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Sleepwalking by Krisha McCoy, MS

Definition

Sleepwalking is a type of sleep disorder. A person who is sleepwalking may walk around or do other complex behaviors while still asleep. It may be as simple as sitting up in bed or as complex as leaving the house and going for a drive.

Causes

It is not clear exactly what causes sleepwalking. Some people are more likely to sleepwalk. The sleepwalking may be triggered by:

Stress
Lack of sleep
Illnesses with fever
Certain medications such as antidepressants, tranquilizers, anticonvulsants, and antihistamines
Medical illness such as migraine , asthma , arrhythmia , heartburn , and sleep apnea
Having a psychiatric disorders such as panic attack or post-traumatic stress syndrome
Hyperthyroidism

Risk Factors

Factors that may increase your risk of sleepwalking include:

Family history of sleepwalking
Being a child—most common in preschool to pre-adolescence

Hyperthyroidism

Symptoms

Along with walking during sleep, other symptoms can include:

Sitting up in bed and repeating certain movements such as rubbing eyes or fumbling with clothes
Talking in your sleep
Difficulty arousing during a sleepwalking episode
Doing inappropriate behavior during a sleepwalking episode such as urinating in closets
Becoming violent when a person tries to wake you
Not remembering the event

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. 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 in a medical clinic.

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 from your room
Keep doors and windows closed and locked

Hypnosis

Some cases of sleepwalking can be treated with hypnosis .

Awakening

Your doctor will ask you to keep track of what time of night the sleepwalking tends to occur. You then schedule a wake up just before that time. This may help stop the sleepwalking.

Medications

Medications that may help reduce sleepwalking include:

Sedative-hypnotics
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
The Better Sleep Council Canada http://bettersleep.org

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. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated January 1, 2011. Accessed June 4, 2013.
Sleepwalking. American Academy of Family Physicians website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/sleepwalking.html . Updated November 2010. Accessed June 4, 2013.
Sleepwalking. National Sleep Foundation website. Available at: http://www.sleepfoundation.org/article/sleep-related-problems/sleepwalking Accessed June 4, 2013.

Last reviewed June 2013 by Michael Woods, MD

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