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Sleepwalking isn't just a childhood phenomenon—it affects adults too. Walking, talking, or performing complex activities while asleep can be confusing and sometimes dangerous. Learn about the causes, risks, and effective management strategies for adult sleepwalking.

What Is Sleepwalking?

Sleepwalking, or somnambulism, is a parasomnia that occurs during deep non-REM sleep. The person may sit up, walk around, or perform complex behaviors while remaining asleep and having no memory of the event upon waking.

While commonly associated with children, approximately 1-4% of adults experience sleepwalking episodes. Unlike children who typically outgrow it, adult-onset sleepwalking often has underlying causes that need to be addressed.

Key Facts About Sleepwalking:

•Usually occurs during the first third of the night during deep sleep
•Episodes can last from a few seconds to 30 minutes or longer
•The sleepwalker typically has no memory of the event
•Eyes are usually open but with a glassy, unfocused appearance
•Attempting to wake a sleepwalker can cause confusion and disorientation

Common Sleepwalking Behaviors

Sleepwalking behaviors range from simple to complex activities, and understanding these can help identify episodes.

Simple Behaviors

Sitting up in bed, looking around, walking around the room, or going to the bathroom without full awareness.

Complex Behaviors

Getting dressed, cooking, eating, driving, or even leaving the house while still asleep.

Sleep-Related Eating

Eating or preparing food during sleep episodes, sometimes consuming unusual or inedible items.

Violent Behaviors

In rare cases, aggressive or violent actions may occur if the sleepwalker feels threatened or is forcibly awakened.

Causes and Triggers

Several factors can cause or trigger sleepwalking episodes in adults.

Sleep Deprivation

Insufficient sleep is one of the most common triggers, as it increases time spent in deep sleep.

Stress and Anxiety

Emotional stress, anxiety disorders, and PTSD can significantly increase sleepwalking episodes.

Medications

Certain sedatives, hypnotics, psychiatric medications, and antihistamines can trigger sleepwalking.

Alcohol and Substances

Alcohol consumption and certain recreational substances can disrupt sleep architecture and trigger episodes.

Sleep Disorders

Conditions like sleep apnea, restless leg syndrome, and other sleep disorders can contribute to sleepwalking.

Medical Conditions

Fever, gastroesophageal reflux, migraines, and certain neurological conditions can trigger episodes.

Risk Factors

Certain factors increase the likelihood of experiencing sleepwalking episodes.

•Family history of sleepwalking (genetic predisposition)
•History of sleepwalking during childhood
•Irregular sleep schedules or shift work
•High levels of ongoing stress
•Use of certain medications
•Sleeping in unfamiliar environments
•Consuming alcohol before bed
•Other sleep disorders

Potential Dangers

While often harmless, sleepwalking can pose significant safety risks.

Physical Injury

Falls, bumping into objects, or tripping over obstacles can cause injuries ranging from minor bruises to serious harm.

Leaving Safe Environments

Sleepwalkers may leave their homes, potentially exposing themselves to traffic, weather, or other outdoor hazards.

Driving

In extreme cases, people have driven vehicles while sleepwalking, posing serious risks to themselves and others.

Relationship Issues

Sleepwalking can disturb bed partners and family members, causing stress and sleep deprivation for others.

Diagnosis

Diagnosing sleepwalking involves a thorough evaluation of sleep habits and medical history.

Sleep History Review

Detailed discussion of sleep patterns, episode frequency, behaviors during episodes, and family history.

Sleep Diary

Keeping track of sleep times, quality, and any unusual nighttime events or daytime symptoms.

Polysomnography

An overnight sleep study that monitors brain waves, heart rate, breathing, and movements during sleep.

Video Monitoring

Recording sleep to capture and analyze episode behaviors and rule out other conditions.

Treatment and Management

Treatment focuses on safety measures and addressing underlying causes.

Sleep Hygiene Improvements

Maintaining consistent sleep schedules, getting adequate sleep, and creating a relaxing bedtime routine.

Safety Precautions

Locking doors and windows, removing hazardous objects, installing alarms, and sleeping on the ground floor if possible.

Stress Management

Techniques like relaxation exercises, meditation, and therapy can help reduce stress-related triggers.

Medication Review

Working with a doctor to identify and potentially adjust medications that may be contributing to episodes.

Scheduled Awakening

Waking the person briefly before the typical time of sleepwalking can help prevent episodes.

Medical Treatment

In severe cases, medications like benzodiazepines or antidepressants may be prescribed.

When to See a Doctor

While occasional sleepwalking may not require medical attention, certain situations warrant professional evaluation.

Seek Medical Help If:

⚠Episodes occur frequently (multiple times per week)
⚠Sleepwalking leads to dangerous behaviors or injuries
⚠Episodes cause significant disruption to you or family members
⚠Sleepwalking begins in adulthood without prior history
⚠You experience excessive daytime sleepiness
⚠Episodes are accompanied by other unusual sleep behaviors

A sleep specialist can help identify underlying causes and develop an effective treatment plan to manage sleepwalking safely.

Conclusion

Sleepwalking in adults is more common than many people realize and can range from mild inconvenience to serious safety concern. Understanding the triggers and implementing proper safety measures are crucial first steps.

If you or someone you love experiences regular sleepwalking episodes, don't hesitate to seek professional help. With proper diagnosis and management, most people can significantly reduce episodes and minimize associated risks.