Sleepwalking: What Causes it and Why We Do It

Sleepwalking is undoubtedly one of the stranger sleep disorders known to mankind. Also called somnambulism, sleepwalking is probably most recognized as a crutch used by writers and directors to allow for ridiculous situations in television and movies. But for those that suffer from the disorder, or for their loved ones who bear witness to the strange symptoms, sleepwalking is an extremely serious condition that demands full respect and careful treatment.

Most of the time this disorder is manageable. Without proper care, it can lead to big problems, however. Read on to learn the science of sleepwalking, as well as what experts believe is the best way to keep the disorder in check.

What is sleepwalking?

Sleepwalking is a sleep disorder belonging to the parasomnia family, a collection of conditions in which patients suddenly “awaken” during different parts of the sleep cycle. Depending on what part of the cycle they are in when they wake, their parasomnia is classified differently.

Sleepwalkers get up in the middle of the night and move around their environment in a state somewhere between awake and asleep. It can be as simple as sitting up in bed, but usually, there are more significant movements. According to WebMD, the most common symptoms of sleepwalking are:

• Walking around the place where the patient awoke, often quietly
• Trying to run or “escape” from something
• Having no memory of your actions from sleeping the next day
• When eyes are open and a blank, glassy stare while sleepwalking
• Unresponsive or slow to respond during sleepwalking
• A physical response such as an elevated heart rate, severe sweating, rapid breathing, or even crying or screaming

These symptoms typically last anywhere from a few seconds to thirty minutes or more. Sleepwalkers who are awakened during these episodes are often groggy and confused, often reacting very poorly to this intervention.

Though sleepwalking can affect anyone of any age, it is most common among young children, affecting between 2-14% of that population according to one study. About one-quarter of children who sleepwalk continue to do so into adulthood.

The Science of Somnambulism

Sleepwalking is associated with problems moving through the sleep cycle in a normal manner. People who suffer from this typically do so in the deepest stages of the sleep cycle: stages 3 and 4 NREM (non-rapid eye movement) sleep. These stages are also known as deep sleep or delta wave sleep, and in a normal sleeper it is a period where there is relatively little brain activity, but a lot of physiological repairs to the body happening. Part of entering this stage requires the body to suspend most muscle activity.

In somebody who sleepwalks, however, there is some evidence that the mechanism that shuts off motor activity fails to activate. These patients also demonstrate an interesting combination of brain waves that mix the delta wave activity of NREM deep sleep with more active high-frequency waves associated with states of wakefulness. Children typically spend more time in NREM sleep stages than adults do, which may explain the higher frequencies of sleepwalkers in their population.

Some sleepwalkers do more than walk around

Walking around a bedroom for a few moments before returning to the safety of the sheets is the most common sleepwalking routine. Besides the fact that simply walking downstairs, or navigating a cluttered living room floor can be hazardous for a sleepwalker, there is also the potential that somnambulism manifests in some much more serious ways.

Furthermore, some sleepwalkers have been known to carry out activities like driving, cooking and other routine tasks that present a clear danger to the sleepwalker and those around them when performed in state of semi-sleep. Using a stove or leaving the house, though almost automatic routines when awake, should not be done when asleep.

There is also disturbing evidence that violent episodes among patients occur at surprisingly high rates. These cases can happen during the normal course of sleepwalking, or when a third party attempts to wake the sleeper. Typically this occurs in older individuals and can lead to some very interesting legal questions, in addition to underlining the importance of treating somnambulism as a serious condition.

Medical Treatments

There is a limited range of treatment options for patients, especially in children. Typically, sleepwalking that occurs relatively infrequently or mildly is not treated at all. According to the Mayo Clinic, more serious cases of the disorder can be treated with a variety of techniques:

• Treat underlying conditions: Sleepwalking can occur as a result of other conditions and will dissipate if they are treated properly.
• Manage medications: Some medications, taken for other reasons, might be the cause of sleepwalking.
• Therapy for sleep: A therapist might help patients develop behavioral techniques that allow for more normal sleep and fewer incidences of serious sleepwalking.
• Medication: In some cases, doctors might prescribe SSRIs or other antidepressants to help with sleepwalking.

How to Manage Somnambulism

Outside of medical treatments for this disorder, most cases are managed by changes in behavior and environment that can lower the chances of an episode resulting in harm to a sleepwalker or those around them. Some of the most common include:

• Anticipatory wakings: Waking a person up before the time in their sleep when they typically have episodes, and keeping them awake for fifteen minutes or so can lower the chances they have an episode.
• Make the environment safe: Locking doors and windows in the bedroom, clearing the floor of obstacles, and otherwise keeping the immediate area around the bed safe will help make sure that someone who sleepwalks does not accidentally injure themselves.
• Maintain healthy sleep hygiene: With all sleep disorders, anything a person can do to normalize their sleep hygiene will help improve their odds of getting regular, healthy sleep. This includes exercising regularly and eating healthfully, avoiding alcohol, caffeine and nicotine, and creating a nighttime environment free from artificial light and any other sources of significant stimulation.