The Truth About Sleep Walking

Sleepwalking, medically known as somnambulism , is a condition where someone walks or carries out complex activities while not fully awake. It is estimated that up to 15 per cent of the general population has sleep walked at some point in their lives.

It is more common in children and most of them outgrow it by their teen years. It tends to occur during a period of deep sleep — usually in the first few hours after falling asleep. It usually does not happen during short naps.

Sleepwalking is not a mental health problem

Contrary to popular belief, sleepwalking is not an indicator of an underlying psychiatric or psychological problem.

Sleepwalkers’ behaviour

Someone who is sleepwalking may get out of bed and walk around. Often, they have a glassy-eyed appearance where they do not appear to see what is around them or recognise familiar faces.

Attempts to communicate with them is difficult as they either do not respond or struggle to speak. In some cases, they may engage in inappropriate activity such as urinating in the cupboard/closet.

Some carry out complex activities such as driving, mowing the lawn, eating, dressing or even dangerous activity like jumping out of a window or running around the neighbourhood.

They have even been known to engage in sexual activity. A few sleepwalkers have night terrors (nightmares sessions).

Most sleepwalkers have no recollection of the night’s activities the following day. However, it can affect their work performance due to fatigue.

Most episodes of sleepwalking last less than 10 minutes. The person may either wake up shortly after the episode or go back to bed and continue sleeping.

Causes of sleepwalking

Although the exact aetiology of sleepwalking is not well understood, the following factors have been linked to it.

Hereditary:It can run in families.

Stress: This contributes to sleep deprivation and chronic fatigue.

Alcohol and drug abuse:Drunk people and those using stimulant drugs tend to have more episodes of sleep walking than those that do not.

Medical conditions: Sleepwalking has been found to be more common during episodes of fever, in people that have obstructive sleep apnea, restless leg syndrome, seizures and psychiatric disorders such as post-traumatic stress disorder (PTSD) or panic attacks.

In a few cases, sleeping in a different or noisy environment or traveling to different time zones (with disruption of the normal sleep pattern) may contribute to sleep walking.

Complications of sleepwalking

Sleepwalking episodes can lead to someone hurting themselves or those around them. They can also contribute to poor work performance the following day due to fatigue.

Regular sleepwalking has been known to cause social and relationship problems as the episodes can be embarrassing, interrupt partners’ sleep and subject them to inappropriate behaviour.

When to see a doctor

Mention any sleepwalking episodes to your child’s paediatrician during your next visit. Often, no treatment or investigations (tests) are needed as most children stop sleep walking by the time they reach puberty. Sleep walking multiple times a night or several times a week should necessitate a chat with your doctor Sleep walkers who engage in regular violent or dangerous activity need treatment. Excessive daytime fatigue, sleepiness and poor work performance/function due to the nocturnal sleepwalking needs intervention Adult onset sleepwalking should also be discussed with your doctor.

What not to do

Do not attempt to wake up a sleepwalker – they will be confused, agitated and have the potential to become aggressive. Instead, gently guide the person back to bed.

Do not punish a child for behaviour carried out whilst sleepwalking – they have no control over these nocturnal activities.

Do not watch as a person carries out harmful activities whilst sleep walking; for example, let him fall down the stairs so that he ‘learns a lesson’ from his injuries and stops sleepwalking. It does not work, the activities are sub-conscious and he will have no recollection of them the following day.

What to do

Make your home environment safe. Children who sleep walk should never sleep on top bunkers in a double bed. Close all windows and doors at night.

Keep car keys away from sleepwalkers who carry out complex activities such as driving. Keep all guns and weapons safely stored away. Place gates on any stairs in the home.

Establish a regular sleep pattern and stick to it. Avoid sleeping in noisy environments or in the presence of stimuli that could interrupt sleep (e.g. sleeping with the television on). The bedroom should be comfortable and quiet.

Deal with any anxiety or stress in your life/environment. Where necessary, seek professional help.

Avoid alcohol or any drugs that may be triggering to your nocturnal activities. Control any medical condition that may be contributing to sleep deprivation.

Treatment of sleepwalking

Medication: Use of certain anti-depressants and sedative-hypnotic drugs has been associated with reduced episodes of sleepwalking

Sleep relaxation techniques and hypnosis: these have been found to be a good and effective way of treating sleep walking in adults.

Hypnosis allows one to go into a deep state of relaxation. There are trained counsellors who can teach you how to achieve this state of mind.