Sleepwalking
Medical Author: John Mersch, MD, FAAP
Medical Editor: William C. Shiel Jr., MD, FACP, FACR
What is sleepwalking?
Sleepwalking is a disorder characterized by walking or other activities while
seemingly still asleep.
What are the causes, incidence, and risk factors of sleepwalking?
Sleepwalking has been described in medical literature dating before
Hippocrates (460 BC-370 BC). In Shakespeare's tragic play, Macbeth, Lady
Macbeth's famous sleepwalking scene ("out, damned spot") is ascribed to her
guilt and resulting insanity as a consequence of her involvement in the murder
of her father-in-law.
Sleepwalking is characterized by a complex behavior (walking) occurring while
asleep. Occasionally nonsensical talking may occur. The person's eyes are
commonly open, but have a characteristic glassy "look right through you"
character. This activity most commonly occurs during middle childhood and young
adolescence. Approximately 15% of children between 4-12 years of age will
experience sleepwalking. Generally sleepwalking behaviors wane by late
adolescence. However, approximately 10% of all sleepwalkers begin their behavior
as teens. It appears that persons with certain inherited genes have an increased
tendency toward developing sleepwalking behaviors.
There are five stages of sleep. Stages 1, 2, 3 and 4 are characterized as
non-rapid eye movement (NREM) sleep. REM (rapid eye movement) sleep is the sleep
cycle associated with dreaming as well as surges of important hormones essential
for proper growth and metabolism. Each sleep cycle (stages 1,2,3,4 and REM) last
about 90-100 minutes and repeats throughout the night. The average person
experiences four to five complete sleep cycles per night. Sleepwalking characteristically
occurs during the first or second sleep cycles, during stages 3 and 4. Due the
short time frame involved, sleepwalking tends not to occur during naps. Upon
waking the sleepwalker has no memory of his or her behaviors.
The sleepwalking activity may include simply sitting up and appearing awake
while actually asleep, getting up and walking around, or complex activities such
as moving furniture, going to the bathroom, dressing and undressing, and similar
activities. Some people even drive a car while actually asleep. The episode can
be very brief (a few seconds or minutes) or can last for 30 minutes or longer.
One common misconception is that a person sleepwalking should not be awakened. It is
not dangerous to awaken a sleepwalker, although it is common for the person to
be confused or disoriented for a short time on awakening. Another misconception
is that a person cannot be injured when sleepwalking; however, injuries caused
by such events as tripping and loss of balance are common for sleepwalkers.
Next: What are associated factors to consider? »
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