Sleepwalking: Causes, Prevention and Treatment

Sleepwalking (Somnambulism) is a disorder in which a person walks or engages in other activities while still asleep. Sleepwalking usually occurs during deep non-REM sleep (stage 3 or 4 sleep), but can also occur during light sleep. Sleepwalking is more common in children and teenagers than it does in adults. Most children usually outgrow sleepwalking after some time, but may continue to experience sleepwalking episodes into adulthood. About 18% of the population sleepwalks. Also boys are prone to sleepwalk more than girls.

The prevalence of sleepwalking is much higher for children, especially those between the ages of three and seven, and occurs more often in children with obstructive sleep apnea. There is also a higher instance of sleepwalking among children who wet the bed. Sleep terrors are a related disorder and both tend to run in families. The main concern with sleepwalking is injury during an episode either to the sleepwalker or in unusual case to someone else. There have been many sleepwalking episodes where the person not only does physical damage to themselves but also damage to property. The sleepwalker experiences a great deal of strength breaking doors off the hinges, jumping through windows, and showing an enormous amount of strength when being restrained.

Other unusual sleepwalking episodes include cleaning up, cooking and eating, running or some other activity. Depending on the sleepwalker sleepwalking episodes can happen infrequently or in more severe cases daily. Sleepwalking involves more than just walking while asleep. Some sleepwalkers may get dressed, drive, sleeptalk, scream (if accompanied by a sleep terror) or in a worse case attack the person trying to wake the sleepwalker. The sleepwalker may also be difficult to arouse during an episode, have eyes open during sleep, have blank facial expression, or sit up and appear awake while asleep. A sleepwalker may be confused, disoriented or have amnesia of the sleepwalking episode upon awakening.

Causes

The exact causes for sleepwalking are not known but some of the reasons could be due to anxiety, stress, fatigue, insomnia, prior sleep loss, mental disorders (in adults), reactions to drugs or alcohol, or organic brain syndrome (in elderly).

Prevention and Safety Measures

The main concern is preventing an injury while sleepwalking. Some safety measure to take into consideration are: making sure a sleepwalker only sleeps downstairs and that he cannot open windows, doors or have access to the keys of a vehicle. Making sure there is nothing for the sleepwalker to bump into or fall over as he sleepwalks is also important.
In a few cases sleepwalkers may exhibit violent behaviors such as hurting someone else while sleepwalking. In one extreme case a man from Arizona stabbed his wife 44 times and drowned her.

�· Avoid the use of alcohol or drugs if prone to sleep walking.
�· If you are in a state of fatigue get plenty of rest because this can trigger an episode of sleep walking.
�· If you are stressed or have anxiety, try relaxation exercises or meditation. Stress and anxiety can also trigger sleepwalking.
�· Maintaining a bedtime routine/ritual can be helpful.

Treatment

There is no particular treatment for sleepwalking but some methods have been helpful in reducing the amount of sleepwalking and of course some safety measures will be needed. Treatment methods include: hypnosis (for both children and adults), psychiatric intervention and medications such as- benzodiazepines, diazepam or lorazepam.