Sleepwalking, formally known as somnambulism, is a common sleep disorder that can be startling for anyone who witnesses it. This phenomenon involves a person getting up and performing activities while remaining in a state of sleep. For bystanders, the sudden appearance of a loved one wandering around the house creates an immediate dilemma: how should one react to ensure their safety? Understanding the nature of this unique state of consciousness is helpful in determining the safest course of action.
Understanding Sleepwalking Behavior
Sleepwalking is classified as a parasomnia, a disorder of arousal that occurs during the deepest stage of non-rapid eye movement (NREM) sleep, specifically the N3 or slow-wave sleep stage. This stage predominates in the first third of the night. During this time, the brain fails to transition cleanly between sleep and wakefulness, resulting in a state of partial arousal where the motor centers are active but higher cognitive functions remain asleep. A sleepwalker’s eyes are typically open, but they often have a characteristic glazed or vacant expression, showing a limited awareness of their surroundings. Because the episode originates from deep sleep, the sleepwalker is generally unresponsive to attempts at communication and will have little or no memory of the event upon waking.
The Immediate Answer: Waking a Sleepwalker
The long-standing cultural belief that waking a sleepwalker can cause a heart attack or brain damage is not supported by medical evidence. However, experts generally advise against abruptly rousing a sleepwalker because of the behavioral risk it poses. A sudden, forceful awakening pulls the individual directly out of deep NREM sleep, triggering an intense state of confusion and disorientation.
This immediate shock can induce extreme fear, anxiety, or panic in the sleepwalker. The person may become temporarily agitated, confused, or even lash out physically in a defensive reaction to being startled. The primary danger in waking a sleepwalker is the possibility of them injuring themselves or the bystander while they are in this confused, fight-or-flight state. The safest approach prioritizes the sleepwalker’s safety and emotional state by avoiding a sudden shock to the system.
Safe Intervention and Guidance Techniques
The most effective strategy when encountering a sleepwalker is to intervene gently, guiding them back to bed without causing a full, abrupt awakening. Approach the person calmly and slowly, using simple, quiet verbal cues to redirect their movements. Phrases like “Come with me” or “Let’s go back to bed” are often effective because they do not require complex processing from the partially aroused mind.
It is important to position yourself between the sleepwalker and any immediate hazards, such as staircases, windows, or exterior doors. If gentle guidance is unsuccessful, the safest action is to closely monitor the individual until the episode resolves itself, which typically occurs within a few minutes.
Environmental safety measures are also important for management:
- Locking windows and doors.
- Installing gates across stairways.
- Removing sharp or fragile objects from the sleeping area.
Taking anticipatory steps to prevent episodes can also be effective, especially if sleepwalking occurs at a consistent time each night. This technique involves gently waking the person 15 to 30 minutes before the usual time of the episode, which alters the sleep cycle and may prevent the somnambulism from initiating. Ensuring adequate sleep hygiene and minimizing stress are foundational measures, as fatigue and sleep deprivation are common triggers for these arousal disorders.
When Sleepwalking Requires Professional Attention
While occasional sleepwalking is not typically a serious concern, certain circumstances suggest the need for consultation with a healthcare provider or a sleep specialist. A medical evaluation is warranted if episodes occur frequently, such as more than once or twice a week, happen multiple times in one night, or result in injury or potentially dangerous actions like driving or leaving the house. The onset of sleepwalking in adulthood, particularly if there is no previous history, is another reason to seek a diagnosis. Adult-onset somnambulism may be related to an underlying medical condition, the use of certain medications, or other sleep disorders, such as obstructive sleep apnea. If the sleepwalking involves aggressive movements, thrashing, or other violent behaviors, a specialist can rule out other parasomnias, like REM sleep behavior disorder.