Sleepwalking, or somnambulism in science speak, is a parasomnia – a sleep disorder that involves abnormal behavior. Although not a rare disorder, somnambulism is still something of a medical mystery. While research has extensively documented what people do while sleepwalking and the various associated risk factors, the precise causes of sleepwalking are still being unraveled. Fortunately, medical science does offer treatment options to help sleepwalkers overcome this potentially risky behavior.
Sleepwalking And The Sleep Cycle
Normal sleep has various stages ranging from the drowsy, about-to-nod-off state to deep sleep. There’s a state during sleep when the eyes move, termed as Rapid Eye Movement (REM). This is also the stage when you see the most vivid dreams. All of us alternate many times between cycles of REM and non-REM sleep when we sleep. Here are some interesting facts about sleepwalking and these sleep cycles:
- Most sleepwalking events happen early at night, during the deep, non-REM sleep phase. In medical parlance, this is also called N3 sleep.
- Some people kick and flail around or climb out of bed during REM sleep too. This is more a symptom of REM behavior disorder and typically manifests closer to morning.
- Less common, but nevertheless a reality, is sleepwalking during a mid-morning snooze.1 2
A sleepwalking episode can last from a few seconds to as long as 30 minutes. On average, however, they last for less than 10 minutes. While sleepwalking, a person may appear awake although they are fast asleep. A sleepwalker may also engage in some activity typically done while awake, say cleaning up, going to the bathroom, or changing clothes. Some have even been known to drive their car!3
Causes Of Sleepwalking
Experts say that sleepwalking is strongly linked to heredity. In one study, 37 children who had a parent (or both) who had sleepwalked were compared against 62 control children. The former were observed to be more likely to sleepwalk, sleep talk, and have emotional issues. The researchers concluded that genetics played a role in sleepwalking and that the problem usually manifested by the age of 8 years.4
If either or both of a child’s parents have been sleepwalkers as adults or children, the child’s chances of inheriting the tendency are double or even triple.5 In fact, through a study that involved four generations of one family of sleepwalkers, researchers have actually zoned in on a defect in chromosome 20 as the faultine that causes sleepwalking. Carrying even one copy of the defective DNA is thought to be enough to cause sleepwalking. The exact gene, however, is yet to be discovered.6 7
2. Health Conditions
Research indicates that even if certain adults may be genetically predisposed to sleepwalk, they would need a trigger for sleepwalking to occur. It has been observed that certain physiological conditions and health disorders can trigger episodes of sleepwalking. They include:
- Partial complex seizures
- Sleep disorders
- Restless leg syndrome
- Obstructive sleep apnea
- Central sleep apnea
- The premenstrual phase
- Head injuries
- Bloated stomach
3. Sleep Deprivation And Fatigue
If your child isn’t getting enough sleep for their age, it could lead to sleepwalking. Sleep deprivation can also be a trigger for sleepwalking among adults. Fortunately, it’s also a problem that’s easier to fix than other causes of sleepwalking. Sticking to a more or less fixed sleep schedule that allows sufficient hours of sleep can help overcome sleepwalking. Caffeine in chocolate, coffee, tea, colas, and energy drinks can act as a stimulant, so avoid them close to bedtime.8
4. Sleeping On A Full Bladder
Some incidents of sleepwalking happen, whether with children or adults, when the person has gone to bed on a full bladder. It could even result in urinating in wrong places, say a closet.9
5. Alcohol And Medications
Sleepwalking among adults can also occur because of factors that increase N3 sleep, making it difficult to arouse the person from sleep. These could include use and abuse of alcohol and medicines such as sedatives, B-blockers, antidepressants, and medicines for nerve problems, among others.10 Episodes of sleepwalking could also be triggered by the side effects of medication, such as leg movements and disordered breathing.11 12 However, more extensive research is required to confirm this cause for sleepwalking.
6. Stress And Anxiety
These can be a flashpoint for both children and adults. Childhood we’d think is a carefree interlude but anxiety and stress over school and peer relationships can affect children. So can trouble at home, say, frequent fights and discord between parents. Sleepwalking, say experts, can be triggered when a child is under pressure. Some adults also tend to sleepwalk when under extreme stress and anxiety.
This, in turn, can set off a vicious cycle. One study of 100 adults concluded that adult sleepwalking can have serious consequences. Scientists who documented the sleep experiences of the participants and a control group found that sleepwalkers had a higher frequency of problems impacting their normal life such as daytime sleepiness, insomnia, fatigue, anxiety, and depression.13
7. External Factors
For people who are prone to sleepwalking, other triggers can include travel and sleeping away from one’s familiar environment. A sudden unexpected sound or touch, or light in the sleeping area can also have the same effect.14
8. Mental Ailments
A 2012 study by the American Academy Of Neurology observed that psychiatric disorders such as depression, anxiety, and obsessive compulsive disorder may increase the risk of sleepwalking. So can the intake of antidepressant medication.15
Among the elderly, sleepwalking may occur as a result of decreased mental functions or because of an organic brain syndrome generally referred to as nocturnal delirium. This is usually seen in elderly people with Alzheimer’s, who tend to be agitated or confused in the night.16
How Common Is Sleepwalking?
Sleepwalking can affect anyone, at any age, although it’s more common among children. Reports about the incidence of sleepwalking vary from study to study. It has been pegged at anywhere between 10–17 percent among children and 2–4 percent among adults.17 Sleepwalking can begin as early as 2 years of age, peak between 8–12 years, and slowly taper off.18 If a child begins sleepwalking at 9 years or later, the problem often continues into adulthood.19 And for some reason, it’s more common among boys.
Medical research in recent years has focused considerably on sleepwalking in adults and studies indicate that it’s time to take this condition seriously. The 2012 study, published by AAN, concluded that adult sleepwalking is more common than was thought – 30 percent of the nearly 16,000 participants in this study had experienced sleepwalking episodes, some more than others.20
Can Sleepwalking Begin In Adulthood?
On very rare occasions, yes. Neurodegenerative changes that occur as a result of conditions such as Parkinson’s disease (PD) can sometimes give rise to sleep-associated behavioral disturbances such as sleepwalking. In a certain study involving 165 PD patients, aged between 46–78 years, 6 were found to have started sleepwalking in adulthood. This finding highlights why you mustn’t ignore sleepwalking incidents that begin in adulthood. There could be a serious underlying reason for the issue.21
When To See A Doctor: Children
Sleepwalking episodes are a relatively normal occurrence in childhood and, typically, require no medical attention. However, there are some situations when you should see a doctor:
- Your child suffers from sleep apnea and therefore has interrupted sleep.
- Your child has a fever or some other illness.
- Medications your child is taking may be a reason for sleepwalking.
- The child has had repeated injuries during sleepwalking.
- The child tends to go outside the house or has been in potentially risky situations.
- Sleepwalking continues into the teenage years.22
When To See A Doctor: Adults
If sleepwalking continues from childhood into adulthood or begins at this later phase in life, it may be appropriate to seek professional help since adults are at greater risk of injuring themselves. Often treating symptoms such as restless legs syndrome, obstructive sleep apnea, and upper airway resistance syndrome can help tackle the problem.23
|↑1, ↑5||Sleepwalking: Overview And Facts. American Academy of Sleep Medicine.|
|↑2, ↑3, ↑12||Sleepwalking. MedlinePlus.|
|↑4||Abe, Kazuhiko, Miyako Amatomi, and Noboru Oda. “Sleepwalking and recurrent sleeptalking in children of childhood sleepwalkers.” The American journal of psychiatry (1984).|
|↑6||Licis, A. K., D. M. Desruisseau, K. A. Yamada, S. P. Duntley, and C. A. Gurnett. “Novel genetic findings in an extended family pedigree with sleepwalking.” Neurology 76, no. 1 (2011): 49-52.|
|↑7||Sleepwalking ‘linked to chromosome fault’. BBC News.|
|↑8, ↑9||About Sleepwalking. The Nemours Foundation.|
|↑10||Stallman, Helen M., Mark Kohler, and Jason White. “Medication induced sleepwalking: A systematic review.” Sleep Medicine Reviews (2017).|
|↑11||Pressman, Mark R. “Factors that predispose, prime and precipitate NREM parasomnias in adults: clinical and forensic implications.” Sleep medicine reviews 11, no. 1 (2007): 5-30.|
|↑13, ↑20||Adult sleepwalking is serious condition that impacts health-related quality of life. American Academy Of Sleep Medicine.|
|↑14||Sleepwalking: Overview And Facts. Sleep Education.|
|↑15||Eyes Wide Shut: Sleepwalking Common In Adults?. American Academy Of Neurology.|
|↑16||Berlin, Richard M., and Usman Qayyum. “Sleepwalking: diagnosis and treatment through the life cycle.” Psychosomatics 27, no. 11 (1986): 755-760.|
|↑17, ↑18||Sleepwalking – Symptoms & Risk Factors. American Academy of Sleep Medicine.|
|↑19||Children And Sleepwalking. The Sleep Well.|
|↑21||Poryazova, Rositsa, Daniel Waldvogel, and Claudio L. Bassetti. “Sleepwalking in patients with Parkinson disease.” Archives of neurology 64, no. 10 (2007): 1524-1527.|
|↑22||Sleepwalking – Diagnosis & Treatment. Sleep Education.|
|↑23||Remulla, Agnes, and Christian Guilleminault. “Somnambulism (sleepwalking).” Expert opinion on pharmacotherapy 5, no. 10 (2004): 2069-2074.|