Sleepwalking in Adults

Sleepwalking in adults occurs to about four percent of the population, but exact numbers are difficult to estimate. Sleepwalking is a sleep disorder also called somnambulism. It involves getting up from bed and walking around, even though you are still asleep. While up, sleepwalkers do not just walk. Many of them perform routine daytime tasks, but in a crude manner or done in the wrong place. For example, sleepwalkers might move furniture around, climb out of a window, or urinate in a trashcan. Although sleepwalkers have their eyes open, and may look awake, their actions suggest otherwise.

To an observer a sleepwalker might look awake. When taking a closer look, it is easy to see that the person fixing up a midnight snack in the kitchen is, in fact, still sound asleep.

Before starting to sleepwalk, someone might first sit up in bed and look around in a confused manner. The eyes will be open, but have a “glassy” look to them. The sleepwalker might also talk or shout as he or she is walking.

When spoken to, sleepwalkers can give strange answers or take a long time to formulate a response. This too is an indication to look out for when you suspect someone from sleepwalking.

Most sleepwalkers will stay indoors and just perform some routine task. Some people will go down to their kitchen and fix up an entire meal, eat it and return to bed, without waking up once. A sure clue you are sleepwalking is if you find signs of these nightly events in the morning. You may find food out, a dirty dish, or even find your furniture moved around.

In rare cases, sleepwalkers will get into their car and drive away.

It can be extremely difficult to wake up a sleepwalker. When they do wake up, they can be very confused. Normally they would have no memory of the entire event, so waking up in a living room instead of the bedroom can be highly confusing. It is very rare to have a clear memory of everything that happened.

At times, you could even attack the person who wakes you. Especially men tend to be more violent when they sleepwalk. This can, in some very rare cases, result in crimes being committed while sleepwalking.

Slowly guiding a sleepwalker back to bed is a safer, and often easier, strategy. In most cases, the sleepwalker will just go back to bed and continue sleeping peacefully.

Up to about four percent of adults sleepwalk, but it rarely starts during their adult life.

Although it is possible to develop sleepwalking later on in life, most adult sleepwalkers developed the disorder during childhood.

Several Causes Linked to Sleepwalking

Certain Medications	Sleep deprivation
Brain injuries	Stress & Environment

Although exact causes are still unknown, sleepwalking has a strong genetic link. Your chances of sleepwalking are doubled if one or both of your parents had sleepwalking episodes during their childhood or adult life.

Sleepwalking is also linked to some other causes, which include the following:

• Sleep deprivation
• Hyperthyroidism (overproduction of thyroid hormones)
• Migraine headaches
• Head injury
• Encephalitis (brain swelling)
• Stroke
• Physical or emotional stress
• Obstructive sleep apnea (OSA)
• Upper airway resistance syndrome (UARS)
• Restless leg syndrome - Periodic limb movement syndrome (RLS-PLMS)
• Sleeping in unfamiliar surroundings
• Certain medications (especially CNS depressant medication)
• Alcohol use and abuse

Sleepwalking can occur because of other sleeping disorders. Obstructive sleep apnea is one of these disorders. Sleepwalking and sleep apnea are thought to be connected because sleep apnea results in fragmented sleep. This is where a person is aroused from sleep frequently throughout the night. These episodes of arousal are not enough to wake someone up fully, but sufficient enough to possibly lead to sleepwalking.

Most commonly, sleepwalking in adults occurs during slow wave sleep, which comprises the first third of the night. Less commonly, sleepwalking can occur in the context of nocturnal epilepsy, parasomnia overlap disorder, where elements of REM and NREM sleep are combined.

Factors that increase the amount of, or disrupt, slow wave sleep, also increase the prevalence of sleepwalking episodes. These include many of the causes listed above, such as stress, medication, and sleep deprivation. Often, sleepwalking is a result of another sleep disorder, such as obstructive sleep apnea, restless leg-periodic limb movement syndrome. Sleepwalking often diminishes or disappears entirely once the underlying sleep disorder is treated.

Sleepwalking does not pose any risk on its own. The major risk of sleepwalking is inadvertent self-injury, or injury to a bed partner. If you sleepwalk, you are not aware of your actions, and thus it is easy to injure yourself by bumping into furniture or climbing out of windows. Some sleepwalkers may accidentally harm their bed partner while enacting their dreams in a sleepwalking episode. However, these incidents tend to be very rare.

Here are some suggestions if you suspect you, or someone you love, is sleepwalking:

• Stick to a regular sleep schedule. Try to go to bed and get up in the mornings at the same times every day to avoid fatigue and sleep deprivation.
• See your doctor for a physical checkup, to rule out any health conditions that could cause or worsen sleepwalking.
• Ask for a referral to a sleep lab to rule out other sleep disorders. Sleep apnea has been linked to sleepwalking, and it is important to treat this condition immediately if there are signs you may have it.
• Avoid drugs and alcohol. Certain prescription drugs also increase your chances of sleepwalking, so check with your doctor.
• Make sure you sleep in a safe place. Preferably, try to use a ground floor bedroom. If you don’t have a choice, lock upstairs windows and balcony doors. Also, lock outside doors to prevent wandering outside.

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