Sleepwalking is a type of parasomnia, an abnormal behavior that occurs during sleep. This phenomenon involves getting up, walking around, or performing complex activities while the brain is not fully awake. It happens during the deepest stage of non-rapid eye movement (NREM) sleep, typically in the first third of the night. During an episode, the body is active but the mind is partially shut down. The central question is whether a sleepwalker should be woken up, or if a safer approach is recommended.
The Immediate Decision: To Wake or Not
The common notion that waking a sleepwalker could cause a heart attack or brain damage is a myth that lacks scientific basis. However, experts advise against sudden, forceful, or loud waking unless the sleepwalker is in immediate danger. This caution is due to the sleepwalker’s brain transitioning abruptly from a deep NREM state. A sudden jolt can trigger a stress response, causing the person to become confused, disoriented, or frightened. This confusion makes them unpredictable; they may lash out defensively or run away, increasing the risk of injury. The goal of intervention is gentle de-escalation, not sudden shock, as their cognitive abilities are temporarily impaired.
Safe Intervention: Guiding the Sleepwalker
Guiding the Individual
The safest course of action is to gently guide the sleepwalker back to their bed without fully waking them. Approach the person calmly and speak softly, using their name to steer them, but avoid grabbing or restraining them, as this can trigger a defensive reaction. If the person is unresponsive and moving toward danger, intervene physically with a light touch to guide them, prioritizing their safety and redirection. Most episodes are brief, often lasting less than ten minutes, and the individual will return to sleep if left undisturbed.
Proactive Safety Measures
In households where sleepwalking occurs, proactive safety measures should be implemented to minimize risk. This includes installing safety gates at the top of staircases and ensuring all windows and exterior doors are locked. Removing potential hazards from the floor, such as clutter or sharp objects, also helps create a safe environment.
Triggers and Causes of Sleepwalking
Sleepwalking is classified as a disorder of arousal, meaning a partial awakening occurs during deep sleep. While the exact cause is not fully understood, there is a strong genetic component. Prevalence is much higher in children, often peaking between ages four and eight, and most outgrow the condition by their teenage years.
Several environmental and physiological factors can trigger an episode:
- Sleep deprivation and inconsistent sleep schedules.
- Emotional stress, anxiety, or fever.
- Use of certain medications, such as sedatives or some antidepressants.
- Pre-existing sleep disorders, like obstructive sleep apnea or restless legs syndrome.
When to Seek Medical Consultation
Occasional sleepwalking episodes that do not result in injury or significant distress usually do not require medical intervention. However, professional assessment by a healthcare provider or sleep specialist is warranted in several situations:
- Episodes occur frequently (several times a week or multiple times a night).
- Sleepwalking leads to self-injury or dangerous behavior, such as attempting to drive or leaving the house.
- The condition begins suddenly in adulthood.
- The individual exhibits aggressive or violent behavior during an episode.
A sleep specialist can perform tests to rule out other underlying sleep disorders.