Sleep Walking

DisclaimerThis page is not here to be used as a self-diagnosis, self-identification, or promotion - it's simply here to be informational. Whether or not one self-diagnoses, self-identifies, and/or seeks a professional diagnosis is up to them.

**Sleep Walking**, also known as **Somnambulism**, involves getting up and walking around while in a state of sleep. Isolated incidents of sleep walking often don't signal any serious problems or require treatment. However, recurrent sleep walking may suggest a sleep disorder.

## Signs & Symptoms

Sleep walking usually occurs early in the night, often one to two hours after falling asleep. It's unlikely to occur during naps. An episode generally lasts for several minutes, but can last longer.

Someone who is sleep walking may:

* Get out of bed and walk around.
* Sit up in bed and open their eyes.
* Have a glazed, glassy-eyed expression.
* Not respond or communicate with others.
* Be difficult to wake during an episode.
* Be disoriented or confused for a short time after being awakened.
* Not remember the episode in the morning.
* Have problems functioning during the day because of disturbed sleep.
* Have sleep terrors in addition to sleep walking.

Sometimes, an individual who is sleep walking will:

* Do routine activities, such as getting dressed, talking or eating.
* Leave the house.
* Drive a car.
* Engage in unusual behavior, such as urinating in a closet.
* Engage in sexual activity with awareness.
* Get injured, for example, by falling down the stairs or jumping out a window.
* Become violent during the periods of brief confusion immediately after waking or, occasionally, during sleep walking.

## Causes

Sleep walking is a disorder of arousal, meaning it occurs during N3 sleep, the deepest stage of non-rapid eye movement sleep.

The exact cause of sleep walking is unknown, but it seems to run in families. One is more likely to sleep walk if other members of their close family have or had sleep walking behavior or night terrors.

The following can trigger sleep walking or make it worse:

* Not getting enough sleep.
* Stress and anxiety.
* Infection with high temperature, especially in children.
* Drinking too much alcohol.
* Taking drugs.
* Certain types of medications, such as sedatives.
* Being startled by a sudden noise or touch, causing abrupt waking from deep sleep.
* Waking up from deep sleep to use the restroom.

Other sleep disorders that can cause one to frequently wake suddenly during the night, such as obstructive sleep apnoea (OSA) and restless leg syndrome (RLS), can also trigger a sleep walking episode.

## Treatment

In many cases, sleep walking requires no active treatment because episodes are rare and pose little risk to the sleeper or those around them. Episodes often get less frequent with age, so for some, sleep walking resolves on its own.

When it is necessary, there are a number of approaches that may be incorporated into a treatment plan.

Harm reduction is an important consideration for individuals who sleep walk. Some ways that safety risks can be reduced include:

* Keeping sharp objects or weapons locked away and out of reach.
* Closing and latching doors and windows.
* Removing tripping hazards from the floor.
* Installing lights with motion sensors.
* If necessary, using door alarms or a bed alarm that goes off if an individual gets out of bed.

If an individual's sleep walking is tied to an underlying disorder like OSA or RLS, treating that condition may resolve sleep walking.

Improving sleep hygiene may improve sleep while reducing the risk of sleep deprivation that ca trigger sleep walking. This includes having a consistent sleep schedule, not drinking caffeine or alcohol close to bedtime, and using the best mattress for ones sleep position and body type.

When other treatments are not effective, medications may be considered to try to stop sleep walking. Examples include benzodiazepines, antidepressants, and melatonin.

## References

https://www.mayoclinic.org/diseases-conditions/sleepwalking/symptoms-causes/syc-20353506

https://www.nhs.uk/conditions/sleepwalking/

https://www.sleepfoundation.org/parasomnias/sleepwalking