The Truth About Sleepwalking

It's a familiar trope in cartoons and other crazy comedies from the early days of film and TV: the pajama-clad character, arms stretched out ahead of himself, sleepwalking through traffic or some other dangerous location. But is sleepwalking real, or just a useful plot device for a Popeye episode?

As it turns out, sleepwalking – or somnambulism – is not only real, but can be even more bizarre than anything Popeye ever experienced!

Sleepwalking is a member of the parasomnia family of disorders. Other members include night terrors, confusion arousals, and sleep paralysis. In general, parasomnia refers to any unwanted event that occurs during sleep.

Sleepwalking can only occur during the deepest, non-REM part of sleep. Since dreaming occurs only during REM, somnambulists are not acting out their dreams (sorry, Popeye!). What has happened is that something has triggered the brain out of deep sleep and into a transitional state between sleeping and waking. The mind is still asleep, but the body is awake, allowing for such complex behavior as eating, walking, and even conversation.

Fortunately incidents of injury during somnambulism are rare. Although sleepwalkers exhibit decreased awareness, most either return to their beds without incident, or end up falling back to “true” sleep somewhere else in the house. Note, however, that sleepwalkers have also been known to urinate in closets, drive cars and discharge firearms!

Somnambulism is an altered state of consciousness, and sleepwalkers usually have no recollection of their midnight adventures. Doctors currently do not know exactly how sleepwalking is brought on biologically, but they have recognized a few of the potential triggers: 

·         Sleep deprivation

·         Alcohol

·         Fever or illness

·         Menstrual cycle or pregnancy

·         Extreme exercise or fatigue

·         Environmental stimuli

·         A full bladder

·         Sleeping in strange surroundings

·         Emotional or situational stress

·         Childhood separation anxiety

·         Medications including phenothiazines, chloral hydrate, zolpidem and lithium.

Your doctor may prescribe a polysomnography, or “sleep study,” to help her understand the nature of your somnambulism. An electroencephalogram (EEG) may also be ordered to determine if the sleepwalking could be a type of seizure. EEG abnormalities have been reported in up to 47 percent of patients with parasomnias.

There is no cure, per se, for somnambulism. Fortunately, sleep quality is generally unaffected by sleepwalking, so as long as the somnambulist takes proper care to “sleepwalk-proof” his house, he can live out his (double) life without issue.

Examples of sleepwalk-proofing may include:

·         Locking windows and doors leading outside

·         Placing mattresses directly on the floor or using a sleeping bag

·         Keeping the sleeping area uncluttered and removing dangerous objects from the bedroom, including mirrors and floor obstructions

·         Keeping firearms or other weapons locked and out of reach

·         Using padding on nearby furniture and the floor beside the bed

·         Using a bedroom on the ground floor in a multilevel home

·         Installing a bedroom door alarm

·         Equipping the top of the stairs with a barrier or toddler gate.

If you feel the need to get a better grip on your somnambulism, certain medications have been used to control symptoms. These include lorazepam, clonazepam, amitriptyline or trazodone.