Sleepwalking

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Biology 202
2000 First Web Report
On Serendip

Sleepwalking

Sarah McCawley

Many people have heard of sleepwalking and even know about symptoms that surround the disorder, but is there more to the story than just waking up during the night and wandering around in an unaware state? What actually causes someone to sleepwalk? To try to understand the answers to these questions it is important to understand not only what kind of disorder it is, but who has the disorder, how frequently it occurs, what the symptoms are, as well as what the treatments are. By exploring these areas, it may be possible to better understand the disorder as well as dispel old notions about it.

The Parasomnias are disorders that intrude into the sleep process and create disruptive sleep-related events. Arousal disorders are parasomnia disorders presumed to be due to an abnormal arousal mechanism. These arousals occur when a person is in a mixed state of being both asleep and awake, generally coming from the deepest stage of nondreaming sleep, stages 3 and 4. This means a person is awake enough to act out complex behaviors but still asleep and not aware or able to remember these actions (1).

One of the most common types of arousal disorders is somnambulism, more commonly known as sleepwalking. Somnambulism affects children much more regularly than adults. In fact, sleepwalking affects approximately 1% to 17% of children and is more frequently seen in boys. Interestingly, 15% of children aged 5-12 years sleepwalk at least once, but only 3-6% sleepwalk more than once (5). It has been noted that the incidence of sleepwalking decreases with age. Although the exact prevalence of sleepwalking in adults is not known, it is estimated to be as high as 10%.(4). It has also been noted that those individuals who start to sleepwalk as adults are more prone to serious problems with it. Because it is found more commonly in children, who are undergoing many physical and chemical changes, if it is seen to start in adults it is thought to be linked to mental disturbances other than fatigue or anxiety. However, mental disturbances can be present without counting as a symptom(3).

No one seems to know exactly what the cause of somnambulism is, but there are theories that have been suggested. Once asleep, it is thought that the part of the brain that controls muscle function is aroused and the "sleepwalker" begins to move even though he or she is still asleep (2). In children, it may 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 (3). It is also interesting to note that in 10-20% of cases there is a familial history of sleep walking (5), so there is a possibility that it is genetically inheritable.

This past summer, however, there was a breakthrough found during a sleep study in Bern, Switzerland. During the sleep study, a 16-year-old male was hooked up to an electroencephalogram, EEG, to monitor his brain activity. During the second night, he woke up, pulled on the EEG leads, and mumbled some gibberish. The brain activity shifted from smooth waves to a high-voltage burst of delta waves, which can be seen during deep sleep. The EEG showed a commotion of activity in the area of the cingulate cortex, a part of the brain that controls regulation of emotions and certain motor functions. While there was activity in this area, there was no activity in the prefrontal cortex, which governs higher mental functioning. In other words, it appears that sleepwalker are confused and upset and react by walking without consciously knowing that they are doing it (7). Nevertheless, researchers are far from knowing exactly what causes this to happen and how to stop it.

Sleepwalking episodes usually occur within one to two hours of falling asleep, when the person is in non-REM sleep (5). The episodes can last anywhere from a few seconds to thirty minutes (3). During the episode, the sleepwalker may simply sit up and appear awake while actually asleep or they may get up and walk around. They may even perform 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. One common misconception is that a sleepwalker should not be awakened. It is not dangerous to awaken a sleepwalker, 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 sleepwalking. Actually, injuries caused by such things as tripping and loss of balance are common for sleepwalkers (3).

Often treatment is unnecessary, except when the health or safety of the individual is being threatened. Often the person can trip over objects, walk out of the house, fall out of windows, or injure themselves with sharp objects like knives. To avoid incidences that may injure the sleepwalker, it is suggested that you locate the sleepwalker's bedroom on the main floor, if possible and lock the windows and cover them with large, heavy drapes. It is also recommended that you keep the floor clear of harmful objects and remove any hazardous materials and sharp objects from the room and secure them in the house (4). However, there are cases when medical treatments are needed. If sleepwalking is frequent or persistent, examination to rule out other disorders (such as partial complex seizures) may be appropriate. It may also be appropriate to undergo a psychological evaluation to determine causes such as excessive anxiety or stress, or medical evaluation to rule out other causes (6).

Medication may be used in cases where episodes are violent, injurious, frequent, or disruptive. Therapy usually consists of either a benzodiazepine, such as Diazepam(r) or Alprazolam(r), or a tricyclic antidepressant. Among other things, these drugs inhibit chemical processes associated with sleep regulation, which, depending on the patient, may or may not result in fewer episodes of sleepwalking. Biofeedback and hypnosis have also been used effectively with individual sleepwalking patients (4).

All of this information, from the definition of what sleepwalking is to how it is treated, gives some insight into what causes this disorder to occur. However, there is still much more to learn. Just like in the course of studying anything, people must continue to ask questions and look for answers. It is possible that we may never know exactly what causes someone to sleepwalk, if indeed there is one particular reason at all. Is it possible that something in the unconscious controls a sleepwalker's actions? Is it like a quadriplegic's ability to withdraw his foot when pinched without knowing that that he has been pinched? Is the brain somehow disconnected from the body's actions when the person is sleepwalking?

 

WWW Sources

1) PARASOMNIAS - AROUSAL DISORDERS INFORMATION

2) Parasomnias

3) Sleepwalking (Somnambulism)

4) SleepChannel

5) SLEEPWALKING

6) Sleep walking

7) "New Images Shed Light on Mystery of Sleepwalking"

 

 

Continuing conversation
(to contribute your own observations/thoughts, write in the Sleepwalking Experiences Forum on Serendip)

01/19/2006, from a Reader on the Web

Hi, I am hoping that you can answer a question that I have. I have two 12 year old twin girls and a 9 year old girl. One of my daughters, a twin used to sleepwalk, and had a terrible sezure at 6 years old. She would walk around, scream if touched, would be hard to wake, and would talk to some invisible person, or just talk in her sleep. Due to newly found information I have realised that she had night terrors. My mother's brother, and father both had similar symptoms. They are all fine now... But I am wondering why one twin has it, and the other didn't. I never sleepwalked, although my ex-husband's sister did on occasion. My daughter is doing a research project for science on the subject, and I was just hoping that you could help my find out why. Thanks, From: An unknown writer (please reply shortly)

 

Comments

Yavor Penchev's picture

my peeing sleepwalk

I'm 15 male and it first started after a night of drinking-it was my father's birthday in a piano bar and we got home at about 6 in the morning.In the morning I wake up and go to the living room to drink my coffee with my parents.After an hour or so,my father asks me straight away if I'd remembered anything-then I asked what he was talking about-he told me I'd entered their room,pissed on the drawer,he'd then sent me off to bed and clean up my piss.In the following weeks I had a party with friends in my house we drank heavily but nothing happened.The second time was after a night out in a bar-I drank 500ml of beer and two glasses of whiskey 50ml each-it had me just a little,I met some schoolmates there and we chatted for 2 hours or so.They went home,I finished my drink and went home myself.(I drank a lot of water while drinking alcohol).I went to bed after 30 mins of watching TV and fell asleep fast.The next morning I remember my mother calling me to the sight of the wet chair in my room.I blamed the cat,but I know it's me as the markings were not in any way a deed of such a small animal-it was me alriht,looks like even a small amount of alcohol can trigger sleepwalking

celeste's picture

question sleep walking or not?

My 8 year old step daughter is here part time and at night she will come down stairs and look at myself and my teenage daughter sitting in the living room watching tv and ask where her dad is, i say in bed and she needs to go back to bed. Is this sleepwalking when they notice one family member is not in the room?

Magento's picture

I did sleepwalking when I was

I did sleepwalking when I was a child, too.

I didn´t know, that I was doing it till the next morning...

linda's picture

sleep walking & living alone

How do I know? I wake up doing strange things- the 1st time I know of,
was sitting on my bdrm floor w/ several small objects around me-
playing cards, pencils, jewerly, paper, my journal, stuffed animals &
I woke up with the cards in my hands...the next time I had my 4 yr
granddaughter Mackenzie spending the night, she was sick and Mom
couldn't get the night off, Kenzie woke me up w/- What are you doing
Grandma! ...I had poured bleach and dishwashing soap all over the
kitchen floor I used up and entire gallon of bleach (I have a very
small kicthen)

no I'm not a drinker....I have a glass of wine 2 or 3 times a month at
the most

I was sleep walker as a child and so was my daughter. I also I have night terrors.

I'm scared because I live alone & live in an upstairs apartment.

sleepwalkers have done many self harm things and harmed others in
there sleep even murder! good thing I do live alone, but I don't want
to take a tumble down my stairs that is a very real possibility.

Any suggestions are much appreciated.

linda's picture

sleep walking - adult

I am 50 yrs old & live alone afte the death of my husband alomost 3 yrs ago. I slept walked as child so did my daughter. I have night terrors. I don't know when I started sleep walking but I have woken up sitting on the floor in a different room. The worst eposide I know is when my 5 yr old granddaughter was spending the night & woke me up after I had poured a gallon of bleach and a container of dishwashing fluid on my kicthen floor (my kitcen is very small). I was in process of trying to clean it up.
I do have boyfriend. I have never sleep walked when he has spend the night. My concern is the self harm that can happen to a sleep walker; they've fallen out of windows, cut themselms w/knives, even driven while sleep walking! I live in an upstairs apartment. It scares me!

linda

Cynthia Smith's picture

My 12 year old son has

My 12 year old son has always been hard to wake up but about a half hour ago he sat up in bed feeling an extremely angry feeling and shoved his mattress off his bed, started punching and kicking it. Then started punching the wall and himself. He said he was yelling "Get out" feeling that someone else was taking over his body. I'm scared and going to call the doctor in the morning. Can you help me out with this??

Anonymous's picture

1st incident

ok so basicly an hour ago, or so i would guess, my boyfriend woke me up, he is 24 and has never sleepwalked before, but tonight he explained how our roomate woke him up standing by the door of her bedroom room saying "dan, i think you are in my bed." at which point he woke up became very embarassed and left and came and woke me up to tell me.

we had fallen asleep at probably two in the morning, after a night of, pizza and beer, and playing wii sports. something not unusual for us. her room is next to ours, possibly he was confused and went into the wrong room? is this common?

any comments or help would be appreciated.

Amy & Dan

donna b's picture

sleepwalking

i can understand how you are feeling i am a 34 years old and for about the last 2 months i have done some bizzar things while i have been sleep walking like going to the loo and getting into my daughters bed and waking up in there, getting dressed or undressed, im not quite sure how or why this has started happening as i allready take anti depresent tablets i get plenty of sleep and do not drink much its starting to scare me as to my knowledge i have never slept walk before.

John sunthang 's picture

help

sir/mam

i am john.

thanks for your insight and wisdom of sleepwalking.

a friend of mine i live with has a terrible sleepwalking almost every night. as i read your aticle. a lot of things are true. my friend is 29 yrs now. sometimes he just get up and sit, sometimes he gets up and do something like looking and searching for something, sometimes, he does terrible things like he literally punches the window glass he sleeps by, sometimes he breaks the glass.

i notice that it is very frequent and harsh.

he is a bible student, doing for masteral degree in manila. by the way we are from Myanmar.

what should he do? do i need to consider for my own safety?

i hope you can guide us these helpless and poors friends.

yours

john

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