Causes and Treatments of Sleepwalking in Children

Sleepwalking is a common condition that occurs in children, but what underlies this behavior? You may wonder not only about the causes of sleepwalking but whether it requires treatment and how best to stop it. Discover facts about the symptoms, causes, and best treatment options of sleepwalking in children.

Boy asleep in bed
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What Is Sleepwalking?

Sleepwalking is the purposeful movement of walking that occurs in a sleep-like state. It is sometimes called somnambulism. Sleepwalking is one of the parasomnias, which is a class of sleep disorders that include abnormal movements and behaviors that occur during sleep.

Common Causes

Children of all ages may sleepwalk, and the cause is not fully understood. It may be due to immature development of the nervous system.

It is estimated that about 15% of children sleepwalk at least once between the ages of 4 and 12.

Sleepwalking becomes less common into adolescence, and rarely persists into adulthood.

There are a few conditions that may provoke sleepwalking. It is thought that sleep-disordered breathing, such as sleep apnea, may make it more likely for a child to have sleepwalking episodes. In addition, movement disorders, such as restless legs syndrome (RLS) and periodic limb movement disorder, may also provoke the behavior. If sleep becomes fragmented, it may become possible to be in a mixed state that allows walking to occur but suppresses full awareness or memory of the action.

Sleepwalking can be is associated with "confusional arousals." These confusional arousals consist of seeming to awaken but remaining in a subconscious state. They occur out of deep sleep, are not usually remembered by the child, and may overlap with sleep terrors.

Other Conditions Similar to Sleepwalking

There are other conditions that may appear similar to sleepwalking. These conditions include:

  • Nocturnal frontal lobe epilepsy (causing seizures)
  • Non-REM parasomnias, such as sleep terrors
  • Psychiatric disorders

These conditions are extremely unlikely and, if suspected, may require further evaluation by a sleep medicine specialist, neurologist, or psychiatrist.

How to Stop Sleepwalking With Effective Treatments

Most sleepwalking episodes are over in a few minutes, and as such, they may not require treatment. However, children may get themselves into dangerous situations inadvertently, so the most important thing is to keep the child safe from harm.

As children often sleepwalk early in the night, it may be necessary to monitor them during this time. This may be especially important in situations where they have been known to sleepwalk in the past (such as during an illness).

Parents often wonder if it is dangerous to wake a sleepwalking child. The short answer is no. In general, it is best to redirect sleepwalking children back to bed without fully waking them. Children who are awakened during this state may seem confused and upset and may have difficulty getting back to sleep.

There is no mental or physical harm to interrupting a sleepwalker by waking them, so don't worry if this occurs.

If the sleepwalking behavior is particularly frequent, prolonged, or dangerous, additional interventions may be necessary. In some cases, therapy can help reduce the number of sleepwalking episodes. Therapy may target poor sleep habits, sleep deprivation, anxiety, and stress. Some children may require bed alarms, or specialized devices that interrupt slow-wave sleep, to awaken themselves or others should they get up. If sleep-disordered breathing or movement disorders are suspected, appropriate treatment of these conditions may improve the sleepwalking.

Finally, the use of the medication clonazepam may be helpful. Clonazepam is one of the benzodiazepine medications and can be used to suppress the nervous system. With its use, your child is less likely to get up during sleep. As there is a risk of side effects, you should carefully discuss the risks and benefits with your child's pediatrician. In most cases, treatment with medication is unnecessary.

5 Sources
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By Brandon Peters, MD
Brandon Peters, MD, is a board-certified neurologist and sleep medicine specialist.