Sleepwalking

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Causes

Sleepwalkers often have a strong family history of sleepwalking. Furthermore, sleepwalking may be triggered by fever, which directly affects the nervous system; general illness; alcohol; sleep deprivation; and emotional stress. The hormonal changes that take place during puberty, pregnancy, and menstruation can precipitate sleepwalking as well. It seems that when the body is enduring physiological or psychological stress, sleepwalking is more likely to occur, perhaps coinciding with the body's inability to rest.

There is also a higher incidence of psychiatric disorders in adults who sleepwalk than in the general public. This is not to say that sleepwalking is a psychiatric disorder; more research is needed to document the concurrence of sleepwalking and mental illness. Medications that have been shown to precipitate sleepwalking include benzodiazepines (antianxiety or sleep-inducing drugs), antiseizure medications, stimulants, antihistamines, and antiarrhythmics drugs.

Are All Sleepwalking Episodes Similar?
Most sleepwalkers become active during delta sleep, or slow-wave sleep, which occurs more frequently during the beginning of the sleep cycle. A person will get up and walk around and then fall into a light stage of sleep. After waking, most people cannot recollect even the conversations they may have had with others during deep delta sleep, though they may have appeared to be somewhat cognizant. Sleepwalkers usually appear placid to those who observe them. For many others, it is common to be awakened by a bed partner, roommate, or family member. Sleepwalking, like other sleep conditions often affects others.

Many sleepwalkers have the unique experience of waking up during their travels. They often describe a dream that they were actually acting out in sleep, i.e. opening a door, dancing, or getting dressed.

Episodes usually last from one to five minutes, but may last as long as one hour. Behavior can range from simply sitting at the end of the bed, to leaving the room or going outside, to getting in the car. Studies have shown that more docile episodes are usually shorter. The following, more complex activities have been documented in personal accounts of sleepwalking:

• Drawing knives from kitchen drawers
• Walking outside, in the yard or street
• Physical and verbal attack of others
• Cooking and eating food
• Getting into automobiles
• Using the telephone
• Moving furniture
• Washing clothes
• Feeding pets
• Dressing
• Bathing

Night terrors, also associated with sleepwalking, are episodes of confused arousal in which people experience extreme fright and violence. During night terrors, they might scream and flail. Like sleepwalking, night terrors, also called sleep terrors, are often governed by dreams.

The extent to which sleepwalking interferes with normal, daily life varies. It typically does not present complications for those who go back to sleep without waking up. It is possible for sleepwalkers to continue sleeping in a new location and to have a fairly peaceful night's sleep. In fact, family members and bed partners often complain more about the effects of sleepwalking than do the sleepwalkers themselves.

People who frequently sleepwalk complain of fatigue, decreased awareness, and unrest during the day. Frequent sleepwalk may be defined as only once or twice a month or less, so the fatigue and dysfunction that some sleepwalkers experience may be a result of something else. Once or twice a month may sound infrequent to those who do not sleepwalk, but it is difficult to comprehend the effects of chronic sleepwalking for those who do not experience it.

Safety

The primary concern for sleepwalkers is safety. Although rare, some sleepwalkers injure themselves while moving around and handling objects. Even less frequently, sleepwalkers injure others who purposely or inadvertently interact with them. Rarely is a sleepwalker violent. If a sleepwalker becomes violent, it is usually because his or her path or intent has been obstructed. Many sleepwalkers claim to be acting out their dreams. If a bystander somehow interferes, the sleepwalker may become irritated, and so he or she may act to eliminate the obstacle. This usually happens when a sleep partner or family member attempts to wake a sleepwalker, which results in the sleepwalker becoming disoriented. Sometimes an individual can become quite agitated during sleepwalking without external intervention. Violent or aggressive behavior may result from the dream scenarios that govern many sleepwalking episodes.

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