Sleepwalking, also known as somnambulism, is a non-rapid eye movement (NREM) sleep arousal disorder, as it generally occurs during non-REM stages of sleep. (Night terrors is the other mot common NREM sleep arousal disorder.) Along with the related disorder of sleep talking and other conditions, sleepwalking is classified as a parasomnia, or an abnormal behavior that occurs during sleep.
Sleepwalking typically involves an individual getting out of bed, walking around, and sometimes even performing complex tasks such as eating. The sleepwalking person does not remember the actions taken, and appears to be awake—for example, their eyes may be open—but they are not. Sleepwalking is most common in children between ages 6 and 12, although people of any age can experience it, and it sometimes runs in families.
In most cases, sleepwalking is harmless, but repeated occurrences, especially those that put the individual or their partners or loved ones at risk, or regularly disrupt others’ sleep, should be addressed with the help of a physician. Help should also be sought when sleepwalking involves more complex and potentially dangerous activities, such as exiting one’s home or driving a car.
Sleepwalking episodes mostly occur in the first third of the evening sleep cycle, during non-REM sleep; sometimes they can occur closer to the morning hours, as the person nears wakefulness. The sleepwalker really is asleep when he or she sits up, gets up, and walks about. Sometimes they will use the bathroom, get dressed, or move furniture or other objects, all the while remaining asleep. A sleepwalking episode typically lasts anywhere from just seconds to about 10 minutes, but can extend to 30 minutes or more.
Signs and symptoms of sleepwalking, as outlined by the DSM-5, include:
- A blank expression
- Sitting up during sleep
- Having eyes open; appearing to be awake
- Walking while asleep
- Activities such as using the bathroom, getting dressed, or driving a car
- Speaking gibberish
- Feeling disoriented upon awakening
- Not remembering the sleepwalking
For a diagnosis of an NREM sleep arousal disorders to be made, sleepwalking episodes must bring an individual clinically significant impairment or distress—or significantly disrupt the lives of members of their households. Episodes can cause acute embarrassment and disrupt romantic, familial, or social relationships. A clinician generally considers the disruptive effects of the episodes more than their frequency when determining a diagnosis or treatment path.
Not unless they are at imminent risk. While it may be disturbing for parents, sometimes intensely so, a child is neither aware of their behavior nor are they typically in any physical danger.
No, it is not usually harmful to wake the person, although may not respond to efforts by others to wake them or talk to them. If woken, they will likely feel disoriented but should quickly experience a full recovery of cognitive function and appropriate behavior. However, even though the episodes may be disconcerting to those living with a sleepwalker, if the person is not putting themselves or others at risk, there is no reason to wake them, and there have been occasional documented incidents of screaming or even violence associated with awoken sleepwalkers.
Injuries can occur, typically after losing balance or tripping, but it is not common. Sleepwalkers have been reported to drive cars or even motorcycles while fundamentally unconscious. On rare occasions, they can be violent, even committing murder. Some individuals have fallen out of buildings or seemed to die by suicide while sleepwalking, although that is extremely rare and the individual’s true state of mind is hard to confirm.
Yes. Sleep-related sexual behavior, or sexsomnia, is a less-common form of sleepwalking. People experiencing sexsomnia can masturbate, grope, fondle, or have intercourse while sleeping, without conscious awareness: The individual may have open eyes and speak or make noises, but they will otherwise appear glassy-eyed and/or nonresponsive, and will most likely not remember their actions when they wake. The prevalence of sexsomnia is unknown because so few people are aware they have it, but it is more common in males and it can have serious social and legal consequences.
Sleep talking is a similar parasomnia to sleepwalking, although unlike sleepwalking it can occur during either REM or non-REM sleep. Many people shave spoken in their sleep at least once, and it is believed to occur annually in about half of children and 5 percent of adults. A sleeping person may speak in full sentences, disconnected words, or complete gibberish. Sleep talking generally does not affect the speaker’s sleep quality, although, like sleepwalking, it may disturb their partners. Sleep talking may also be a symptom of another sleep disorder, such as night terrors. Children are more likely than adults to talk in their sleep, and the disorder appears to have a strong genetic component as it has been found to run in families.
Sleepwalking appears to have a strong genetic component. A family history may be present in up to 80 percent of those who sleepwalk, and if both parents have a history of sleepwalking, their children may be 60 percent likely to sleepwalk themselves.
For people prone to sleepwalking, several risk factors can increase the likelihood of episodes, including sedative use, fever, sleep deprivation, sleep schedule disruptions, exhaustion, and physical or emotional stress or anxiety.
Medical conditions such as partial complex seizures may be associated with sleepwalking, and the condition may also be a symptom of an organic brain dysfunction in elderly adults.
It’s fairly common, especially early in life; 10 to 30 percent of children have had at least one sleepwalking episode, and 2 to 3 percent of children sleepwalk often. The prevalence of occasional sleepwalking among adults is estimated at between 1 and 7 percent, but fewer than 1 percent of adults sleepwalk as regularly as once a month.
Sleepwalking occurs more often among girls than among boys, but is documented more often in adult males than in females. Eating during sleepwalking is more common among women.
Yes, but it’s rare, and when it occurs, clinicians should investigate potential causes such as sleep apnea, nocturnal seizures, or the side effects of medication.
There are no specific treatments for sleepwalking—most children will grow out of the disorder in time—but a visit to a physician is recommended for persistent episodes, and if anxiety, stress, or another co-occurring condition appears to be triggering the behavior, a mental health evaluation may be recommended, and in some cases a medical examination as well. A doctor may recommend short-acting tranquilizers to curtail episodes in some individuals.
Since serious disorders do not normally accompany sleepwalking, steps to improve sleep hygiene may be all that is needed to reduce occurrences, including being more mindful of alcohol consumption or depressants; getting sufficient sleep and avoiding exhaustion and fatigue; and limiting stress and anxiety. Experts also strongly advise taking steps to reduce the potential for injury, such as creating a sleep environment clear of obstacles by doing the following:
- Padding the floor around the bed with a mattress or pillows
- Padding corners of nearby furniture
- Window protection
- Removing dangerous objects, such as guns or sharp objects, from the bedroom area
- Locking doors and windows
- Sleeping in a separate room from the bed partner until symptoms are under control