Parasomnias
Sleepwalking
Getting up and walking or doing other activities while still mostly asleep, usually early in the night, with little or no memory afterward.
Overview
Sleepwalking (somnambulism) is a parasomnia in which a person gets out of bed and walks or carries out other activities while in a state between deep sleep and wakefulness. Episodes typically happen in the first third of the night, during deep non-REM sleep. The person's eyes are often open, but they appear glassy, are hard to wake and usually remember little or nothing.
Sleepwalking is far more common in children and often stops by adolescence. Adults can sleepwalk too, especially with a family history, sleep deprivation, stress or certain medicines.
Most episodes are harmless, but injuries can happen, for example from stairs, windows or leaving the house. Making the home safe and addressing triggers are the main steps.
A 2016 meta-analysis estimated that about 5% of children and 1.5% of adults sleepwalked in the previous year, and about 6.9% of people sleepwalk at some point in life.
Common symptoms
- Getting out of bed and walking around while asleep
- A blank, staring expression with eyes open
- Being difficult to wake, and confused if woken
- Little or no memory of the episode
- Sleep talking or unusual behaviour such as moving objects
- Episodes usually in the first few hours of sleep
Causes and risk factors
- Family history of sleepwalking or night terrors
- Sleep deprivation and irregular sleep schedules
- Stress and anxiety
- Fever or illness in children
- Obstructive sleep apnea or other disorders that fragment sleep
- Alcohol
- Certain medicines, including some sleep medicines such as zolpidem
How it is diagnosed
Sleepwalking is usually diagnosed from a description of the episodes, often from a family member, and a video recording can be very helpful. A sleep study may be recommended if episodes are frequent, dangerous, start in adulthood or could be seizures, or if sleep apnea is suspected.
Treatment options
Safety measures
Locking doors and windows, using alarms on doors and removing hazards.
Treating triggers
Getting enough sleep, managing stress and treating sleep apnea.
Scheduled awakenings
For children with predictable episodes, gently waking them shortly before the usual time can reduce events.
Medication review
Stopping or changing medicines that can trigger complex sleep behaviours. In 2019 the FDA added a boxed warning about complex sleep behaviours to eszopiclone, zaleplon and zolpidem.
Medication or therapy
Occasionally used for frequent or dangerous episodes, under specialist guidance.
What you can do yourself
- Keep a regular sleep schedule and get enough sleep
- Make the bedroom safe: lock windows and outside doors, use stair gates for children
- Sleep on the ground floor if possible
- Avoid alcohol
- Gently guide a sleepwalker back to bed rather than forcefully waking them
When to see a doctor
- Episodes are frequent or involve injury or danger
- Sleepwalking starts or returns in adulthood
- Episodes happen after starting a new medicine
- You also snore or have breathing pauses
- Episodes involve violent behaviour
Frequently asked questions
Is it dangerous to wake a sleepwalker?
It is not dangerous for them, but waking them suddenly can cause confusion or agitation. It is usually better to gently guide them back to bed.
Will my child grow out of sleepwalking?
Most children who sleepwalk stop by adolescence. Keeping a regular schedule and making the home safe are the main steps.
Can sleeping pills cause sleepwalking?
Yes. The FDA requires a boxed warning on eszopiclone, zaleplon and zolpidem because of rare but serious complex sleep behaviours, including sleepwalking and sleep driving. Contact your prescriber if this happens.
Why do I sleepwalk when I'm stressed or tired?
Sleep deprivation and stress increase deep sleep pressure and partial arousals, which can trigger episodes in people prone to sleepwalking.
Sources
This page is general information, not a diagnosis or medical advice. Read our medical disclaimer.