What
is Sleepwalking (Somnambulism)?
Sleepwalking (Somnambulism)
is a series of complex behaviors that are initiated during slow wave sleep
and result in walking during sleep.
What are the symptoms of
Sleepwalking (Somnambulism)?
Ambulation (walking or moving
about) that occurs during sleep. The onset typically occurs in prepubertal
children.
Associated features include:
- difficulty in arousing the
patient during an episode
- can be triggered by a sleep related breathing problem.
- amnesia following an episode
- episodes typically occur in
the first third of the sleep episode
- polysomnographic monitoring
demonstrates the onset of an episode during stage 3 or 4 sleep
- other medical and psychiatric
disorders can be present but do not account for the symptom
- the ambulation is not due
to other sleep disorders such as REM sleep behavior disorder or sleep
terrors
How Common is Sleepwalking?
Medical reports show that about
18% of the population are prone to sleepwalking. It is more common
in children than in adolescents and adults. Boys are more likely to
sleepwalk than girls. The highest prevalence of sleepwalking was 16.7%
at age 11 to 12 years of age. Sleepwalking can have a genetic tendency. If
a child begins to sleepwalk at the age of 9, it often lasts into adulthood.
How serious is Sleepwalking?
For some, the episodes of sleepwalking
occur less than once per month and do not result in harm to the patient
or others. Others experience episodes more than once per month, but not
nightly, and do not result in harm to the patient or others. In its most
severe form, the episodes occur almost nightly or are associated with physical
injury. The sleepwalker may feel embarrassment, shame, guilt, anxiety
and confusion when they are told about their sleepwalking behavior.
If the sleepwalker exits the
house, or is having frequent episodes and injuries are occurring -- DO
NOT delay, it is time to seek professional help from a sleep
disorder center in your area. There have been some tragedies with sleepwalkers,
don't let it happen to your loved one!
What can be done about sleepwalking?
There are some things a sleepwalker
can do:
- Make sure you get plenty of
rest; being overtired can trigger a sleepwalking episode.
- Develop a calming bedtime
ritual. Some people meditate or do relaxation exercises; stress can
be another trigger for sleepwalking.
- Remove anything from the bedroom
that could be hazardous or harmful.
- The sleepwalker's bedroom
should be on the ground floor of the house. The possibility of the
patient opening windows or doors should be eliminated.
- An assessment of the sleepwalker
should include a careful review of the current medication so that modifications
can be made if necessary.
- Hypnosis has been found to
be helpful for both children and adults.
- An accurate psychiatric evaluation
could help to decide the need for psychiatric intervention.
- Benzodiazepines have been
proven to be useful in the treatment of this disorder. A small dose
of diazepam or lorazepam eliminates the episodes or considerably reduces
them.
What
are Sleep Terrors?
Sleep Terrors are characterized
by a sudden arousal from slow wave sleep with a piercing scream or cry,
accompanied by autonomic (Controlled by the part of the nervous system that
regulates motor functions of the heart, lungs, etc.) and behavioral manifestations
of intense fear. Also known as Pavor Nocturnus, incubus, severe autonomic
discharge, night terror.
What are the symptoms of
Sleep Terrors?
- A sudden episode of intense
terror during sleep
- The episodes usually occur
within the first third of the night
- Partial or total amnesia occurs
for the events during the episode.
Associated features include:
- Polysomnographic monitoring
demonstrates the onset of episodes during stage 3 or 4 sleep
- Tachycardia usually occurs
in association with the episodes.
- Other medical disorders are
not the cause of the episode, e.g., epilepsy
- Other sleep disorders can
be present, e.g., nightmares.
How serious are Sleep Terrors?
Some people have episodes of
sleep terror that may occur less than once per month, and do not result
in harm to the patient or others. While some people experience episodes
less than once per week, and do not result in harm to the patient or others.
In its severest form, the episodes occur almost nightly, or are associated
with physical injury to the patient or others. Consult a sleep specialist
if you are concerned.
Books
to read:
Go to The
SleepMall and click on Sandman's Bookstore. Most books that
focus
on Infants and Children are listed in the Children's Sleep Books Category.