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Medical Author:

John Mersch, MD, FAAP

John Mersch, MD, FAAP

Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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In this Article

• What is sleepwalking?
• What are the causes, incidence, and risk factors of sleepwalking?
• What are associated factors to consider?
• What are symptoms of sleepwalking?
• What are the signs and tests for sleepwalking?
• What other conditions will my doctor consider before diagnosing sleepwalking?
• What is the treatment for sleepwalking?
• What is the prognosis of sleepwalking?
• What are the complications of sleepwalking?
• When should you call your health care practitioner about sleepwalking?
• How can I prevent sleepwalking?
• Sleepwalking At A Glance
• Find a local Sleep Specialist in your town
• Sleepwalking Index

A person who has a sleepwalking disorder can take the following measures:

• get adequate sleep;
  
  
• meditate or do relaxation exercises;
  
  
• avoid any kind of stimuli (auditory or visual) prior to bedtime;
  
  
• keep a safe sleeping environment, free of harmful or sharp objects;
  
  
• sleep in a bedroom on the ground floor if possible to prevent falls and avoid bunk beds;
  
  
• lock the doors and windows;
  
  
• remove obstacles in the room, tripping over toys or objects is a potential hazard;
  
  
• cover glass windows with heavy drapes; and
  
  
• place an alarm or bell on the bedroom door and if necessary on any windows.

If sleepwalking is caused by underlying medical conditions, for example, gastroesophageal reflux, obstructive sleep apnea, periodic leg movements (restless leg syndrome), or seizures; the underlying medical condition should be treated.

Medications for the treatment of sleepwalking disorder may be necessary in the following situations:

• when the possibility of injury is real;
  
  
• when continued behaviors are causing significant family disruption or excessive daytime sleepiness; and
  
  
• when other measures have proven to be inadequate.

Benzodiazepines, such as estazolam (ProSom), or tricyclic antidepressants, such as trazodone (Desyrel), have been shown to be useful. Clonazepam (Klonopin) in low doses before bedtime and continued for three to six weeks is usually effective.

Medication can often be discontinued after three to five weeks without recurrence of symptoms. Occasionally, the frequency of episodes increases briefly after discontinuing the medication.

Relaxation techniques, mental imagery, and anticipatory awakenings are preferred for long-term treatment of persons with sleepwalking disorder.

• Relaxation and mental imagery should be undertaken only with the help of an experienced behavioral therapist or hypnotist.
  
  
• Anticipatory awakenings consist of waking the child or person approximately 15-20 minutes before the usual time of an event, and then keeping him or her awake through the time during which the episodes usually occur.