Sleep walking

Definition

Sleep walking is a disorder that occurs when a person walks or does another activity while they are still asleep.

Alternative Names

Causes

The normal sleep cycle has distinct stages, from light drowsiness to deep sleep. During rapid eye movement (REM) sleep, the eyes move quickly and vivid dreaming is most common.

Each night people go through several cycles of non-REM and REM sleep. Sleep walking (somnambulism) most often occurs during deep, non-REM sleep (stage 3 or stage 4 sleep) early in the night. If it occurs during REM sleep, it is part of REM behavior disorder and tends to happen near morning.

The cause of sleep walking in children is usually unknown but may have to do with fatigue, lack of sleep, or anxiety. Sleep walking in adults can have to do with mental disorders, reactions to drugs and alcohol, or medical conditions such as partial complex seizures. In the elderly, sleep walking may be a symptom of an organic brain syndrome

When someone sleep walks, they may sit up and look as though they are awake while they are actually asleep. They may get up and walk around, or do complex activities such as moving furniture, going to the bathroom, and dressing and undressing. Some people even drive a car while they are asleep. The episode can be very brief (a few seconds or minutes) or can last for 30 minutes or longer.

Some people mistakenly believe that a sleep walker should not be awakened. It is not dangerous to awaken a sleep walker, although it is common for the person to be confused or disoriented for a short time when they wake up. Another misconception is that a person cannot be injured when sleep walking. Actually, sleep walkers are commonly injured by tripping and losing balance.

Sleep walking can occur at any age, but it happens most often in children aged 4 - 8. It appears to run in families.

Symptoms

• Eyes open during sleep
• May have blank look on face
• May sit up and appear awake during sleep
• Walking during sleep
• Other detailed activity of any type during sleep
• Not remembering the sleep walking episode upon awakening
• Confused, disoriented upon awakening
• Sleep talking does not make sense

Exams and Tests

Usually, people won't need further examinations and testing. If the sleep walking occurs often, the doctor may do an exam to rule out other disorders (such as partial complex seizures). If you have a history of emotional problems, you also may need to have a psychological evaluation to look for causes such as excessive anxiety or stress. Or, you may need to have a medical exam to rule out other causes.

Treatment

Most people don't need any specific treatment for sleep walking.

Safety measures may be needed to prevent injury. This may include changing the area by moving objects such as electrical cords or furniture to reduce the chances of tripping and falling. You may need to block off stairways with a gate.

In some cases, short-acting tranquilizers have been helpful in reducing sleep walking episodes.

Outlook (Prognosis)

Sleep walking may or may not reduce with age. It usually does not indicate a serious disorder, although it can be a symptom of other disorders.

Possible Complications

A complication is getting injured while sleep walking.

When to Contact a Medical Professional

You probably won't need to visit your health care provider if you are sleep walking. However, discuss the condition with your doctor if:

• You also have other symptoms
• Sleep walking is frequent or persistent
• You perform potentially dangerous activities (such as driving) while sleep walking

Prevention

• Avoid the use of alcohol or central nervous system depressants if you sleep walk.
• Avoid getting too tired and try to prevent insomnia, because this can trigger a sleep walking episode.
• Avoid or minimize stress, anxiety, and conflict, which can worsen the condition.