Sleepwalking, formally known as somnambulism, is a type of parasomnia that occurs when a person is in a state of partial arousal from deep sleep. This deep sleep phase is part of non-rapid eye movement (NREM) sleep, specifically stage N3, and typically happens during the first few hours after falling asleep. A sleepwalker may perform complex behaviors like walking, talking, or engaging in routine activities while remaining largely unconscious and unresponsive to external stimuli. There is a widely held belief that waking a sleepwalker can cause severe physical harm, such as a heart attack or stroke. This myth is not supported by scientific evidence, though abruptly waking someone can lead to other consequences.
The Reality of Waking a Sleepwalker
Waking a sleepwalker does not pose a physical danger to their heart or brain, and the common myths suggesting otherwise are false. The actual risk associated with abrupt waking is psychological and behavioral, stemming from the sudden transition from a deep, dissociated sleep state. When a person is abruptly awakened, they are likely to experience intense confusion and disorientation. This state of cognitive impairment, sometimes called sleep inertia, can last up to 30 minutes.
The sudden shock of being awake in an unfamiliar location can trigger fear and anxiety. Because the sleepwalker’s brain has not fully transitioned to wakefulness, they may react defensively or unpredictably to the person who woke them. This agitation is a stress response, not an intentional attack, and it makes the sleepwalker clumsy and prone to injury. The primary danger is the risk of the sleepwalker injuring themselves or others due to their startled and disoriented state.
Safe Strategies for Guiding Sleepwalkers
Since abrupt waking can cause confusion and agitation, the recommended approach is to gently guide the person back to bed without fully rousing them. If you encounter a sleepwalker, remain calm and approach them slowly to avoid startling them. Use a soft, quiet voice to speak their name or offer simple, reassuring instructions, as loud noises or sudden movements can trigger a stress response.
Gently take their arm and steer them toward their bedroom, using minimal physical contact. Before an episode occurs, clear pathways of clutter and ensure the environment is secure by locking windows and doors to prevent outdoor wandering or falls. If the sleepwalker is in immediate physical peril and guiding them is impossible, a gentle but firm verbal awakening is preferable to letting them continue into a dangerous situation.
Common Triggers and Prevention
Sleepwalking episodes often occur due to underlying factors that disrupt the stability of the sleep cycle. Common triggers include severe sleep deprivation or an irregular sleep schedule. Conditions that increase arousals from sleep, such as high levels of stress, anxiety, or fever, particularly in children, can also precipitate an episode.
Certain substances and medications are known to increase the likelihood of sleepwalking, including alcohol and some sedative-hypnotics or antidepressants. Management involves improving sleep hygiene, which means maintaining a consistent bedtime and wake-up time. For frequent episodes or those posing a significant risk, safety measures such as installing safety gates or door alarms can provide early detection and help prevent serious accidents.