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Sleepwalking by Krisha McCoy, MS

Definition

Sleepwalking is a type of sleep disorder known as a parasomnia. This happens when a person partially awakens during the night, walks, or does other complex behaviors while still technically asleep.

Causes

Some causes of sleepwalking include:

Genetic
Stress
Magnesium deficiency
Sleep deprivation
Febrile illnesses
Certain medications (eg, antidepressants, tranquilizers, anticonvulsants, antihistamines)
Medical illness (such as, migraine , asthma , arrhythmia , heartburn , sleep apnea )

Risk Factors

These factors increase your chance of walking in your sleep. Tell your doctor if you have any of these risk factors:

Being a child (most common in preschool to preadolescence)
Having hyperthyroidism
Having a psychiatric disorders (eg, panic attack , post-traumatic stress syndrome )
Being sleep deprived
Having sleep apnea
Wetting the bed (in children)
Taking certain medications

Hyperthyroidism

Symptoms

If you experience any of these symptoms, do not assume they are due to sleepwalking. These symptoms may be caused by other conditions. If you experience any one of them, see your doctor:

Walking during deep sleep
Sitting up in bed and repeating certain movements (eg, rubbing eyes, fumbling with clothes)
Talking in your sleep
Difficulty arousing during a sleepwalking episode
Doing inappropriate behavior during a sleepwalking episode (eg, urinating in closets)
Screaming during sleepwalking episodes
Becoming violent when a person tries to wake you

Diagnosis

Your doctor will ask about your symptoms and medical history. She will also do a physical exam. You will be asked about your:

Family history
Fatigue
Medication
Underlying illness or stress

Your doctor may refer you to a sleep specialist. You may need to have a sleep study done.

Treatment

Talk with your doctor about the best treatment plan for you. Treatment options include:

Strategies to Prevent Injury

Your doctor will help you prevent injury during sleepwalking by recommending that you:

Remove dangerous objects
Keep doors and windows closed and locked

Hypnosis

Some cases of sleepwalking can be treated with hypnosis .

Medications

These medications may be helpful in reducing the incidence of sleepwalking:

Sedative-hypnotics
Tranquilizers
Antidepressants

Prevention

To help reduce the chances of sleepwalking, take the following steps:

Increase the amount of time scheduled for sleep.
Avoid alcohol and certain medications that may trigger sleepwalking.
Have a regular bedtime routine.

RESOURCES:

American Academy of Family Physicians http://www.familydoctor.org/
National Sleep Foundation http://www.sleepfoundation.org/

CANADIAN RESOURCES:

About Kids Health http://www.aboutkidshealth.ca/
Better Sleep Council Canada http://www.bettersleep.ca/

References:

Guilleminault C, Kirisoglu C, Bao, G, et al. Adult chronic sleepwalking and its treatment based on polysomnography. Brain . 2005; 128:1062-1069.
Guilleminault C, Palombini L, Pelayo R, Chervin RD. Sleepwalking and sleep terrors in prepubertal children: what triggers them?. Pediatrics . 2003;111:17-25.
Hafeez ZH, Kalinowski CM. Somnambulism induced by quitapine: two case reports and a review of the literature. CNS Spectrums. 2007;12:910-912.
Pressman MR. Factors that predispose, prime and precipitate NREM parasomnias in adults: clinical and forensic implications. Sleep Med Rev . 2007:11:5-30
Sleepwalking. National Sleep Foundation website. Available at: http://www.sleepfoundation.org/sleeptionary/index.php?id=22&subsection=basics. Accessed September 26, 2006.
Sleepwalking in children. American Academy of Family Physicians website. Available at: http://familydoctor.org/160.xml . Accessed September 26, 2006.

Last reviewed September 2011 by Marjorie Bunch, MD

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