What is sleepwalking?
Sleepwalking (also called somnambulism) is a behavior in which the child gets up during the night and walks or does other activities. The child usually does not remember getting up or being engaged in the activities.
Sleepwalking tends to occur during the first part of the night, usually within an hour or two of falling asleep.
Do I need to be concerned if my child sleepwalks?
No. Most children who sleepwalk do not have emotional or psychological problems. Childhood sleepwalking usually disappears on its own at the time of puberty, but may last longer. About 18% of people sleepwalk at some point in their life.
Symptoms and Causes
What are the causes of sleepwalking?
Causes of sleepwalking include:
- Hereditary (the condition may run in families).
- Lack of sleep or extreme fatigue.
- Interrupted sleep or unproductive sleep, from disorders like sleep apnea (brief pauses in the child's breathing pattern during sleep).
- Illness or fever.
- Certain medications, such as sleeping pills.
- Stress, anxiety.
- Going to bed with full bladder.
- Noises or touches.
- Changes in sleep environment or different sleep setting (example: a hotel).
- Head injuries.
What are the symptoms of sleepwalking?
In addition to getting out of bed and walking around, other symptoms exhibited by sleepwalkers include:
- Sitting up in bed and repeating movements, such as rubbing eyes or tugging on pajamas.
- Looking dazed (sleepwalkers' eyes are open but they do not see the same way they do when they are fully awake).
- Clumsy or awkward behavior.
- Not responding when spoken to, or responses may not make sense.
- Being difficult to wake up.
- Talking in their sleep.
- Urinating in undesirable places (for instance, a closet).
Management and Treatment
How is sleepwalking treated?
For children who sleepwalk more often, doctors may recommend a treatment called scheduled awakening. This treatment works as follows: for several nights, record the time between when your child falls asleep and the beginning of the sleepwalking event.
Then, for the next several nights in a row, rouse your child 15 minutes before the expected time of the sleepwalking event. You do not need to completely awaken the child -- simply disturb the sleep enough to cause a brief stirring. This momentarily interrupts the sleep cycle and may stop the sleepwalking in some cases.
Other ways to try to reduce your child’s sleepwalking include the following:
- Have your child relax at bedtime by listening to soft music.
- Establish regular nap and sleep schedules and stick with them. Naps are important in the younger child. This will eliminate sleep deprivation (a lack of sleep), a known trigger for sleepwalking.
- Cut back on the amount of liquids your child drinks in the evening and make sure he or she goes to the bathroom before bedtime (a full bladder may contribute to sleepwalking).
- Avoid caffeine near bedtime (caffeinated products include coffee, tea, colas, some non-cola pops, energy drinks, and chocolates).
- Make sure your child's bedroom is quiet, calm, comfortable, cool (less than 75° F) and dark.
If stress is thought to be contributing to the problem, your child may benefit from counseling, hypnosis or biofeedback. On rare occasions, doctors may prescribe a medication to help your child sleep.
Outlook / Prognosis
What should I do if my child sleepwalks?
If you find your child sleepwalking, gently guide him or her back to bed. Do not awaken him or her. Attempting to block, grab, restrain, or wake a sleep walker may result in violence. Instead, just steer your child back to bed while offering calm, reassuring statements, such as "you are safe, you are in your own bed."
If your child sleepwalks, preventing injury is the most important thing you can do:
- Keep dangerous objects out of your child’s reach.
- Close and lock windows and doors as appropriate. Latches or bolts on outer doors may need to be installed beyond your child’s reach.
- Consider installing heavy drapes to help prevent your child from climbing out a window.
- If necessary, have your child sleep on the ground floor of your home so that he or she doesn’t fall down stairs.
- Don’t let your child sleep in a bunk bed.
- Remove sharp objects from around your child’s bed and eliminate clutter from floors.
- Install safety gates outside your child’s room and at the top of stairs.
- Keep car keys out of reach.
- Remember gun safety.
- Turn down the set-point on your water heater to prevent scalding.
When should I call the doctor about my child’s sleepwalking?
Consider calling your doctor if any of the following occur:
- The episodes are frequent, severe or could injure your child.
- The sleepwalker gets repeatedly injured during events.
- The sleepwalker leaves the house.
- Sleepwalking occurs after the teenage years.
- Sleepwalking causes daytime sleepiness.
- Stress, anxiety, or other psychological factors appear to contribute to sleep disturbances.
- You think that there might be a medical cause for the sleepwalking, such as a seizure disorder, sleep apnea or a limb movement disorder. These may need to be investigated by a sleep study or an electroencephalogram (EEG), a test in which the electrical signals of the brain are recorded by electrodes placed on the scalp.
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