Sleepwalking

What is sleepwalking?

Sleepwalking means getting up during sleep and walking around, despite still being asleep. Sleepwalking usually occurs during a period of deep sleep and often occurs in the first few hours after falling asleep.

Sleepwalking is just one of a group of conditions involving unwanted behaviour during sleep. The group of conditions is called parasomnias. Other parasomnias include talking during sleep, waking up confused, sleep terrors and nightmares. Studies have shown that 1 in 3 children who have sleep terrors in early childhood often develop sleepwalking when they get older.

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Sleepwalking in children and adults

Sleepwalking is common in children. About one in five children will experience at least one episode of sleepwalking. Sleepwalking can start at any age but is much more common in children than in adults. It often starts around the age of 10 years.

Sleepwalking causes

The exact reason why people sleepwalk is not known. Sleepwalking seems to be more common in children with other close family members who have had sleepwalking or night terrors.

Episodes of sleepwalking may sometimes have specific triggers. The following may trigger sleepwalking or make it worse:

• Not getting enough sleep.

• Not having a regular routine of when to go to bed.

• Stress and anxiety.

• Illness with a high temperature (fever), especially in children.

• Drinking too much alcohol.

• Taking recreational drugs.

• Some medicines, especially those that cause drowsiness (sedatives).

Some other sleep problems may also trigger a sleepwalking episode - eg, obstructive sleep apnoea and restless legs syndrome.

Symptoms of sleepwalking

Episodes of sleepwalking are very variable. The person is still asleep but gets out of bed and walks around.

• The person may then perform complex activities such as opening cupboards or windows, getting dressed, having something to eat or drink, or even walking out of the house.

• While sleepwalking occurs, the person's eyes are usually open and they appear fully awake, but the person will not recognise anyone. The person may talk but usually doesn't make any sense and can't have a conversation.

• Sleepwalking episodes vary in duration. Most episodes last less than 10 minutes but they can go on for much longer. At the end of each episode, the person may wake up or they may return to bed and go to sleep. They usually won't remember having the sleepwalking episode or may just have only a slight memory of it.

• If the person is woken while sleepwalking, they may be shocked. They tend to feel confused and not remember what has happened. The person may also become aggressive and violent.

How to stop sleepwalking

There is no specific treatment for sleepwalking. Some treatments can be tried if the episodes of sleepwalking do not respond to simple advice, are very frequent or cause the person to be in danger. Treatments such as cognitive behavioural therapy or hypnotherapy may be helpful.

Most people with sleepwalking don't need to see a GP. You should see your GP or other health professional if the sleepwalking episodes occur often, cause a risk of injury or persist until adult life. Your GP may refer you to a specialist sleep centre.

The sleep centre will make a thorough assessment, including sleep studies to assess whether there may be other problems with sleep such as obstructive sleep apnoea. Most people with sleepwalking do not have any associated sleep problems.

The best form of treatment is to try to prevent sleepwalking episodes. This involves making sure you have enough sleep and a regular routine of when you go to bed. It is also important to relieve stress and avoid other triggers such as alcohol, recreational drugs and medicines that are used to help sleep.

Therefore, strategies that may help include improving sleep hygiene (see the leaflet on Insomnia for further details).

• Try to go to bed at the same time each night.

• Restrict drinks before bedtime. Avoid drinks with caffeine or alcohol in the few hours before going to bed.

• Find ways to relax before going to bed. The best ways to relax are different for different people. Reading or having a bath are often helpful.

• If your child sleepwalks at the same time most nights, try waking them for a short time 15 to 30 minutes before sleepwalking occurs. This may alter their normal sleep cycle and prevent sleepwalking.

What should I do when someone is sleepwalking?

It is best to gently guide them back to bed and they will often go back to sleep. Reassure them as you guide them back to bed. It is important not to startle them. It is best not to try to restrain them, unless they are in any danger. Startling or restraining the person may make them become aggressive.

It's also important to make sure anyone staying with the person knows what to do if a sleepwalking episode occurs. It is essential to make sure the person stays safe and avoids any accidents.

Preventing accidents

It is important to keep the person safe if they sleepwalk. Remove any items that may cause an accident, including moving furniture and anything on the floor that could be tripped over.

If your child sleepwalks, don't let them sleep on the top bed of a bunk bed. Other important measures are safety gates at the top of the stairs and locking windows and doors at night.

What is the outcome (prognosis)?

Most children will grow out of sleepwalking before becoming teenagers. Only a few children who sleepwalk will continue to sleepwalk when they become adults. Studies show that adult sleepwalkers often report that it was preceded by sleep deprivation or a stressful event.