Sleepwalking: The Ultimate Guide (2021)

Why Do People Sleepwalk? Causes, Symptoms & Dangers

Do you sleepwalk or know of someone who does? If so, you’re certainly not alone. Most people have done something a little out of the ordinary while sleeping at some point in their life – sleeptalking, flinching, and snoring are common occurrences for many.

However, sleepwalking can be a little more serious and is something that affects around 3.6% of adults in the US. It more commonly affects children, though, with most growing out of it by their teen years.

So what causes someone to sleepwalk, is it dangerous, and can it be prevented? We’re going to answer all these questions and more throughout this article.

Table of contents

What is sleepwalking?

Sleepwalking, or somnambulism, is a disorder that causes individuals to get up and walk around or perform other activities while sleeping. It’s part of a group of sleep disorders known as parasomnias, which can be identified by “abnormal, unpleasant motor verbal or behavioral events that occur during sleep or wake-to-sleep transitions.

Sleepwalking usually occurs around two hours after falling asleep, with most episodes lasting up to 10 minutes. However, they have been known to last anything from a few seconds to 30 minutes.


How to tell if someone is sleepwalking

While it may be called sleepwalking, people who sleepwalk don’t just get up and walk around during sleep; some may run or perform other activities, too.

Not sure how to tell if someone is sleepwalking? Here are some of the most common ‘symptoms’:

  • Eyes open with a glazed-over, glassy appearance
  • Blank, expressionless look on one’s face
  • Doesn’t respond or communicate with others
  • Gets out of bed and walks around
  • Sits up in bed and opens eyes
  • Performs routine activities such as getting dressed, eating, or attempting to drive a car
  • Engages in sexual activities while sleeping (also known as sexsomnia)
  • Engages in abnormal activities such as urinating in inappropriate places
  • Others have difficulty waking the individual during a sleepwalking episode
  • Appears disoriented after being awakened
  • May become violent after waking or during sleepwalking
  • No recollection of the sleepwalking episode the next day
  • Has difficulty functioning throughout the day due to disturbed sleep
  • May experience sleep terrors as well as sleepwalking episodes


What stage of sleep does sleepwalking occur?

Sleepwalking is a non-REM parasomnia, which occurs during stage 3 of the sleep cycle. Stage 3 sleep is our deepest sleep, lasting around 20-40 minutes. During this time, our bodies become less responsive to what’s going on around us, and it becomes harder for us to be awakened. Night terrors and bedwetting are also types of non-REM parasomnias that happen during this stage of sleep.

What causes sleepwalking?

While sleepwalking is often thought to follow a familial pattern, other factors come into play, too. Here are some of the main causes of sleepwalking.

Genetics

Scientific research suggests that sleepwalking may be genetic, with several generations in a family often experiencing sleepwalking episodes. One study found that 62% of children with two sleepwalking parents would also sleepwalk, approx. 47% of those with one sleepwalking parent would sleepwalk, and just 23% of children whose parents didn’t sleepwalk would develop the disorder.

Sleep deprivation

Not getting enough sleep is another cause of sleepwalking. This is thought to be because after a period of sleep deprivation, we usually spend more time in deep sleep (stage 3) to catch up.

Stress and anxiety

It’s widely known that stress and anxiety can affect our sleep, with many experiencing insomnia as a result of anxiety disorders or stressful life events. Research also shows that children who experience sleepwalking or sleep talking are more likely to present with anxiety. One study found that children with at least one episode of sleepwalking/talking in the last year were more likely to have an anxiety disorder. In an adult sleepwalking study, one of the triggering factors found to increase the severity and frequency of sleepwalking episodes was stressful events.

Alcohol

Alcohol use has been linked to sleep disturbances, including insomnia, sleep-disordered breathing, and sleepwalking. However, some research suggests there is not enough evidence to claim that alcohol triggers sleepwalking episodes.

Medications

Certain medications, especially those with a sedative effect, are thought to increase the chances of sleepwalking episodes occurring. One study found that a certain medication used to treat insomnia can cause sleepwalking episodes in some patients.

Fever

Have you ever noticed a rise in somnambulism when your sleepwalking family member or child is unwell? This could be because fever has also been linked to sleepwalking episodes – especially in children and adolescents.

Age

Sleepwalking is most commonly seen in children, with data suggesting 1 in 5 children will sleepwalk at least once. Yet, most will grow out of it when they reach puberty. The onset of sleepwalking among adults is often linked to an underlying health condition.

One study found that 29% of children aged 2-13 years experienced sleepwalking episodes, peaking between ages 10 and 13. It’s worth noting, however, that the percentage of sleepwalkers across all age groups is hard to measure because one of the symptoms of sleepwalking is not remembering the episode. People usually only find out that they sleepwalk when someone tells them.

Obstructive sleep apnea (OSA)

Obstructive sleep apnea (OSA) is a sleep disorder that causes the upper airway to become partially or fully blocked while sleeping. It’s a condition often associated with snoring and has also been linked to sleepwalking and other parasomnias. The chances of sleepwalking are significantly higher in individuals with severe OSA compared to mild OSA.

Restless leg syndrome (RLS)

Restless leg syndrome is a condition that causes uncomfortable sensations in the legs (usually in the evening or at night when resting), which can only be relieved by movement. The disorder causes nighttime arousals, during which individuals may experience sleepwalking episodes. Research shows that children with chronic parasomnias may also present RLS, and that treating RLS symptoms can improve the prevalence of parasomnias.

Gastroesophageal reflux disease (GERD)

Those who experience gastroesophageal reflux disease or acid reflux may also be at greater risk of sleepwalking, with studies showing a link between GERD and sleep disturbances.

Is it dangerous to wake someone who is sleepwalking?

Contrary to popular belief, it’s not necessarily dangerous to wake someone who is sleepwalking, and sometimes it’s the only way to keep a sleepwalker out of harm’s way.

Waking a sleepwalker won’t cause brain damage, despite the urban legend; however, it can cause short term stress, leading to a fight or flight response.

Upon waking, the sleepwalker may appear disoriented and confused (and, in some cases, violent) for a short period of time. They may also become stressed, angry, or anxious and could fall and hurt themself.

If you find someone sleepwalking, the best thing to do is gently guide them back to bed without waking them. This way, their sleep won’t be disturbed, and they won’t be at risk of harming themself.

If you must wake a sleepwalker, try to do so in a gentle way, rather than shaking them vigorously, for example.


The dangers of sleepwalking

If you live with a sleepwalker, you may find it funny relaying anecdotes of their activities the night before; however, sleepwalking can come with some dangers.

While occasional sleepwalking episodes are not generally anything to worry about, if sleepwalking becomes a regular occurrence, it could be a cause for concern – especially if the sleepwalking begins in adult life.

Injury

The most notable danger of sleepwalking is that the sleepwalker could get hurt during an episode – whether it be from tripping over, or something more serious, like falling down the stairs, trying to drive a car, or handling sharp objects. If you live with someone who sleepwalks, try to ensure they are safe during sleepwalking episodes.

Violent behavior

As mentioned above, sleepwalkers can become confused and lash out violently in the moments after waking. This is dangerous for those in close proximity to the sleepwalker, and also for the sleepwalker, as they may hit into something or fall and injure themself.

Daytime drowsiness and mental health concerns

Just like any kind of sleep disorder, if sleepwalking episodes happen regularly, it can begin to affect everyday life. One study found that adult sleepwalkers experienced a higher frequency of daytime sleepiness, fatigue, insomnia, and depressive and anxiety symptoms than those who did not sleepwalk.


How to stop sleepwalking

So, can you prevent sleepwalking, or is it something you just have to live with? 

If you or someone you know sleepwalks, there are some things that may help reduce the frequency of episodes. However, if your sleepwalking is a regular occurrence, we’d advise speaking to a doctor to rule out any underlying medical conditions or sleep disorders.

Practice good sleep hygiene

For many, implementing sleep hygiene practices, such as those mentioned below, can help prevent sleepwalking episodes.

  • Stick to a bedtime routine
  • Sleep in a dark, quiet room
  • Avoid caffeine before bedtime
  • Unwind before bedtime, for example, with a bath, or meditation
  • Minimize screen time before bed
  • Avoid alcohol

For more sleep hygiene tips, read our article about how to sleep through the night.

Treat underlying sleep disorders

In some instances, sleepwalking happens due to an underlying health condition or sleep disorder such as sleep apnea, restless leg syndrome, and gastroesophageal reflux disease. Certain medications can also induce sleepwalking. If you think your sleepwalking may be caused by an underlying health condition, be sure to make an appointment with your doctor.

Anticipatory awakening

If your child or someone you live with regularly sleepwalks at the same time, anticipatory awakening may help. This is where you gently wake the sleepwalker for a short time, 15 to 30 minutes before they usually sleepwalk. This will alter their sleep cycle, and they should fall asleep again with ease.

Psychotherapy

Studies have shown that types of psychotherapy, like cognitive behavioral therapy (CBT), can help reduce sleepwalking frequency and relieve sleepwalking-related symptoms. Hypnotherapy may also help.

Medication

If no other sleepwalking treatments work, and you’re a regular sleepwalker or your sleepwalking episodes cause a serious risk of injury, your doctor may be able to prescribe some medication. Certain medicines like benzodiazepines, antidepressants, and melatonin are sometimes used to minimize sleepwalking frequency and help patients sleep better.

Managing sleepwalking

If you are a sleepwalker, or live with someone who is, taking steps to prevent injury in the event of a sleepwalking episode occurring can be beneficial. Consider the following:

Remove obstacles

To prevent any trips or falls happening during a sleepwalking episode, take care to remove any tripping hazards like wires or toys before you go to bed.

Hide dangerous objects

Sharp objects, weapons, and car keys can all prove dangerous in the hands of a sleepwalker, so it’s best to store them away in a safe place.

Keep windows and doors locked

In some cases, sleepwalkers may try to exit the property during an episode, and in extreme circumstances, have been known to jump out of windows. To prevent such danger, ensure all windows and doors are locked at night. If the sleepwalker’s bedroom is on the first floor, installing a stair gate may also help.

Install window or door alarms

Another way to prevent injuries related to windows and doors is to install safety alarms, which will go off if the sleepwalker tries to open them. This will either wake the sleepwalker up or alert a member of the household of danger.

Keep a sleep diary

Keeping a sleep diary can help individuals keep track of sleepwalking episodes, and will prove helpful when it comes to getting a diagnosis. If you are a sleepwalker, it’s highly unlikely you’ll be able to remember any of your sleepwalking episodes; however, if you live with someone else, you can ask them to notify you of any events that occur.

Make note of things like:

  • How long after going to bed sleepwalking episodes occur
  • Whether the timing is consistent
  • Parasomnia behaviors that occur
  • How long episodes last
  • Bedtime routine
  • Quality of sleep
  • Alcohol intake
  • Medications taken


Speaking to your GP about sleepwalking

If your sleepwalking becomes chronic, starts to affect your daily life, causes significant sleep disruption, or if you are worried about the safety of someone who sleepwalks, we’d recommend seeking medical advice.

Your GP will likely ask the following questions before being able to advise further treatment, so it’s a good idea to keep a sleepwalking diary:

  • When did your sleepwalking begin?
  • Have you experienced sleepwalking in the past?
  • Does anyone in your family sleepwalk or have a sleep disorder?
  • Have you experienced any sleep apnea symptoms?
  • Have you experienced any daytime drowsiness?
  • What sleepwalking-related problems have you noticed?

To diagnose somnambulism, your doctor may do the following:

  • Physical exam to rule out other conditions
  • Discuss your symptoms
  • Polysomnography (nocturnal sleep study), which monitors your brain waves, the oxygen level in your blood, heart rate and breathing, and eye and leg movements while sleeping.

This concludes our comprehensive guide to sleepwalking – we hope you’ve found it helpful in understanding more about why we sleepwalk and how to stop sleepwalking.

Remember: if you sleepwalk on a regular basis and it’s begun to affect your daily life, please seek medical help.

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