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sleep walking disorder

Alternative Names
somnambulism, noctambulation, noctambulism, walking during sleep

Definition
Sleepwalking is a disorder of sleep in which sleeping and waking states are combined. The individual partially wakes from deep sleep and carries out some type of activity. Often this is walking, but other detailed tasks may be performed.

What is going on in the body?
This disorder of sleep involves carrying out complex motor acts. It occurs primarily during the first third of the night but not during rapid eye movement, or REM, sleep.

What are the signs and symptoms of the condition?
Symptoms of the disorder include the following while sleeping:
  • walking
  • open eyes but blank facial expression
  • lack of co-ordination
  • performance of seemingly purposeful acts. These might include getting dressed, turning lights on and off, opening a door, or similar tasks.
  • appearance of being awake
  • confusion and disorientation upon waking during an episode
  • speech that cannot be understood or does not make sense
  • occurrence of symptoms in the first third of the night
  • episodes beginning in stage 3 or 4 sleep, which is a deeper level of sleep


These episodes may last for 5 to 20 minute in length. The individual may have no recall of this behaviour after waking up. Waking up after such episodes may be difficult.

What are the causes and risks of the condition?
Sleepwalking often runs in families. It is thought to be heredity. Sleepwalking that starts at an early age typically goes away as the child gets older. Fifteen percent of normal children between the ages of 5 and 15 years old sleepwalk.

What can be done to prevent the condition?
There is no known prevention for sleepwalking. As with other sleep disorders, avoiding alcohol, other central nervous system depressants, such as prescription sleeping pills or painkillers, and tranquilisers, will help control the problem. Maintaining good sleep habits and avoiding fatigue, stress, and anxiety can also help improve the condition. Individuals who sleepwalk are at risk for injury during the episodes. They should be protected against accidents as much as possible.

How is the condition diagnosed?
Sleep studies are rarely needed to make the diagnosis. If sleepwalking occurs frequently, the doctor may perform an examination to see if any other conditions are aggravating the problem. A psychological examination may be suggested if stress and anxiety are thought to contribute to the problem.

What are the treatments for the condition?
Behavioural changes can be used to help the person establish good sleeping habits. Sticking to a regular routine of sleeping and waking times is helpful. Using relaxation techniques to reduce stress and anxiety can help with the condition. Eliminating the use of alcohol is also recommended.

Another person can help the sleepwalker by:
  • gently leading the person back to bed
  • protecting the person from accidents or injury
  • helping the person avoid becoming overtired. This is particularly necessary for children.
The following method has been shown to be helpful in reducing or eliminating sleepwalking. It is thought to interrupt the distressing sleep pattern. The treatment involves the help of someone who can be present while the affected person sleeps.
  • The number of minutes that pass from the time the person falls asleep to the time sleepwalking starts should be logged for several nights.
  • On the following nights, the person should be awakened 15 minutes before the start of the expected sleepwalking episode. This timing is based on the information gathered in the log.
  • The person should be kept awake for 5 minutes.
  • This procedure should be followed for 7 consecutive nights.
  • If sleepwalking begins again, the procedure should be repeated for 7 more consecutive days.
Author: Ann Reyes, Ph.D.
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request


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