Sleepwalking: Symptoms, Causes, and Treatment

Oct 08, 2024
Fact Checked
Learn how sleepwalking can affect you, and the steps to take for treatment

Key Takeaways

When you see sleepwalking in the movies, it often looks like people in pajamas with their arms outstretched in front of them and their eyes closed. They may get into mischief, and the entire scene is supposed to make people laugh. While Hollywood tends to portray inaccurate views of sleepwalking, there are some truths. For example, people who sleepwalk can get out of bed, walk around, talk, and eat while asleep. Less often, they may even drive a car or cook. 

We spoke with sleep experts to get the most accurate information about sleepwalking, including why it happens and its symptoms. 

What is sleepwalking? 

Sleepwalking, formerly called somnambulism, is a type of parasomnia—an unusual behavior that happens while you sleep. What makes parasomnias unusual is they can occur in the period between being asleep and being awake. “When you sleepwalk, you can physically walk or move around your home despite being asleep,” explained Camilo Ruiz, DO, a doctor and sleep medicine expert at Sleep and Internal Medicine Specialists in Fort Lauderdale, Florida.

“When people sleepwalk, they may act as if they are awake by sitting up, picking up items—even moving furniture,” said Ruiz. He added that their eyes may be open, but they may not recognize someone who tries to talk to them. And if they speak, their words may not make sense. 

According to Bijoy John, MD, a sleep specialist and founder of Sleep Fix Academy in Tennessee, sleepwalking usually happens during the first couple hours of sleep. 

Sleepwalking affects up to 4% of adults in the United States, according to the American Academy of Sleep Medicine. It is less common in older adults because non-REM sleep, which happens early in the sleep cycle, decreases with age. Non-REM stands for non-rapid eye movement; sleepwalking usually happens during this stage.

Symptoms of sleepwalking 

Sleepwalking symptoms can look different for everyone. “Sleepwalking can cause you to wake up suddenly with a panicked look and can cause behaviors such as arranging pillows or fixing bed sheets,” explained John. “The movements are usually purposeless.” 

Sleepwalking symptoms can look different for everyone. “Sleepwalking can cause you to wake up suddenly with a panicked look and can cause behaviors such as arranging pillows or fixing bed sheets,” explained John. “The movements are usually purposeless.” 

Sleepwalking behaviors

Sleepwalking might be alarming to someone watching the behaviors. “People can bump into furniture or push objects down, but sometimes they can have complex behaviors like cooking, eating food, and driving a car,” John said. 

According to Mayo Clinic, some common behaviors of someone who sleepwalks might be:

Less often, there might be more dangerous activities you might do while sleepwalking. Mayo Clinic says these might involve:

Physical signs

During sleepwalking, you might show physical signs, such as:

Causes of sleepwalking 

There can be several different causes for sleepwalking—some of which you may have control over and some you may not, such as genetics. 

Genetics

According to sleep specialist John, genetics or your family history can play a major role in whether you sleepwalk or not. Eight out of 10 people who sleepwalk have an immediate family member, such as a parent or sibling, who also sleepwalks or did in the past. 

A study published in 2015 found about 47% of children who sleepwalk have a parent with a history of sleepwalking. If both parents have a history of sleepwalking, the number rises to more than 61%. 

Sleepwalking is also common in twins, especially identical twins, and can be found in extended family members such as aunts, uncles, and cousins, according to John. 

Sleep deprivation

Sleep deprivation can cause you to sleepwalk. “During the three stages of the non-REM sleep cycle, the body’s muscles relax, heart rate lowers, and blood pressure drops,” said sleep medicine expert Ruiz. This plays an important role in helping the body repair itself. 

Sleepwalking is more likely to happen during deep, non-REM sleep. As you get older, your body needs less of this deep non-REM sleep. But if you’re sleep-deprived, your body spends more time in this stage of sleep, making sleepwalking more likely to happen. 

Mental health conditions

Feeling stressed can make it harder to fall asleep. If stressors such as work, finances, or relationships are keeping you up at night, you can become sleep-deprived, which can trigger sleepwalking. 

Some mental health conditions can also increase your risk for sleepwalking, such as:

Certain medications

Some medications can make you more likely to sleepwalk. Although sleepwalking is most common in childhood and usually goes away on its own, according to Ruiz, it’s usually due to certain medications when it happens in adults. 

Ruiz explained that zolpidem (Ambien), a medication used to treat insomnia, can increase the risk of sleepwalking. Insomnia is a condition that makes it hard to fall asleep or stay asleep.

Other medications that might increase the risk of sleepwalking include:

Alcohol

Alcohol changes how you progress through the different sleep cycles and can disrupt you from getting quality sleep. It may also increase the risk of sleepwalking, although more research is needed to verify the connection.

Medical conditions

Some brain conditions, such as Parkinson’s disease, might cause sleepwalking. Restless leg syndrome (RLS) might also put you at higher risk for sleepwalking, according to a study on RLS in children published in 2019. 

“Sometimes respiratory conditions, such as sleep apnea—a sleep-related breathing disorder—can trigger it as well,” explained Ruiz. A study published in 2018 found that those with more severe sleep apnea were more likely to sleepwalk than those with a milder form. 

Diagnosing sleepwalking 

According to Mayo Clinic, your health care provider may diagnose sleepwalking by asking questions about your medical and family history. The health care provider may then perform a physical exam to make sure your sleepwalking isn’t caused by another medical condition, such as seizures, panic attacks, or other sleep conditions. 

If someone  you live with has told you that you sleepwalk, you may want to take them to your appointment so they can provide your health care provider with information about how you look and act while sleepwalking. They may also ask whether anyone else in your family has a history of sleepwalking. 

Your health care provider may recommend a sleep study, but they aren’t always needed. Sleep studies are typically for more severe and dangerous forms of sleepwalking or when health care providers want to rule out sleep conditions with similar symptoms to sleepwalking. Sleep studies are usually done at night in a sleep lab. 

Sleepwalking treatment options 

Sleepwalking doesn’t always require treatment. Sometimes, lifestyle adjustments are enough. But there are things you can do to help reduce the number of times you sleepwalk or treat the underlying problem so you no longer sleepwalk. 

Lifestyle changes

Here are some ways to lower your chances of sleepwalking: 

Safety measures

“Sleepwalking is not generally dangerous. But it does require some precautions in order to prevent injury,” said Ruiz. He offered some ideas to help you stay safe if you sleepwalk, such as:

Medical interventions

Unfortunately, the Food and Drug Administration hasn’t approved any medication to treat sleepwalking. But health care providers sometimes prescribe medications to help. 

“Benzodiazepines can be effective in controlling sleepwalking behavior since they cause muscle relaxation during sleep,” explained Ruiz. Benzodiazepines are a class of medication known as depressants that cause sedation and relaxation. “If sleepwalking becomes a frequent occurrence and if it becomes a risk of injury, medication is recommended,” said Ruiz.

If sleepwalking is caused by another health condition, such as sleep apnea, your health care provider will want to diagnose and treat the underlying cause. If sleepwalking is caused by a medication you’re taking, the medication will likely be stopped or the dose adjusted. 

Therapies

Cognitive behavioral therapy (CBT) can help if you have a sleep condition. This type of therapy helps you figure out what might be causing your sleep problems, such as insomnia, and helps you learn healthier sleep habits, such as changing your bedtime routine or using relaxation techniques. 

Talking with a therapist can help you if you are struggling with anxious thoughts, stress, or sleep deprivation that can make you more likely to sleepwalk. 

Bottom line 

Sleepwalking in adults isn’t as common as sleepwalking in children. In adults, sleepwalking is often related to medication or an underlying health condition. So it’s important to find the cause.

Sleepwalking might be a rare occurrence, or it can happen regularly with potentially dangerous consequences. With treatment, sleepwalking can often be resolved on its own. 

If sleepwalking is damaging your sleep, relationships, or overall life, you may want to consider talking with your health care provider about options for treatment. 

Have questions about this article? Email us at reviewsteam@ncoa.org.

Sources

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