Sleepwalking, formally known as somnambulism, is a sleep disorder where a person gets up and performs activities while remaining in a state of low consciousness. This behavior is classified as a parasomnia, an undesirable event that occurs during sleep. Sleepwalking typically happens during the deepest stage of non-rapid eye movement (NREM) sleep, usually within the first few hours after falling asleep. Since the sleepwalker is not fully aware of their surroundings, the main concern for anyone witnessing an episode is how to react without causing injury to the person. Clear guidelines exist to ensure the individual’s safety during the event.
The Immediate Response: To Wake or Not to Wake
Abrupt or forceful awakening of a sleepwalker is generally discouraged by sleep experts. The primary objective is to ensure the sleepwalker’s immediate physical safety, rather than interrupting the episode. While the old myth that waking a sleepwalker can cause a heart attack or brain damage is untrue, the risk lies in the person’s reaction to being startled. The priority is to gently intervene and guide the individual away from danger.
The person is in a state where parts of the brain controlling motor function are active, but areas responsible for full awareness are still asleep. Because of this mixed state of partial arousal, the individual is not fully conscious and will likely not respond to normal communication. The goal is to facilitate a smooth return to the safety of their bed without causing sudden confusion or fear.
Understanding the Risks of Abrupt Awakening
Waking someone from deep NREM sleep can trigger a severe state of disorientation because their mind is suddenly pulled from a profound rest state. This sudden shift can result in extreme confusion, as the sleepwalker has no immediate context for where they are or why someone is intervening. The sense of surprise can activate the body’s innate fight-or-flight response.
Due to this startled reaction, the sleepwalker may lash out defensively, not recognizing the person trying to help them. This potential for agitation or defensive aggression is the practical reason why forceful awakening is considered risky. Attempting to shake or physically restrain them increases the likelihood of the sleepwalker falling, stumbling, or otherwise injuring themselves or the person intervening.
Techniques for Safe Redirection
The best strategy involves gentle, calm redirection back to a safe space. Approach the sleepwalker slowly and avoid sudden movements or loud noises that could startle them into a defensive reaction. Speak to them in a soft, low, and reassuring voice, perhaps calling their name gently to try and establish a minimal level of awareness.
If they are moving toward a dangerous area, place yourself between the sleepwalker and the hazard, such as a flight of stairs or an exterior door. You can gently take their hand or lightly touch their arm to steer them back toward their bedroom. The key is to be patient and avoid physical restraint unless it is absolutely necessary to prevent immediate injury, such as a fall.
Securing the Sleepwalker’s Environment
For individuals who sleepwalk frequently, long-term safety involves modifying the home environment to minimize risks during an episode. Several proactive measures should be taken to secure the home:
- Install childproof locks, high deadbolts, or alarms on all exterior doors and windows to prevent the sleepwalker from exiting the house unnoticed.
- Place safety gates at the top of any stairways to prevent dangerous falls.
- Remove clutter, electrical cords, and loose rugs from the floor in bedrooms and hallways to eliminate tripping hazards.
- Use soft nightlights along the paths the sleepwalker is most likely to take, as this low-level illumination can help guide them.
- Keep sharp or breakable objects out of reach.