Imagine it: you’re watching your favorite spooky movie late at night. It’s autumn and the wind rattles your windows, whistling through the cracks and crannies of your home. You feel the hair on the back of your neck stand straight up, and there it is: a shadowy figure stumbling toward you, feet shuffling, face shrouded with hair, head bent and lolling. You begin to scream, but you stop just in time. It’s just your daughter, and she’s wandering around in quite an unconscious state.

Sleepwalking, or somnambulism, covers a range of nighttime movement and activity, but the activity most known of and shown in television shows and films is the thrilling mystery of a person standing up and walking in their sleep. But what causes this parasomnia, and how can it manifest?

Why Does it Happen?

Sleepwalking is a disorder defined as a parasomnia, and it typically occurs during N3 sleep: the deepest stage of non-rapid eye movement sleep, or NREM sleep. This is also the state in which night terrors can occur, a parasomnia that often goes hand-in-hand with sleepwalking. NREM sleep happens in the first couple of hours of sleeping, and is unlikely to occur during naps.

There are a few factors that can contribute to sleepwalking, not the least of which are genetics and age. If one or both parents have a history of the disorder, it’s likely their children will adopt the trait. Sleepwalking is more prevalent in children than adults, so when it is seen in adulthood it is possibly related to other underlying conditions.

If your child is not genetically predisposed to the disorder, there are other things that can cause a temporary uptick in the behavior. Sleep deprivation, stress, fever, full bladder, a new medication, or interruptions in schedule can lend to such responses, disrupting the NREM cycle.

Facts, Figures, and Data:

• Sleepwalking is prevalent between an estimated 1% to 15% of the general population, though in children under 7 it can be as high as 17%
• The persistence of sleepwalking in adulthood is common
• Triggers for sleepwalking in adults include sleep deprivation, depressants (like alcohol), medication, febrile illnesses, and sedative agents
• Sleepwalking occurs much higher in children ages 3-7
• There are higher instances of children who sleepwalk as well as have sleep apnea or experience bed-wetting
• Sleep or night terrors are a closely-related disorder and tend to run in families

Sleepwalking in Adults

Though sleepwalking can be triggered by similar things in both children and adults, it can manifest quite differently for adults, and with higher risk factors. Adults who have experienced sleepwalking have reported:

• Going about mundane activities like getting dressed, talking, or eating
• Engaging in sexual activity without awareness, sometimes with strangers
• Driving a car
• Leaving the house
• Jumping out of a window
• Becoming violent without awareness, sometimes with a spouse
• Falling down the stairs
• Screaming
• Urinating in undesignated areas

Though some of this behavior can be self-harming, like getting in an automobile accident, receiving bodily injury, or having unexpected weight-gain, some of the results can influence others, such as unprovoked violence or having relations with someone other than a partner. Understanding the underlying causes can be imperative in understanding—and hopefully, preventing—such high-risk experiences.

Causes of sleepwalking in adults can include:

• Sleep-disordered breathing
• Narcolepsy
• Migraines
• Hyperthyroidism
• Restless leg syndrome
• Head injuries
• Stroke
• Alcohol abuse
• Antihistamines or stimulants
• Stress
• Noise or light
• Gastroesophageal reflux disease

Trying to zero in on the cause of your sleep disorder can be the first step to help remedy the situation.

Can We Fix It?

The short answer is possibly. Sleepwalking is such a broad and nebulous phenomenon that it’s often difficult to identify the underlying cause, let alone find a permanent solution. Cases vary from person to person, but there are measures you can take to try and find restful, uninterrupted slumber.

Design a routine. For both children and adults with sleep disorders, routine is key. As children, our parents often put us to bed with methods like reading stories or singing songs, but we often lose the practice as adults. Sending signals to your brain that it’s bedtime can be wonderfully helpful in getting to sleep and staying asleep. Children should adopt regular bedtimes and participate in a routine of their own, such as a warm bath and bedtime stories, that aid in winding down. Children should also have regular naptimes, but adults who sleepwalk may want to avoid naps.

Create an environment. Our sleep spaces can contribute a great deal to our patterns. Sometimes sleeping in a strange place can’t be helped, but our own spaces can be arranged to promote healthful sleep. Block outside lights with room-darkening curtains, maintain a 65-degree temperature, and if necessary, utilize a noise machine or ear plugs. Humidifiers with soothing scents like chamomile offer aid to those with breathing disorders like sleep apnea.

Be careful with beverages and other substances. A full bladder can play a huge part in NREM disruption, so be careful about liquid intake close to bedtime. Adults should avoid alcohol, nicotine, or caffeine near bedtime, as both can affect sleep patterns. Sugar is of course a sleep-disrupter, so it should be avoided as well. Make sure your child goes to the bathroom before bed and doesn’t drink too much water an hour or so before their nightly routine.

Consider Household Safety

Nighttime wanderers, like their scary movie counterparts, could potentially do harm to themselves or others. Taking some safety precautions with a sleepwalker in the house can only be a good thing.

• Keep dangerous things out of reach. This can include sharp objects, the car keys, or even guns. Tuck things away and keep them up high.
• Make sure the hallways are clutter-free so your sleepwalker doesn’t stumble.
• Block off stairways. Baby gates aren’t only for babies and pets. They can keep your zombie-husband from taking a dangerous tumble in the dark.
• Lock and bolt those windows and doors.
• If possible, don’t wake them! Not only can it seem impossible, but it can be dangerous to wake a sleepwalker as they could attack you in their dreaming state. Just gently guide the sleepwalker back to bed with soft words and a gentle hand, and the episode should hopefully pass. Words of encouragement and assurance can help in soothing even unconscious people.

When Do I Need to Worry?

In many people, sleepwalking is likely a result of disruption and does not have an underlying emotional influence. A large majority of children grow out of sleepwalking as they reach adolescence. Reasons to contact a sleep specialist include frequent, severe, or potentially injurious episodes or the events lasting beyond the teenage years. You may also want to reach out to a doctor if psychological factors seem to play into the disorder or if you suspect epilepsy or another seizure disorder.

Our sleep specialist here at Alaska Sleep Clinic have seen and heard it all – even zombie-like sleepwalkers eerily wandering through the house at night. If you live in the Anchorage, Alaska area, be sure to call today for a free 10-minute consultation.