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| Sleepwalking
(Somnambulism) Is a Sleep Disorder characterized by walking or other activity while seemingly still asleep. Sleepwalking (Somnambulism) is a series of complex behaviors that are initiated during slow wave sleep and result in walking during sleep. Sleepwalking is a rapid eye movement (REM) behavior disorder occurring in the dream stage of sleep. During this phase, the body releases a chemical that paralyzes the body. However, those who sleepwalk do not have this chemical trigger, hence the behavior. Symptoms and Features:
The normal sleep cycle involves distinct
stages from light drowsiness to deep sleep. Rapid eye movement (REM) sleep
is a different type of sleep, in which the eyes move rapidly and vivid
dreaming is most common. During a night, there will be several cycles of
non-REM and REM sleep. Sleep walking (somnambulism) most often occurs
during deep non-REM sleep (stage 3 or stage 4 sleep) early in the night.
It can occur during REM sleep near morning. In children, the cause is usually unknown
but may also be related to fatigue, prior sleep loss, or anxiety. In
adults, sleep walking is usually associated with a disorder of the mind
but may also be seen with reactions to drugs and/or medications and
alcohol, and medical conditions such as partial complex seizures. In the
elderly, sleep walking may be a symptom of an organic brain syndrome or
REM behavior disorders. The sleep walking activity may include
simply sitting up and appearing awake while actually asleep, getting up
and walking around, or complex activities such as moving furniture, going
to the bathroom, dressing and undressing, and similar activities. Some
people even drive a car while actually asleep. The episode can be very
brief (a few seconds or minutes) or can last for 30 minutes or longer. One common misconception is that a sleep
walker should not be awakened. It is not dangerous to awaken a sleep
walker, although it is common for the person to be confused or disoriented
for a short time on awakening. Another misconception is that a person
cannot be injured when sleep walking. Actually, injuries caused by such
things as tripping and loss of balance are common for sleep walkers. Sleep walking occurs at any age, but it
occurs most often in children aged 6 to 12 years old. It may occur in
younger children, in adults, or in the elderly, and it appears to run in
families. Sleepwalking
(somnambulism) is fairly common, especially among children. An estimated
15 percent of all children between the ages of 5 and 12 have walked in
their sleep at least once, and most outgrow the disorder. Typically, the
child (or adult) sleepwalker sits up, gets out of bed, and moves about in
an uncoordinated manner. Less frequently, the sleepwalker may dress, open
doors, eat, or go to the bathroom without incident and usually will avoid
obstacles. But sleepwalkers don't always make their rounds in safety. They
sometimes hurt themselves, stumbling against furniture and losing their
balance, going through windows, or falling down stairs. In children, sleepwalking is not believed
to be influenced by psychological factors. Usually, it is enough for parents of sleepwalkers to provide their children with emotional support. They should also lock windows and doors and make sure the child does not sleep near stairways and potentially dangerous objects. For severe cases, a doctor may prescribe drugs. 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. 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. Amnesia is another danger that usually
follows a sleepwalking episode. Sleepwalkers usually remember little to
nothing. But there are times sleepwalkers have a vague memory of an
episode where they think they were being burned, buried alive, caught
under a roof or trying to escape a dangerous situation. Sleepwalking
primarily occurs in young children and is more prevalent in boys than
girls. Sleepwalking episodes can range from
sitting up in bed to walking, and can even lead to frantic attempts to
escape as if threatened or fleeing. Homicide or suicide during sleepwalking has
rarely been reported when a person has tried to awaken a sleepwalker. Sleepwalking can be treated with drugs, but
hypnosis has also proven to be successful on a short-term basis. An important component in dealing with this disorder is to make the environment as safe as possible, such as having sleepwalker's bedroom on the ground floor, removing hazardous items from the house, locking windows and placing an alarm on the bedroom door. It is very important that 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. In a few instances, sleepwalking can result
in violent behavior. It is very important that a chronic sleepwalker seek
professional help. Treatment:
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. |