Sleep Disorders Sleep Disorder Basics

Eyes Wide Open: The Sleepwalking Story

You might picture a sleepwalker as someone walking Frankenstein-like across the room with their arms stretched out in front of them. But the real-life sleepwalker is much more likely to wander about their house doing ordinary everyday activities, such as getting dressed and undressed, albeit with an eerily glassy look in their eyes.

Sleepwalking, however, can be unhealthy or hazardous to the sleepwalker and others, especially if the sleepwalker engages in complicated activities like eating, cooking or driving. Some sleepwalkers even act out violet dreams. Carlos Schenck, MD, a senior staff psychiatrist at the Minnesota Regional Sleep Disorders Center in Minneapolis who has produced an educational DVD called "Sleep Runners: The Stories Behind Everyday Parasomnias," has many years of experience treating people with sleepwalking, which is a type of parasomnia. Healthology recently talked with Dr. Schneck about sleepwalking in adults and children, and how sleepwalkers and family members can learn to manage a condition that can lead to some unusual and sometimes bizarre nocturnal activity.

What is sleepwalking?
It's a series of complex behaviors that are usually initiated during partial awakenings from sleep. People will walk around with an altered state of consciousness and impaired judgment. Various investigators have found that sleepwalkers have a lot of disruption of slow-wave sleep, the deepest stage of sleep, which occurs in the first half or first third of the night. And with each disruption, there is a vulnerability to sleepwalking.

At what age is sleepwalking most common?
It's particularly common in childhood. In fact, the peak prevalence in childhood is 17 percent between the ages of 8 and 12. Most children will outgrow sleepwalking before or with puberty, although you can have the onset of sleepwalking after puberty. Up to 4 percent of adults are sleepwalkers.

What causes sleepwalking in children?
The vast majority of cases in children seem to have genetic basis. For example, if one parent is affected by sleepwalking, the chances are 45 percent that one of the children will also be affected by sleepwalking. If both parents sleepwalk, then there is a 60 percent probability that one of the children will also sleepwalk. Sleep walking in children is considered a relatively common developmental phenomenon.

What causes sleepwalking in adults?
In adulthood, in addition to genetics, various conditions can predispose someone to sleepwalking, such as hyperthyroidism, migraine headaches, head injury and encephalitis. Obstructive sleep apnea, which is increasingly common because of the obesity epidemic in our country, is also a risk factor for sleepwalking.

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