A healthy living blog from Marshfield Clinic

Should you worry about sleepwalking?

Illustration: Stripped pajamas and bunny slippers - What you need to know about sleepwalking

Sleepwalkers are partially awake but not aware of what they’re doing.

Have you ever gotten ready for work or made a snack in the middle of the night and don’t remember doing it?

You may have been sleepwalking.

Occasional sleepwalking episodes may be embarrassing or frightening. If it happens often, it can reduce your quality of life and put you or your family in danger.

Partially awake, partially asleep

Sleepwalking, a complex set of behaviors, happens during slow wave sleep, or deep sleep, said Dr. Sharat Ahluwalia, a Marshfield Clinic neurologist and sleep medicine specialist.

“Functional MRI scans show increased activity in areas of the brain during deep sleep similar to activity seen in the awake state,” Ahluwalia said.

Sleepwalkers may sit up in bed and open their eyes, talk, move around the house, do routine activities like getting dressed, or rarely, engage in violent or dangerous behavior. They are in an altered state of consciousness and not aware of what they’re doing.

What causes sleepwalking?

Doctors aren’t entirely sure what causes sleepwalking but genetics seem to play a role. You have a 45 percent chance of sleepwalking if one of your parents sleepwalks and a 60 percent chance if both do.

Certain situations and substances can trigger episodes, including:

  • Sleep deprivation. This is the most common trigger. Some people only sleepwalk when they don’t get enough sleep.
  • Stress.
  • Alcohol, drugs and certain medications, including Ambien, which is used to treat insomnia.

Sleepwalking is more common in children than adults. Most children stop but 2-4 percent continue as adults. About 15 percent of people who sleepwalk do so every night, half sleepwalk once a week and the rest do so occasionally.

See your doctor if you sleepwalk regularly or have ever done anything violent while sleepwalking. Sometimes other medical conditions, including dementia and epilepsy, can look like sleepwalking.

What’s the harm?

Sleepwalking can affect your ability to function.

“People who sleepwalk tend to feel tired during the day and have trouble falling asleep,” Ahluwalia said. “They report higher rates of depression and anxiety than the general population.”

It can be a safety risk for you and people you live with. Some sleepwalkers have fallen out of windows or down stairs, gotten hypothermia from walking outside in cold weather and unknowingly driven cars. Others have assaulted family members believing they were fighting off intruders.

A manageable disorder

Your doctor may recommend certain steps to help you stop sleepwalking and keep you safe if you do it:

  • Improve sleep habits. Go to bed and wake up at the same time every day and get enough sleep.
  • Improve safety in your home. Locks doors and windows. Remove or lock away dangerous items like weapons.
  • Practice stress management.
  • Get screened and treated for depression and anxiety if necessary.
  • Avoid trigger substances including alcohol and drugs. Your doctor may change your prescription if you take medications known to trigger sleepwalking.
  • Doctors sometimes prescribe low-dose benzodiazepines or antidepressants for treatment.

“There is no permanent cure for sleepwalking but it can be managed,” Ahluwalia said. “Help is available.”

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