Sleep walking is a kind of parasomnia—or a condition that causes irregular behavior during sleep—where a person is able to walk around or perform complex activities while they are still asleep. There are five stages of sleep (N1, N2, N3, N4, and REM) ranging from mild tiredness to very deep sleep, and people go through these different stages about four to five times per night. Sleepwalking often happens during deep non-REM sleep. Because sleepwalking happens at a certain stage of deep sleep, the condition doesn’t always present itself each night or when a person is taking short naps.
While adults can be sleepwalkers, the condition is most commonly seen in children. Most children grow out of sleepwalking, but some still have the condition during adolescence and adulthood. It is especially seen in people who are overly fatigued, stressed, or unable to obtain a normalized sleep schedule. Researchers have found that those with an irregularity on chromosome 20 may also be prone to developing sleepwalking. Alcohol and some medications, such as antihistamines, sleeping pills, and the like, can cause a person to sleep walk. Lastly, sleep walking can also be caused by some medical conditions, like seizures, or organic brain syndrome (OBS).
As the name suggests, sleepwalkers tend to get out of bed and walk around or perform everyday activities. However, despite this physical activity, sleepwalkers are in a state of low consciousness and cannot remember their episodes when they awaken. Sleepwalkers also have glassy eyes that don’t focus or notice others trying to wake them; they may have a blank look on their face, speak incoherently, and act angry or confused if woken.
There is no single reason why sleepwalking occurs; instead, several factors could be at play in any one person who sleepwalks. Typically, sleepwalking occurs during NREM sleep, when the brain is relatively inactive and sleep is deep, but the body remains active. We tend to toss and turn frequently during this period of sleep.
Often, sleepwalking occurs when we haven’t had enough sleep. Individuals with an inconsistent bedtime routine are also more likely to sleepwalk. Alcohol and stress are also known to increase the risk.
Sometimes medical conditions can cause sleepwalking. Conditions particularly well known for it include:
Genetics also play a role in sleepwalking. People with a first-degree relative who sleepwalks are ten times more likely to sleepwalk themselves. Interestingly, identical twins often sleepwalk.
While some sleepwalkers may be angry if woken, it is a misconception that they shouldn’t be woken at all. If a sleepwalker is at risk for hurting themselves, such as tripping easily while sleepwalking, then he or she should be woken. Changing obstacles or locking doors around the home can help to mitigate injury for those who regularly sleepwalk.
If a child sleep walks around the same time each night, a parent or guardian can try anticipatory awakenings. This is where a child is woken up about 20 minutes before they typically sleepwalk and then put back to sleep after the period when they usually sleepwalk passes.
Some medications, like trazodone, can help sleepwalkers get adequate rest. However, some medications can exacerbate symptoms, so it is recommended that patients work with their doctors or try relaxation or visualization techniques.
To prevent sleepwalking, it can help to establish a regular sleep hygiene routine. Choose a time to where you usually begin to feel sleepy and go to bed at that same time every night. You should also try to get up at the same time each morning.
If you have trouble getting to sleep straight away, adopt some relaxation techniques which will help to prepare you for sleep, such as taking a warm bath, having a warm, non-caffeinated drink, or meditating. Avoiding synthetic light from cellphones and tablets in the hour before bed might also help. Sometimes having a full bladder can lead to a sleepwalking episode, so don’t drink too many liquids in the hours before bed.
Sometimes episodes of sleepwalking can be prevented if the individual is woken up briefly before sleepwalking begins. Sleepwalking often occurs around the same time each night, so if possible ask your partner of family member to let you know when it occurs. You can then set an alarm or have someone else wake you around 15 minutes before sleepwalking is expected. You do not have to be fully awake, but just have sleep disturbed enough to disrupt the sleep cycle.