Sleepwalking: Symptoms, Causes, Risks, Complications, Diagnosis and Treatment

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A women who walking from asleep because she has the sleep disorder sleepwalking

1Overview

There are times when some individuals may wander off at night while they are sleeping.
In lay man’s term this is called sleepwalking but it medical terms, it’s dubbed as somnambulism. It involves getting up from sleep and wandering around in a state of sleep.

This is often seen in children more than in adults. It is a behavior where the child appears to wake up during the night and walk around without any memory of these activities upon waking up. This is just a simple health problem but isolated incidents show that this may seldom result in serious problems, like going out of the house, endangering the welfare and safety of the patient.

This sleeping problem originates during deep sleep and results in walking or performing complex activities while asleep. Most likely, this happens when the person is deprived of adequate sleep. During this behavior, it is usually very hard for other people to wake up the sleepwalker.

Sleepwalking usually involves more than just walking during sleep. The symptoms of sleepwalking may vary, depending on which activity the person does. Some people may just sit up in bed or some cases, leave the house or wander around the neighborhood.

2Symptoms

Sleepwalking usually happens early in the night at about two hours after falling asleep.
It seldom happens during short naps. The most obvious sign is getting out of bed and walking around. The signs and symptoms of sleepwalking includes:

  • Sitting up and repeating certain movements like rubbing the eyes
  • Not responding to people when they’re talking
  • Getting out of bed and walking around
  • Having a glazed expression
  • Urinating in undesirable places
  • Being clumsy
  • Hard to wake up
  • Sleep talking
  • Not communicating with others
  • Looking disoriented and confused
  • Not remembering the incident in the morning
  • Experiencing sleep terrors

In some cases, a person who is sleepwalking will:

  • Engaging in unusual behaviors such as urinating in the closet or bed
  • Engage in sexual activity without awareness
  • Doing routine activities like getting dressed, eating or talking
  • Leaving the house
  • Driving around
  • Getting injured like jumping out of the window and falling down the stairs
  • Becoming violent

Some episodes of sleepwalking may be characterized by the person sitting up in bed and looking around looking dazed and groggy. In some people, they wake up and walk around, opening cupboards or getting out of the house. They also may look anxious and agitated, and in some cases, the person may perform complicated tasks like operating machinery and driving a car.

People who are sleepwalking have open eyes but they will not respond to others who are talking to them. They can well-navigate around items and objects. They may also say things or sentences that do not make sense.

The episodes of sleepwalking may last less than ten minutes and can be longer in some people. At the end of each episode, the sleepwalkers may return to bed and fall asleep again. In the next morning, they do not remember or can’t recall the incident that transpired during the night.

3Causes

About 15 percent of children between 4 and 12 years old will experience sleepwalking. However, most cases will reduce in adolescence and 10 percent will develop or start the behavior of teens.

Sleep has four stages. These stages are characterized by non-rapid eye movement (NREM) sleep. The other one is REM (rapid eye movement), which is the sleep linked to dreaming. Stage 3 of sleep involves the discharge of hormones important for proper growth and development. Sleepwalking happens during the first or second sleep cycles. It also happens in stage 3 sleep or during deep sleep.

The common causes of sleepwalking include sleep deprivation, fever, stress and sleep interruptions.

In some cases, sleepwalking can be triggered by underlying health conditions such as:

  • Taking some medicines such as sedatives, antipsychotics, and sleep-disordered breathing.
  • Drinking alcohol before sleeping
  • Gastroesophageal reflux disease (GERD)
  • Restless leg syndrome

4Risk Factors

Some factors may heighten the risk of sleepwalking, including:

Age – Sleepwalking is more common in kids than adults. Both boys and girls are equally affected and can begin as soon as a child can walk. Children are affected at a rate of 17 percent and it peaks by the time they are 8 to 12 years old.

Genetics – The condition can be passed among family members and relatives. It runs in families.

5Complications

Sleepwalking, when left untreated, may cause certain secondary conditions that can be dangerous to the safety of the patient. Though it may not be a concern, a sleepwalker can:

  • Injure themselves if they walk near the stairs, trip over furniture and other objects, wandering outdoors and driving a car.
  • Injure others
  • Disturb the sleep of others
  • Experience prolonged sleep disruption, which leads to excessive daytime sleepiness, problems at work and in school.
  • Injure someone else nearby
  • Be embarrassed or have problems in relationships with others.

6Diagnosis

Occasional sleepwalking does not usually need medical attention. It is also rarely a sign of anything severe or serious. It may also decrease in time, especially in children. However, a sleepwalker should consider seeking medical attention if the episodes happen more often and could endanger the safety of the person and others. Also, medical attention is needed if sleepwalking continued to adulthood.

Sleepwalking is fairly normal in kids and does not need medical treatment. The parents need to make sure the house is safe and they keep a watch on the child. Usually, a sleep specialist is the doctor needed to diagnose and treat a sleepwalker. The doctor will often ask to complete a sleep diary for about two weeks to provide clues to the doctor on what might be causing the sleep problem.

There is a scale that can be used, too. The Epworth Sleepiness Scale is used to rate the sleep. This will help measure sleep quality and how sleep affects the daily life of the patient. The doctor will also ask certain questions about the medical history of the patient, medicines being taken and if the patient is drinking alcohol before sleep.

Also, the doctor will ask if the patient has another sleep disorder, the use of medication, a mental health disorder, substance abuse, and a medical condition. These factors could increase the risk of sleepwalking.

Furthermore, the sleep specialist may also want to test sleeping disorders through a sleep study. Also dubbed as a polysomnogram, the patient needs to sleep in the laboratory and the doctor will use sleep study charts to measure the brain waves, breathing rate, and heartbeat during sleep. This test can also detect how the legs and arms move and the behavior of the patient during sleep via a video.

7Treatment

For children, sleepwalking tends to go away on its own when they enter adolescence, even without treatment. However, sleepwalking can also occur when sleep is affected by other sleeping problems such as obstructive sleep apnea (OSA), which is a common medical problem. The goal of sleepwalking treatment is to prevent injury, provide safety and promote a good night’s sleep.

Treating the underlying medical condition – If sleepwalking is tied to lack of sleep or an underlying sleep disorder such as obstructive sleep apnea (OSA), these should be addressed first and eventually, the frequency of sleepwalking will also decrease.

Anticipatory awakenings – If you know someone who sleepwalks and knows the time at which he or she usually does it, it’s important to wake the person about 15 minutes before sleepwalking then letting him or she stay awake for a few minutes before sleeping again.

Adjusting the medication dosages – If the sleepwalking is caused by the consumption of certain medications, adjusting the dosage, especially in the night is important.

Medication – Some medicines like benzodiazepines and antidepressants may cause sleepwalking. Ask the doctor for adjustments or alternatives.

Therapy and counseling – This is usually done by a mental health professional who can suggest methods to reduce stress, improve sleep and promote relaxation and self-hypnosis.

Self-hypnosis – This method is usually done by a trained professional who is familiar with parasomnias. Some individuals can learn self-hypnosis and benefit from attaining a deep state of relaxation and having a good night’s sleep.

Home remedies

In homes where someone is sleepwalking, there are ways to ensure that he or she is safe and away from harm:

Provide a safe environment – If sleepwalking has led to certain injuries and accidents, you should make sure the house is designed to prevent injuries. Close and lock all doors and windows before sleeping and if you can provide bells or alarms when the door is opened, it would better. This will alert you if someone has opened the door or went out of the house.

Lead a person who is sleepwalking – This does not mean waking up the person but this means that it’s important for you to guide the sleepwalker back to the bed to ensure that he or she will be safe.

Establish a routine before bedtime – Perform calming and relaxing activities before bedtime to make sure the person or child is relaxed and calm.

Get enough sleep – Tiredness or fatigue can contribute to sleepwalking. A person who lacks sleep may sleepwalk more often. Try sleeping earlier, getting more regular sleep schedules, getting naps and preventing anxiety and stress.

Avoid alcohol before sleeping – For adults who are sleepwalking, staying away from alcohol before bedtime may improve the condition.