Sleepwalking (somnambulism) is a series of complex behaviors initiated during slow wave sleep that results in walking during sleep.
Ambulation (walking or moving about) that occurs during sleep. The onset typically occurs in prepubertal children.
Associated features include difficulty in arousing the patient during an episode and amnesia following an episode. Episodes typically occur in the first third of the sleep episode. Polysomnographic monitoring demonstrates the onset of an episode during stage 3 or 4 sleep. Other medical and psychiatric disorders can be present but do not account for the symptom. The ambulation is not due to other sleep disorders such as REM sleep behavior disorder or sleep terrors.
Medical reports show that about 18 percent of the population is prone to sleepwalking. It is more common in children than in adolescents and adults. Boys are more likely to sleepwalk than girls. The highest prevalence of sleepwalking was 16.7 percent at age 11 to 12 years of age. Sleepwalking can have a genetic tendency. If a child begins to sleepwalk at the age of 9, it often lasts into adulthood.
For some, the episodes of sleepwalking occur less than once per month and do not result in harm to the patient or others. Others experience episodes more than once per month, but not nightly, and do not result in harm to the patient or others. In its most severe form, the episodes occur almost nightly or are associated with physical injury. The sleepwalker may feel embarrassment, shame, guilt, anxiety and confusion when they are told about their sleepwalking behavior.
If the sleepwalker exits the house or is having frequent episodes, causing injuries, seek professional help immediately.
There are some things a sleepwalker can do to prevent the frequency and/or severity of sleepwalking:
- Make sure you get plenty of rest; being overtired can trigger a sleepwalking episode.
- Develop a calming bedtime ritual. Some people meditate or do relaxation exercises; stress can be another trigger for sleepwalking.
- Remove anything from the bedroom that could be hazardous or harmful.
- The sleepwalker's bedroom should be on the ground floor of the house. The possibility of the patient opening windows or doors should be eliminated.
An assessment of the sleepwalker should include a careful review of current medications so that modifications can be made if necessary. Hypnosis has been found to be helpful for both children and adults.
An accurate psychiatric evaluation could help to decide the need for psychiatric intervention. Benzodiazepines have been proven to be useful in the treatment of this disorder. A small dose of diazepam or lorazepam eliminates the episodes or considerably reduces them.