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 Sleep
walking is quite common. Medical reports show that about 18%
of the population are prone to sleep walking. It is more
common in children than in adolescents and adults. Boys are
more likely to sleepwalk than girls. There seems to be some
inherited component; children are more likely to sleep walk if
their parents did. If a child begins sleepwalking at the age
of 9, it often lasts into adulthood.
Sleepwalking is a series of complex behaviors that are
initiated during slow wave sleep and result in walking during
sleep. It usually happens in the first third of the night.
During a sleepwalking episode, the brain is half-awake and
half-asleep. Occasionally it can carry out simple tasks like
avoiding obstacles, but sleepwalkers can be confused. They may
fall down the stairs or mistake a window for a door. There are
stories of sleep walkers driving cars, boarding planes, going
swimming, and performing other complex actions. This is
unlikely. Sleepwalkers do not have the fast reflexes and the
comprehension needed for such complicated actions.
Symptoms:
Walking during sleep (typically in the first third of sleep
episode)
Difficulty in arousing the patient during an episode
Amnesia following an episode
Sleep study demonstrates the onset during deep sleep (stage
3 and 4)
Usually, children who sleepwalk are psychologically as
healthy as children who do not. However, medical and
psychiatric disorders can be present.
Children usually outgrow the problem as they get older
How serious is sleep walking?
Most patients experience sleep walking infrequently (less than
once per month) and those episodes do not result in harm to
the patients. Others experience episodes more frequently. In
its most severe form, the episodes occur almost nightly or are
associated with physical injury. Sleepwalking may cause
embarrassment, shame, guilt, anxiety and confusion to the
patient. If the sleepwalker exits the house, or is having
frequent episodes and injuries are occurring, it is time to
seek professional help. There have been some tragedies with
sleepwalkers; do not let it happen to your loved one.
Sleepwalking in adults is more worrisome. Extreme anxiety,
stress and occasionally epilepsy are possible causes.
Therefore, adults with this problem should seek medical help.
What can be done about sleep walking?
There are general advises to be told to the sleepwalker:
Tiredness can trigger sleepwalking, therefore, make sure you
get plenty of rest
Anxiety, tension and stress are other triggers for
sleepwalking, therefore, try to develop a calming ritual or do
relaxation exercises
Put away dangerous and sharp objects and car keys and
consider putting a bell on the bedroom door and a grill on the
windows
The sleepwalkers bedroom should be on the ground floor of
the house and he/she should not have a high bed (to avoid
falling)
If you have to spend some nights outside your house consider
the same precautions and notify the people you are staying
with (or the hotel receptionist) about your sleep problem
An accurate psychiatric and medical evaluation could help to
decide the need for psychiatric or medical intervention. The
patient should reassured about the benign nature of the
problem if the above precautions are applied
In severe cases, some medications can be used to reduce the
frequency of the episodes
Dr. Ahmed BaHammam
Director Sleep Disorders Center
King Khalid University Hospital
Associate Professor, College of Medicine, King Saud University
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