. Sleepwalking may start at any age but is often seen in children. It is believed that 1 out of 5 children have the problem of sleepwalking at least once. Most get rid of it by the time they reach puberty, but it may sometimes continue into adulthood. The specific reason for sleepwalking is not yet known but usually seen in an individual whose close family members have this problem. [1-3]
The symptoms of sleepwalking vary from person to person but some common symptoms include: [1,4]
Difficulty in sleeping through the night
Waking up disoriented or confused
Tiredness during the day
Finding bruises or cuts on the body for which you do not find the cause.
Displaying movements, vocalizations, expressions or activities that are told to you by your bed partner, but you do not recall at all.
Get out of bed and walk nearby
Sit up in bed and open your eyes
Have a glazed glassy-eyed expression
Find difficult to wake up
Be confused
Quickly return to sleep
Playing musical instruments
Not remember what has happened in sleep
Have sleep terrors
In rare cases, someone with sleepwalking may:
Leave the house
Engage in abnormal behaviour such as urinating on nearby
Drive a car
Get injured
Become violent
Causes And Risk Factors
There are various causes of sleepwalking those are listed below:[2,4]
Family history of sleepwalking also increases the chances of sleepwalking. It is studied scientifically that 47% of children have the problem of sleepwalking if one parent had this problem in the past, and 61% of children have the problem of sleepwalking if both parents have the problem.
Some medications have a sedative (inducing sleep) effect and can push persons into a form of sleep that raises the chances of sleepwalking episodes.
Drinking alcohol in the evening may cause instability in somebody’s sleep stages and increase the risk of sleepwalking.
Brain injuries, including inflammation (swelling) of the brain, could induce sleepwalking.
In a child, fever can make sleepwalking more likely.
Obstructive sleep apnoea is a sleep disorder in which the air tract of the body gets blocked, causing short pauses in breathing while asleep. These pauses may occur a number of times per night and create sleep disturbances that lead to sleepwalking.
Restless Leg Syndrome is a form of sleep disorder that causes a strong urge to move the limbs, particularly the legs when lying on the bed. It causes arousal during the night time from which an individual can enter into a sleepwalking episode.
Several types of stress can have an impact on sleep, including leading to more disrupted or fragmented sleep that can raise the tendency for sleepwalking. Stress can be emotional or physical, such as from pain. Some forms of stress might be related to change or discomfort, like when travelling or sometimes sleeping in an unfamiliar place.
Sleep deprivation
Hyperthyroidism (higher production of thyroid hormones)
Bloated stomach
Migraine headaches
Stroke
The premenstrual period
Other sleep-related disorders or events
Noise or light
Prevention
Some forms of sleepwalking are unlikely to be prevented, such as sleepwalking caused by neurological diseases, heredity or mental health issues. Other reasons can be prevented by getting 7-9 hours of sleep a night, following consistent bedtime and wakeup times, and avoiding recreational drug and alcohol use. Also, consult your doctor to check your current medications. Many of them can interrupt sleep. In this case, different drugs other than the
current one can be prescribed.[1]
Diagnosis
A doctor often asks you to fill out a sleep diary for two weeks. This will give the doctor hints as to what is causing your problems. You may also rate your sleep with a standard questionnaire to show how your sleep is upsetting your daily life. The doctor will ask for your complete medical history. Be sure to inform your doctor of any prior or current medication use. Also, inform the doctor if you ever had or currently having any other sleep disorder. A doctor will try to understand if certain things are causing sleepwalking or worsening the symptoms, such as:
Another sleep disorder
Medication use
A medical condition
A mental health disorder
Substance abuse
The doctor may ask you for the examination of your sleep using a sleep study known as polysomnography. Polysomnography is a sleep study that records your brain waves, breathing as you sleep and heart rate. It also observes how your legs and arms move.
Your behaviour during sleep is recorded on video. This helps to show if you go out of bed and do anything abnormal during your sleep study.[4]
Treatment
Sleepwalking in children is usually normal and does not require medical treatment. Parents can keep a close eye on their children. An adult who has continued to sleepwalk or started to sleepwalk is at a higher risk of injury. In such cases, it is recommended to have the advice of a doctor. Below are some recommendations often used to treat sleepwalking:[1,5]
Psychotherapy may be helpful in sleepwalking.
As told above, medications are not generally prescribed for sleepwalking. However, when medications are used, benzodiazepines are the first choice, and the effect of medications is long-lasting. However, there are several potential side effects of these medications. The use of benzodiazepines is the main drug for the management of the most persisting problem of sleepwalking.
Tricyclic antidepressants are also recommended sometimes.
Psychological approaches are also used to treat the problem of sleepwalking. Some examples of psychological approaches are relaxation therapy, hypnosis or cognitive behavioural therapy.
Lifestyle/management
Treatment begins after identifying sleep problems and any other health problems, as well as reviewing medications that may induce sleepwalking. But instead of medicines, general management strategies are recommended:[1,5]
Follow healthy sleep habits: 7 to 9 hours of sleep should be taken to give proper rest to your mind and body. To avoid any disturbances in your sleep, you must turn off the TV, lights and electronic devices, keep the room temperature cool, and avoid vigorous exercise and caffeine use near bedtime).
Maintain your sleeping and waking up schedule regular. Have the same routine for bedtime and also for wake up time.
Avoid or limit the use of alcohol or recreational drugs.
Take all recommended medications as directed by your doctor.
Stop sleepwalk inducing agents such as benzodiazepine receptor agonists, antipsychotics, and antidepressants that could be a possible inducer for sleepwalking.
In the case of adults, it is important to educate the suffering people and their bed partners about safety methods to ensure the safety of the sufferer. Patients should be advised to remove any sharp objects, firearms or furniture near the sleeping area.
In rare cases, an individual having a sleepwalking habit can become violent to the sleeping partner. Removing these things are also helpful for the sleeping partner.
Bedroom door alarms and locking the windows are useful for sleepwalkers
Patients should be recommended to use extra pillows or padding on both sides of the bed
Use padded armrests on the sides of the bed to prevent falls and injury
Keep bottles and cups of water by your bedside
References
1. Parasomnias & Disruptive related disorders. Cleveland Clinic. Available at:
https://my.clevelandclinic.org/health/diseases/12133-parasomnias--disruptive-sleepdisorders.
2. Sleepwalking. Sleep Foundation. Available at:
https://www.sleepfoundation.org/parasomnias/sleepwalking.
3. Sleepwalking. NHS. Available at: https://www.nhs.uk/conditions/sleepwalking/
4. Sleepwalking. AASM. Available at: https://sleepeducation.org/sleepdisorders/sleepwalking/
5. Singh S. Cureus. 2018 Dec 31;10(12):e3807.
Sometimes a loved one can find you talking, walking and making strange sounds while sleeping. They might think that you are awake but in truth you are not.
Now, treatment your lung diseases can be easier. As, The All India Institute of Medical Sciences (AIIMS) has set up Virtual Bronchoscopy Navigation (VBN)
Researchers at the University of Warwick have found a significant link between the presence of persistent nightmares in childhood and psychotic experiences in adolescence.
By clicking “Accept All Cookies”, you agree to the storing of cookies on your device to enhance site navigation, analyze site usage, and assist in our marketing efforts. Cookie Policy.
