Written by Dr Sofia Eriksson for Doctify

We all know the old saying: “Never wake a sleepwalker!” But why not? And what actually is sleepwalking in the first place?

Here to answer that and other sleepwalking-related queries is Doctify Neurologist, Dr Sofia Eriksson.

What happens to our brains during a ‘normal’ night’s sleep?

This is a surprisingly difficult question to answer. During sleep our bodies and mind seem to recuperate and regain energy.

Sleep is also important to consolidate memory and lack of sleep has increasingly been associated with disorders such as depression, dementia and obesity.

And what happens when someone sleepwalks?

Sleepwalking belongs to a group of disorders called Non-REM parasomnias. During these events, people seem to wake up abruptly, may look confused or scared. Some may get out of bed and walk, sometimes even out of the house.

Other types of non-REM parasomnias include confusional arousal, where people may just sit up in bed and look confused and call out. However, there may also be more complex behaviour such as sleep eating, cooking or even sexual activities.

What causes sleepwalking?

During sleepwalking events, there seems to be an incomplete arousal from deep non-REM sleep. Research also suggests that there is a mismatch between some parts of your brain (occipital lobes for vision and limbic system for emotions) waking up and other parts (frontal lobes for “sense”) staying asleep. That means that people often seem awake and can interact with their environment but often not as well as they would do during wakefulness.

Non-REM parasomnias often run in families and there seem to be some predisposing genetic factors. Non-REM parasomnias may be triggered by sleep deprivation (lack of sleep), stress, fever and sometimes alcohol.

Other sleep disorders, such as obstructive sleep apnoea may also make non-REM parasomnias worse

Can it be cured?

Identifying and reducing possible triggers (such as sleep deprivation and alcohol) can help reduce the number and severity of events or even stop them. This is often the only treatment needed.

However, if symptoms are severe or violent, medication is sometimes needed for a shorter or longer period. The drugs used are either long-acting benzodiazepines, sedatives (Clonazepam) or antidepressants (such as paroxetine).

How long does it last and can sleepwalkers seem lucid to other people?

Events are usually short, lasting less than a few minutes. Sometimes events can be longer and last up to half an hour but this is unusual.

People usually have their eyes open and look awake and aware to other people. During sleepwalking events people can seem lucid to others but may also talk out of context and what they say or do may not make sense.

Do people remember having done it?

People don’t always remember having had events but they may have some recollection of events and can describe feeling chased, cornered, seeing spiders or snakes. In general, not nice things and people can wake with a pounding heart, feeling scared and upset.

Is it dangerous to wake a sleepwalker or is that an urban myth?

Well, it is possible that you can make someone more confused if you try to wake them and it may be best to carefully guide people back to bed where they tend to go back to sleep very quickly.

Others may have another event if they haven’t woken fully and need/wish to wake properly so it clearly varies from one person to another.

 


 

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