Sleepwalking — also known as somnambulism — involves getting up and walking around while in a state of sleep. More common in children than adults, sleepwalking is usually outgrown by the teen years. Isolated incidents of sleepwalking often don't signal any serious problems or require treatment. However, recurrent sleepwalking may suggest an underlying sleep disorder.
Sleepwalking in adults has a higher chance of being confused with or coexisting with other sleep disorders as well as medical conditions.
If anyone in your household sleepwalks, it's important to protect him or her from potential injuries related to sleepwalking.
Sleepwalking usually occurs early in the night — often one to two hours after falling asleep. It's unlikely to occur during naps. A sleepwalking episode can occur rarely or often, and an episode generally lasts several minutes, but can last longer.
Someone who is sleepwalking may:
- Get out of bed and walk around
- Sit up in bed and open his or her eyes
- Have a glazed, glassy-eyed expression
- Not respond or communicate with others
- Be difficult to wake up during an episode
- Be disoriented or confused for a short time after being awakened
- Not remember the episode in the morning
- Have problems functioning during the day because of disturbed sleep
- Have sleep terrors in addition to sleepwalking
Sometimes, a person who is sleepwalking will:
- Do routine activities, such as getting dressed, talking or eating
- Leave the house
- Drive a car
- Engage in unusual behavior, such as urinating in a closet
- Engage in sexual activity without awareness
- Get injured, for example, by falling down the stairs or jumping out a window
- Become violent during the period of brief confusion immediately after waking or, occasionally, during sleepwalking
Occasional episodes of sleepwalking aren't usually a cause for concern and typically resolve on their own. You can simply mention the sleepwalking at a routine physical or well-child exam. However, consult your doctor if the sleepwalking episodes:
- Occur often — for example, more than one to two times a week or several times a night
- Lead to dangerous behavior or injury to the person who sleepwalks or to others
- Cause significant sleep disruption to household members or the person who sleepwalks
- Result in daytime symptoms of excessive sleepiness or problems functioning
- Start for the first time as an adult
- Continue into your child's teen years
Sleepwalking is classified as a parasomnia — an undesirable behavior or experience during sleep. Sleepwalking is a disorder of arousal, meaning it occurs during N3 sleep, the deepest stage of non-rapid eye movement (NREM) sleep. Another NREM disorder is sleep terrors, which can occur together with sleepwalking.
Many factors can contribute to sleepwalking, including:
- Sleep deprivation
- Sleep schedule disruptions, travel or sleep interruptions
Sometimes sleepwalking can by triggered by underlying conditions that interfere with sleep, such as:
- Sleep-disordered breathing — a group of disorders featuring abnormal breathing patterns during sleep (for example, obstructive sleep apnea)
- Taking certain medications, such as hypnotics, sedatives or certain medications used for psychiatric disorders
- Substance use, such as alcohol
- Restless legs syndrome
- Gastroesophageal reflux disease (GERD)
Factors that may increase the risk of sleepwalking include:
- Genetics. Sleepwalking appears to run in families. It's more common if you have one parent who has a history of sleepwalking, and much more common if both parents have a history of the disorder.
- Age. Sleepwalking occurs more often in children than adults, and onset in adulthood is more likely related to other underlying conditions.
Sleepwalking itself isn't necessarily a concern, but a person who sleepwalks can:
- Hurt themselves — especially if they walk near furniture or stairs, wander outdoors, drive a car or eat something inappropriate during a sleepwalking episode
- Experience prolonged sleep disruption, which can lead to excessive daytime sleepiness and possible school or behavior issues
- Be embarrassed or experience problems with social relationships
- Disturb others' sleep
- Rarely, injure someone else nearby
To diagnose sleepwalking, your doctor reviews your medical history and your symptoms. Your evaluation may include:
- Physical exam. Your doctor may do a physical exam to identify any conditions that may be confused with sleepwalking, such as nighttime seizures, other sleep disorders or panic attacks.
- Discussion of your symptoms. Unless you live alone and are unaware of your sleepwalking, you'll likely be told by others that you sleepwalk. If your sleep partner comes with you to the appointment, your doctor may ask him or her whether you appear to sleepwalk. Your doctor may also ask you and your partner to fill out a questionnaire about your sleep behaviors. Tell your doctor if you have a family history of sleepwalking.
- Nocturnal sleep study (polysomnography). In some cases, your doctor may recommend an overnight study in a sleep lab. Sensors placed on your body will record and monitor your brain waves, the oxygen level in your blood, heart rate and breathing, as well as eye and leg movements while you sleep. You may be videotaped to document your behavior during sleep cycles.
Treatment for occasional sleepwalking usually isn't necessary. In children who sleepwalk, it typically goes away by the teen years.
If sleepwalking leads to the potential for injury, is disruptive to family members, or results in embarrassment or sleep disruption for the person who sleepwalks, treatment may be needed. Treatment generally focuses on promoting safety and eliminating causes or triggers.
Treatment may include:
- Treating any underlying condition, if the sleepwalking is associated with sleep deprivation or an underlying sleep disorder or medical condition
- Adjusting medication, if it's thought that the sleepwalking results from a drug
- Anticipatory awakenings — waking the person who is sleepwalking about 15 minutes before he or she usually sleepwalks, then staying awake for a few minutes before falling asleep again
- Medication — such as benzodiazepines or certain antidepressants
- Learning self-hypnosis — when done by a trained professional who is familiar with parasomnias, people who are receptive to suggestions during hypnosis may benefit by achieving a deep state of relaxation through which a change in unwanted activities during sleep is promoted
- Therapy or counseling — a mental health professional can help with suggestions for improving sleep, stress-reduction techniques, self-hypnosis and relaxation