An Overview of Sleepwalking

Symptoms, Causes, Treatment and More

In This Article

Sleepwalking involves physically doing something and engaging in other complex behaviors while asleep. Sleepwalking is a condition more common in children, but adults experience sleepwalking if they are sleep deprived.  Sleepwalkers tend to remain in deep sleep during sleepwalking episodes. 

It may be difficult to wake the sleepwalker, and he or she will likely not recall the incident when awake. The condition has unique symptoms, causes, and risk factors, though treatment is usually not required. However, sometimes both medicinal and non-medicinal therapies are beneficial to cases that do require treatment.

Symptoms of sleepwalking
Illustration by Brianna Gilmartin, Verywell

Prevalence 

It is estimated that 2 to 3 percent of adults sleepwalk, whereas prevalence is much higher in children. Up to 40 percent of children sleepwalk, and up to 3 percent sleepwalk multiple times per month. The onset or persistence of sleepwalking is quite common and generally not related to any mental health disorders or neurological problems.  

Symptoms 

Sleepwalking involves more than just walking around during sleep. It involves other activities while sleeping, with walking being the most obvious. Some people will sit up in bed, look around, or walk around their homes. Others may leave home or drive long distances.

Sleepwalking usually occurs during deep sleep stages 3 and 4, or within a few hours of falling asleep. The sleepwalker may look or behave as if they are partially awake during episodes. In addition to walking around, other symptoms of sleepwalking are: 

  • Sleep talking
  • No memory of the episode
  • Inappropriate behavior, especially in children, such as urinating in a closet
  • Screaming (if the person is also having a night terror)
  • Behaving violently, especially to the person trying to wake them

Causes and Risk Factors

Sleepwalking is a parasomnia—a behavior carried out while asleep. 

The main factors that contribute to sleepwalking include sleep deprivation, stress, fever, and an interrupted sleep schedule.

Sleepwalking can also be triggered by health conditions or other factors including:

  • Substance abuse (including alcohol)
  • Certain medications such as sedatives, hypnotics, and those used for treating psychiatric conditions
  • Sleep-disordered breathing disorders
  • Restless leg syndrome—a nervous disorder that causes an uncontrollable urge to move the legs
  • Gastroesophageal reflux disease or GERD—occurs when stomach acid frequently flows back in the esophagus (tube connecting the mouth to the stomach)

Risk factors for sleepwalking include both genetics and age. Sleepwalking appears to run in families and it's common in people with at least one parent who has a history of sleepwalking. The risk increases if both parents have a sleepwalking history. Sleepwalking is more common in children; adult-onset tends to be related to health and other sleep disorder conditions. 

Sleepwalking in young children may be associated with sleep apnea, a sleep disorder where breathing is interrupted. The symptoms of sleep apnea in children are different than in adults. Sleep apnea in children causes snoring, daytime sleepiness, and breathing interruption for longer periods than with adults. Sleep apnea may also be associated with bedwetting and nightmares.  

Diagnosis and Treatment

Sleepwalking in children is common and treatment is usually not needed. Parents simply need to keep a close eye on a child who sleepwalks to keep the child safe from injury.  An adult who sleepwalks, however, has a greater risk of injury and should seek the advice of a doctor who specializes in sleep disorders.  

The doctor will want the sleepwalker to keep a sleep diary for at least two weeks to determine how sleep is affecting their life. The doctor will also look at medical history and present drug, alcohol, and medication use. The sleep doctor will then try to determine the cause of sleepwalking.

Common Causes of Sleepwalking

  • Another sleep disorder
  • Medical disorders
  • Medication use
  • Mental health conditions
  • Alcohol or drug abuse

The sleep doctor may also want to conduct a sleep study. A sleep study—called a polysomnogram—records brain waves, heartbeat, and breathing as a person sleeps. It will also look at arm and leg movements and behavior through video. This way the doctor can determine if a person gets out of bed or does anything unusual while asleep. 

Sleepwalking in children usually goes away by the time they are teens.  However, other sleep problems and concerns should be brought to the attention of a doctor. Treatment for sleep disorders, including sleep apnea, may resolve sleepwalking. 

Medications

Medications are only necessary if the sleepwalker is at risk for injury, if someone experiences significant daytime sleepiness, or if the sleepwalking is causing household disruption. Medications prescribed for sleepwalking include estazolam, clonazepam, and trazodone.

These medications only need to be taken for a few weeks without the chance of recurrence. However, there are cases where sleepwalking with return after discontinuing medication, but in those instances, the episodes are usually brief and end up resolving. 

Non-Medicinal Options

Non-medicinal options may also help for long-term term treatment of sleepwalking. Relaxation techniques, mental imagery, and anticipatory awakening have all been proven to be effective.

Anticipatory awakening, for instance, involves a parent waking up the child hours after the child has fallen asleep. The parent may wake up the child again right before the usual time of the sleepwalking incidents. This method has been shown to be effective in several studies and could help to completely eradicate the sleepwalking episodes.

A Word From Verywell 

Sleepwalking is not usually a serious condition and can be resolved without treatment, especially in children. When treatment is necessary, it can be treated effectively. Drug treatment for sleepwalking may be needed when there is an underlying health condition or when sleepwalking is a safety concern for the sleepwalker and/or others. Other non-medicinal options are also available.

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