Somnambulism is a common parasomnia (abnormal behavior in sleep) consisting of a series of complex behaviors that result in large movements in bed or walking during sleep.
Sleepwalking is a disorder of arousal, meaning it occurs during the deepest stages of non-rapid eye movement (NREM) sleep. Another NREM disorder is sleep terrors, which can occur in tandem with sleepwalking.
Many factors can contribute to sleepwalking, including:
While most frequent in children (2 to 14 percent), sleepwalking is typically a benign, self-limited maturational occurrence and often decreases with the onset of puberty. However, at least 25 percent of children with recurrent sleepwalking may continue the disorder into adulthood. Chronic sleepwalking in children is often associated with other subtle sleep disorders, behavioral problems and poor emotional regulation.
Sometimes, sleepwalking can be triggered by underlying conditions that interfere with sleep, such as:
- Sleep-disordered breathing—a group of disorders featuring abnormal breathing patterns during sleep (for example, obstructive sleep apnea [OSA])
- Taking certain medications such as hypnotics and sedatives or those used for psychiatric disorders
- Substance use such as alcohol
- Restless legs syndrome
- Gastroesophageal reflux disease (GERD)
What are the signs and symptoms of somnambulism?
In addition to physically getting out of bed and walking around, sleepwalkers may exhibit other symptoms, such as:
- Sitting up in bed and repeating movements, such as rubbing eyes or tugging on pajamas
- Looking dazed (the sleepwalkers’ eyes are open but do not look the same way as when they are fully awake)
- Clumsy or awkward behavior
- Not responding when spoken to or giving senseless responses
- Difficulty waking up
- Talking in their sleep
- Urinating in undesirable places (for instance a closet)
Diagnosis
Sleepwalking is usually simple to diagnose. Your healthcare professional will ask about your symptoms and medical history. They may even suggest some tests to find out whether a medical condition is causing sleepwalk, which may include:
- Physical exam
- Polysomnography (sleep study)
- Electroencephalography (EEG)
How is somnambulism treated?
Treatment for occasional sleepwalking usually isn't necessary. In children who sleepwalk, it typically goes away by their teen years.
If sleepwalking leads to the potential for injury, is disruptive to family members or results in embarrassment or sleep disruption, treatment may be needed. Treatment generally focuses on promoting safety and eliminating causes or triggers.
Treatment for somnambulism may include:
- Treating any underlying condition: if the sleepwalking is associated with sleep deprivation or an underlying sleep disorder or medical condition.
- Anticipatory awakenings: such as waking the person up about 15 minutes before they usually sleepwalk, and then staying awake for a few minutes before they fall back asleep again.
- Medications: such as benzodiazepines or certain antidepressants.
- Learning self-hypnosis: performed by a trained professional who is familiar with parasomnias. People who are receptive to suggestions during hypnosis may benefit by achieving a deep state of relaxation, which promotes a change in unwanted activities during sleep.
- Therapy or counseling: a mental health professional can help with suggestions for improving sleep, stress-reduction techniques, self-hypnosis and relaxation.
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