Sleepwalking

Sleepwalking (somnambulism) is a disruption of normal sleep where the sleeper gets up and walks around while still asleep.

Sleepwalking may affect up to 15% of the population and is more common in children aged between four and eight years old. 

Children normally grow out of sleepwalking once they reach their teens. Sleepwalking in adults tends to be more frequent and can last for longer periods.

If you or a family member occasionally sleepwalks it’s usually nothing to worry about. But, if it happens regularly, it can be a sign of an underlying sleep issue that may need specialist help.

What causes sleepwalking?

Sleepwalking is an undesirable sleep behaviour (parasomnia) that occurs when we are in the non rapid eye movement (NREM) phase of sleep.

There are several underlying factors that may cause sleepwalking:

• Genetic – where sleepwalking can run in families 
• Sleep deprivation
• Jet lag
• Alcohol or drug abuse
• Stress 
• Epilepsy or anti-psychosis medications
• Antihistamine medications
• Pregnancy and menstruation, which can increase the risk of sleepwalking in some women

Sleepwalking usually happens within the first couple of hours of falling asleep. 

If you’re sleepwalking you may:

• Walk around for several minutes or longer
• Have open eyes and a glazed expression
• Not respond to questions or speak
• Not wake easily from your sleep
• Have night terrors while you sleepwalk
• Have no memory of sleepwalking once you are awake
• Display confusion once you’re awake
• Feel tired the following day due to distrubed sleep

As you sleepwalk you may start doing routine activities, such as getting dressed and eating. 

Rarely, you may try to leave the house and get in your car.  

Some sleepwalkers can put themselves in danger by doing things like trying to get out of a window or lighting a fire. 

They can become aggressive or may try to engage in sexual activity.

Sleepwalking in children isn’t usually serious and they normally grow out of it once they reach their teens. 

If you have a child who sleepwalks it can be a worry because there is a chance they could harm themselves while they’re asleep. 

The main danger is if they fall over, bang into things, or open a door to the outside. 

If your child sleepwalks, remove any potentially dangerous objects from their room and make sure they are unable to leave the house when they sleepwalk.

There are a few other tips you can follow to help your child sleep better including:

• Ensure they have good sleep habits
• Set up regular bedtime and waking times
• Don’t allow TV or screens in bed
• Ensure they get plenty of exercise and sunshine
• Ensure they have a good diet which can help with sleep 
• Try to manage any stress in your child’s life such as problems with schoolwork or homelife

Speak to your doctor or specialist as they may be able to offer advice or refer your child to a sleep clinic.

Sleepwalking and the sleep cycle

When we go to sleep we enter into a sleep cycle which has two main phases: 

• Non-rapid eye movement (NREM) phase
• Rapid eye movement (REM) phase

The NREM sleep phase subdivides into four stages, N1–N4 which you pass through before entering REM sleep. 

In most people the cycle of N1-N4 sleep plus REM sleep lasts about sixty to ninety minutes, so it’s common to go through about five sleep cycles each night.

If you sleepwalk it will normally happen in the first or second sleep cycle and within that cycle it tends to happen within the N3 or N4 stages when you are deeply asleep.

Sometimes underlying conditions can trigger sleepwalking including: 

• Abnormal heart rhythms (arrhythmias) 
• Asthma
• Fever
• Gastroesophageal reflux (GORD)
• Narcolepsy
• Panic attacks
• Post traumatic stress disorder (PTSD)
• Sleep apnoea (difficulty breathing while asleep)

There are also medical conditions and habits associated with sleepwalking including: 

• Narcolepsy – falling asleep during the day but having difficulty sleeping at night. Narcoleptics can ‘sleepwalk’ while catnapping
• Automatism – which is unconsciously performing routine activities over and over again. It occurs in sleepwalking and may also occur in narcolepsy and in some forms of epileptic fit
• Night terrors – can cause extreme fear and physical symptoms such as a very rapid pulse rate, sweating, screaming and thrashing. Like sleepwalking  a night terror tends to occur in the NREM stages of sleep
• Sleep-talking – this often occurs with sleepwalking but can also occur on its own
• Nocturnal enuresis – bed-wetting is common in children who sleepwalk

At The London Clinic we have a dedicated sleep clinic and different treatment options for sleepwalking and other sleep disorders.

Private patients can choose from three study packages which are run in collaboration with Sleep & Health Clinic Ltd:

• Sleep study with real-time attendance and an overnight multiple sleep latency test (MSLT)
• Sleep study with subsequent reporting and analysis
• Home outpatient sleep study

All of our packages include the Sleep & Health Clinic study fees.

One of our renowned sleep specialists will treat you for your sleepwalking and any underlying issues that may be contributing to episodes of disrupted sleep.