For some people, sleepwalking has devastating consequences. Here’s what you need to know.
By Annie Hayes
Sleepwalking, also known as somnambulism, causes you to get up and move around while you’re sleeping. Some people might just sit up in bed and look around, while others may walk around, get dressed for work, make a sandwich, or even initiate sex.
While sleepwalking is generally harmless, there have been instances when sleepwalking has had devastating consequences. People have jumped out of windows, driven their cars, and even committed murder – all without any recollection of doing so.
We speak to psychologist Şirin Atçeken, an EMDR therapist for WeCure, about the triggers, symptoms, and treatment tips for somnambulism – plus, the best thing to do if you come across someone who is sleepwalking:
What is sleepwalking?
Sleepwalking is a type of sleep disorder known as a parasomnia, which refers to ‘unusual behaviours that people experience before falling asleep, while asleep, or during the arousal period between sleep and wakefulness’, says Atçeken. Sleep paralysis is another example of a parasomnia.
Sleepwalking occurs in the very deepest part of non-rapid eye movement (NREM) sleep, a ‘slow wave’ sleep stage. People tend to engage in simple, repeat activities usually performed during a state of full consciousness, despite having ‘limited awareness and responsiveness to their environment,’ says Atçeken.
Sleepwalking people tend to engage in simple, repeat activities usually performed during a state of full consciousness.
Sleepwalking is far more common in children than in adults – it’s thought that one in five children will sleepwalk at least once – and most people grow out of it by the time they reach puberty. Only around one in 50 adults are thought to be sleepwalkers.
What does sleepwalking look like?
Sleepwalking tends to occur early in the night, within a few hours of falling asleep and typically lasts several minutes, but sometimes longer. Sleepwalkers usually have little or no memory of the incident and often find out about their nighttime wanderings from a housemate or family member.
Despite the name, sleepwalking is not just limited to walking. Like other parasomnias, sleepwalking occurs on the boundary of sleep and wakefulness. This means someone who is sleepwalking might do any of the following:
- Have a blank, glassy-eyed expression
- Get out of bed and walk around the house
- Sit up in bed and talk with their eyes open
- Be unresponsive or say things that don’t make sense
- Be disoriented or confused if woken up
- Experience sleep terrors at the same time
- Be exhausted during the daytime
‘A sleepwalking person might be observed sitting, changing or sorting clothes, walking around the house, opening drawers, drinking water, eating, talking – with very incoherent speech – and sometimes leaving the house,’ says Atçeken. ‘Unfortunately sleepwalking sometimes leads to injuries if the person loses balance or hits the furniture around at that semi-conscious state.’
Sometimes, sleepwalking can lead to unusual behaviours, such as eating cat food or urinating in a wardrobe. It can result in injury, if someone falls down stairs or walks out into the road. Some people may even find they become violent while sleepwalking or if they are woken up suddenly.
What is the cause of sleepwalking?
The exact cause of sleepwalking is unknown. ‘Sleep experts believe that sleepwalking occurs during deep sleep because of an unusual stimulus from the nervous system triggering the person to partially awaken,’ says Atçeken.
There also seems to be a genetic link. If members of your close family have experienced sleepwalking or other parasomnias, you’re more likely to do so too. Certain lifestyle factors and medical conditions can make a sleepwalking episode more likely. These include:
- Sleep deprivation or disruption
- Stress, burnout, and stressful life events
- Fever, especially in children
- Drinking too much alcohol or taking recreational drugs
- Taking certain types of medication, such as sedatives and hypnotics
- Brain injury, such as swelling of the brain
- Sleep breathing disorders, such as obstructive sleep apnea
- Other sleep disorders, such as restless leg syndrome
- Mental health conditions, such as depression and anxiety
- Underlying conditions, such as gastroesophageal reflux disease or seizures
In many cases, sleepwalking doesn’t require any treatment, because episodes are so rare and pose little risk to the sleeper or those around them. However, if they occur frequently, become dangerous, or start to interfere with your everyday functioning, you should see a doctor. They can help you pinpoint the cause and recommend treatments to try.
What are the dangers of sleepwalking?
Sleepwalking can have serious health consequences – not just during the episode, but afterwards too. ‘Sleepwalking people can harm themselves, since they are not aware of their surroundings,’ says Atçeken. ‘Accidents and injuries can happen while people are sleepwalking. It can also cause sleep deprivation and daytime drowsiness, decreasing the person’s functionality, performance and making them feel more tired during the day.’
Sleepwalking can have serious health consequences – not just during the episode, but afterwards too.
Some people may do things while sleepwalking that they would never dream of doing in real life. This can cause embarrassment – for example, if they email a work colleague, scream at a neighbour, or engage in sexually explicit behaviour – and even land them in trouble with the law, if they commit a crime, become violent, or endanger someone’s life.
Is it safe to wake someone sleepwalking?
You shouldn’t wake a sleepwalking person unless it’s absolutely necessary. ‘Sleepwalking people have very limited responsiveness to other people trying to intervene and they don’t have memory or remembrance of what happened,’ says Atçeken. Waking them can cause confusion, anger and fear.
If you need to move them away from a potential danger, ‘try to be very gentle,’ says Atçeken. ‘Just observe and accompany them from a distance to prevent any potential harm. Direct them to bed with a soft tone of voice and a nice gentle touch if you need to.’
How is sleepwalking treated?
While it’s not possible to prevent sleepwalking entirely, they are steps you can take to make an episode less likely to occur. ‘Most sleepwalking episodes are resolved by time and don’t require active treatment,’ says Atçeken. Others might need to be treated by sleep expert doctors, she says, with extra cautionary steps taken. These might include:
✔️ Eliminate safety risks
The most important factor in managing sleepwalking is to remove potentially harmful environmental factors, says Atçeken. ‘Move sharp objects out of easy reach, close windows, lock the doors, install lights with motion sensors, use door alarms, and remove sharp edged furniture,’ she says.
✔️ Tackle the triggers
Working out what triggers your sleep disorder can help, including managing your day-to-day stress levels and seeking treatment for any underlying medical issues. ‘Get treatment for disorders like restless leg syndrome or obstructive sleep apnea that might increase the probability of sleepwalking,’ says Atçeken. ‘If you are using sedative medications that might also be contributing to sleepwalking, talk to your doctor to change the dosage or the medication.’
✔️ Work on sleep hygiene
Perfect your pre-bedtime routine to make sleep as inviting, comfortable and restful as possible. ‘Go to bed and wake up the same time every day and try to get enough sleep every night,’ says Atçeken. ‘Stop caffeine, other stimulants and alcohol around four or five hours before sleep. Participate in relaxing activities before going to bed like meditation, listening to soft music, and avoiding screens. Get a more comfortable mattress if you need to.’
✔️ Try anticipatory awakening
Since sleepwalking tends to occur within the first few hours of sleep at around the same time every night, setting an alarm 15 minutes before an episode might occur and staying awake for the typical time period might help you to bypass the partial awakening that leads to sleepwalking. ‘If there is a pattern of sleepwalking episodes, waking up just before it happens can also prevent it from happening,’ says Atçeken.
Certain medications such as benzodiazepines may help you fall asleep faster, stay asleep longer, and wake less frequently during the night. Your doctor may prescribe these if you’re at risk of injury while sleepwalking and other treatment options haven’t worked. However sleeping tablets are a temporary measure as people quickly build tolerance and dependence on them, so it’s not advisable to use them long-term.
In small-scale studies, both cognitive behavioural therapy (CBT) and hypnotherapy have been proven as effective treatments options for people who sleepwalk. Mental health professionals such as therapists and counsellors can share techniques to prevent stress-related sleepwalking episodes.