Note: Originally written for tiny medicine. Click on the link below to watch the animated version of this blog post
Sleepwalking or somnambulism is when a person acts out activities in their sleep. These activities can range from simple activities like walking and eating to complex activities like driving.
A normal sleep cycle consists of NREM sleep and REM sleep.
NREM sleep consists of 3 stages.
Stage 1 – Stage of falling asleep and drowsiness
Stage 2 – Stage of light sleep
Stage 3 – Stage of Deep sleep. This is the stage where the body repairs itself and releases hormones and therefore during this stage the brain is particularly resistant to awakening.
Stage 3 is followed by REM sleep. This is the stage in which dreaming occurs.
Sleep walking is a disorder of arousal that can be classified under the umbrella term parasomnia. It occurs due to partial awakening from stage 3 of NREM sleep. The sleepwalker is in a transient state between sleeping and wakefulness. Here the motor system becomes activated, but consciousness remains clouded. As consciousness is clouded sleepwalkers generally have no recollection of their actions upon waking. Contrary to popular belief sleepwalkers are not acting out their dreams when they are sleepwalking as dreaming occurs in REM sleep.
During a sleepwalking episode, a person generally has a glassy eyed expression which gives you the feeling that the person is looking right through you coupled with a blank look. Sleepwalking episodes can range from a few seconds to half an hour. Some people may go back to bed and sleep on their own or some like in my case may wake up confused while still out of bed.
Studies have revealed that people who sleepwalk have higher levels of excessive daytime sleepiness and insomnia symptoms. But it is not proven whether these symptoms are a result of sleepwalking or a result of an underlying factor affecting sleep that increases the risk for both sleepwalking and daytime drowsiness
A family history of sleep walking, stress, sleep deprivation, drugs such as antihistamines, stimulants and medical conditions like nighttime asthma, restless legs syndrome, nighttime seizures are said to cause sleepwalking.
On its own sleepwalking does not pose any real danger. But the injuries one can sustain when he/she trips, falls, or collides whilst sleepwalking can be dangerous. I dread to think of what would have happened that day if my head had not banged on the roof. I would probably not be alive today to tell the tale. Therefore, measures such as keeping doors and windows locked and keeping sharp and harmful objects locked away should be taken in order reduce safety risks.
Sleepwalking is generally easy to diagnose with the history and medical symptoms. However, a sleep study and EEG can be used to determine if any medical condition is causing a person to sleepwalk.
This condition is common in children especially between the ages of 5-12 years. Most grow out of it as they grow older. Probably explains why I have not had an episode of sleepwalking in the recent past.
Until it resolves spontaneously certain measures can be taken to prevent sleepwalking. Simple lifestyle changes like sticking to a sleep schedule, having a relaxing bedtime routine, and improving overall sleep hygiene generally helps. In addition, cognitive behavior therapy and anticipated awakening technique can be used. In sleepwalking secondary to certain medical conditions treating the underlying cause should do the trick. Finally, when other treatments have failed medicines like benzodiazepines and antidepressants can be prescribed.