Sleepwalking is a medical condition. It is also known by other names such as somnambulism and parasomnia. People who suffer from that medical condition get up while they are sleeping and can complete various actions varying from simple to complex. It is commonly believed that it is characterized by only walking while asleep, but in reality there may be other actions involved. A sleepwalker can perform complex activities while he is in this particular state. Sometimes the individual may simply sit up suddenly. He can even look around with a confused expression. In other cases, a person may just jump out of bed and run away from a threat that he is dreaming at the same time. Although it may scare some people, this condition is not serious. The only serious and harmful outcome which may arise is from an injury while the sleepwalker performs a certain action. Sleepwalking is not linked to any long-term complications.
History of Sleepwalking
In the past, sleepwalking was shrouded in mystery since there was no serious investigation into what causes it and if it was a medical condition at all. The first serious studies of sleepwalking were conducted in the 19th century by German parapsychologist and chemist Baron Karl Ludwig von Reichenbach. He formulated an extensive theory on that topic. His work put in place the foundation of the attempt to understand this condition.
At first, a person who suffers from somnambulism was considered as a dreamer who physically participates in his or her dream. With more observant and elaborate research, that notion changed. With the invention of electroencephalogram and others, more accurate studies appeared.
Sigmund Freud also analyzed and provided theories on that medical condition. According to him, sleepwalking and the fulfillment of sexual desires have some connection. Another of his suggestions was that a personâ€™s sleepwalking is triggered by the desire to sleep in the same area where he slept as a child. Later on, he was preoccupied with the task to elaborately analyze dreams, their subconscious origins and the dreamerâ€™s consciousness. Unconscious impulses during the sleep may be expressed with action during that state.
What Happens When a Person Sleepwalks?
Sleepwalkers do not only walk while they are asleep. They may talk or scream in that state. Usually, their eyes are wide open. Another characteristic is that their eyes are expressionless and glassy. Sleepwalkers may do their everyday tasks in the middle of the night. Often, their actions are bizarre or clumsy. Such actions include moving furniture around, urinating in strange places, walking through a window or walking around naked. Sometimes, the person may be aggressive and violent. There are some rare cases in which the sleepwalker is able to drive a car, even go on a long distance trip. Indecent exposure and other sexual related behavioral peculiarities are also possible. Dreaming and hallucinating is possible while a person is sleepwalking. Some eat snacks while sleepwalking.
Sometimes, waking up a sleepwalker requires tremendous effort. Usually, when you succeed in waking them up, they feel flabbergasted because there is no memory of what they have done. In some cases, people can remember only particular moments of their actions. It is uncommon for a patient to remember what he has done during his unconscious state. In other cases, the sleepwalker may unconsciously attack the person who is trying to wake him up. Aggressive behavior in such situations is more typical for males. Sometimes, sleepwalking ends suddenly without any reason. The individual could get confused why he is in a particular place undertaking a certain action. Moreover, he does not have a clue how he ended up there. In other cases, the sleepwalkers can return back to bed and resume their normal night sleep without knowing that they were out of bed on a night journey.
Sleepwalking can occur with different frequency depending on the individual. It can be repeated several nights in a row. The only threat that should be considered as serious is that the individual may hurt himself or another person, including bed partners or people who live in the same house or even strangers on the street.
However, according to science, sleepwalking is fairly normal for children. It is seen as part of their early sleep pattern. They may go to their parentsâ€™ bedroom but can go to more dangerous journeys like going outside the house or staying extremely close to an open window. This can be really life-threatening. An older child can be more noisy and active while sleepwalking. Usually, he speaks while sleepwalking and have nightmares.
When Does Sleepwalking Occur?
Sleep is subdivided into four stages. They are known as non-rapid eye movement stage or non-REM. There is another stage which is called REM after the rapid eye movement that occurs during that phase. The REM stage allows a person to dream. Stage three of the sleep cycle is linked with the secretion of important hormones that are in charge of the individualâ€™s growth and metabolism.
Each of the four stages has fixed duration between 90 and 100 minutes and the sleep cycle is repeated several times throughout the night. The average repetition of those stages is about four or five times per night, although it depends on the individual and his night routine. Sleepwalking occurs in stage three or four from the non-REM sleep. It can also appear in REM sleep near dawn. During stages 3 and 4, the person sleeps deeply. Naps are relatively short, thus the cycle cannot reach those stages where sleepwalking occurs. This is why it is unusual sleepwalking to occur during naps.
Symptoms of Sleepwalking
Walking around the house in unusual hours is the main characteristic. The patient may look confused, dizzy and awkward in their actions and it becomes evident that they are not fully aware of what they are doing.
- Eyes lack expression – they can appear glassy. Sleepwalkers stare in an indefinite direction while walking.
- Sleepwalkers do not walk with their arms extended in front of their bodies. This is a false notion promoted by some movies.
- When trying to communicate with a person who is sleepwalking, you will receive slow answers. The thoughts expressed are simple, absent or inadequate.
- Sleepwalkers cannot recall what happened when they wake up.
- They can only sit on the edge of the bed, do nothing, as if awake, with eyes wide open.
- Sleepwalkers may do their everyday actions while they are sleepwalking.
- A person who is sleepwalking may be extremely difficult to wake up due to the deep phase of sleep he is in.
- Usually, sleepwalkers have sleep terrors.
- Leaving the house unaware or driving a car is uncommon.
- Unusual behavior is also possible because sometimes the sleepwalkers dream at the same time.
- The sleepwalker can even unconsciously engage in sexual intercourse.
- They may get injured because they are unaware of their surroundings.
- Sleepwalkers may become aggressive and violent without obvious reasons.
Other Factors Contributing to Sleepwalking
Children are more likely to be sleepwalkers. It affects both genders. This medical condition can occur right after the toddler is able to walk. Research showed that nearly 17% of children sleepwalk. Between the age of eight and twelve, they are most likely to sleepwalk.Most of them are also talking in their sleep or have night terrors.
However, sleepwalking may occur at any age. Â 4% of adults suffer from somnambulism. Aggressive behavior in such phase is more typical in the males.
The triggering factors of sleepwalking can be divided into inherited, environmental, psychological, physiological, medical or drug-induced.
- Inherited: this contributes significantly to the occurrence of sleepwalking because it runs in the genes.
- Environmental: Lack of sleep is one of the main factors that contribute to this condition. Chaotic sleep routine can also trigger sleepwalking. Fever and stress, both physical and emotional are also common factors. Sleeping in unfamiliar surroundings, noise and light are other factors.
- Psychological factors: these include the length and depth of sleep. Psychiatric disorders are also involved in the triggering of sleepwalking. Mental conditions including post-traumatic stress disorder or multiple personality disorder are also known to have an effect on sleepwalking.
- Physiological and medical factors: these may include pregnancy and menstruation, arrhythmias, asthma, seizures and gastroesophageal reflux. Other factors linked to sleepwalking include migraines and headaches, hyperthyroidism, head injury, stroke, and encephalitis. They increase the possibility of sleepwalking.
- Drug: they are linked to the use or the abuse of alcohol and illegal drugs. Sedatives or hypnotics which improve sleeping, minor tranquilizers that are used for their calming effect, stimulants that are used to increase brain and physical activity, neuroleptics that are used to fight psychosis, antihistamines that are used to treat the symptoms of various allergies.
Other Disorders Related to the Issue
Other common medical conditions related to sleepwalking include night terrors and confusional arousals. Both of them occur in non-REM sleep and have similar symptoms. Many children have experienced one of the conditions mentioned above. Another factor responsible for unusual sleep behavior are nocturnal seizures.
Night terrors, similar to sleepwalking, happen in stage three of the sleeping cycle. The difference between sleepwalking and night terrors is that, during night terror, the person often wakes up in a sudden and frenzied manner. The person usually looks terrified. Night terrors appear at an early age and the condition is characterized by accelerated heart rate and breathing. Sweating and dilated pupils are also observed. The causes may vary, but the usual ones are the lack of sleep, anxiety or under the influence of certain drugs. Another difference between sleepwalking and night terror is that the latter may reoccur for a longer period of time. There are periods when they subside completely and then appear again.
Another condition related to unusual sleep behavior is confusional arousals. The person wakes up suddenly and violently in an agitated manner. The distinction between this condition and sleepwalking is distinguishable speech. The difference between night terrors and those arousals is that no sweating, fast breathing, and heart rate or dilated pupils is observed. Like the rest of the mentioned conditions, this one also occurs in the third stage of non-REM sleep. Usually, it continues for 5 to 30 minutes and the person does not remember anything.
Nocturnal seizures, on the other hand, are really short-lived. However, their repetition and frequency may cause the condition to be confused with some of the others listed above. The unique feature of nocturnal seizures is that they happen in the second half of the sleep cycle. After such occurrence, the patient may have a headache, feel moody or feel a lack of energy in the morning.
Diagnosis of Sleepwalking
Medical treatment is not necessary for kids. The only preventive measure that parents need to take is to watch carefully their children. When it comes to sleepwalking in adulthood, things get a bit serious because there is risk of injury. In such cases, consulting a specialist may help. Doctors who deal with such medical disorders are called sleep medicine physicians. To identify the peculiarities of sleepwalking, the specialist will ask the patient to make a sleep diary for two weeks. This will give an insight of what the causes of the disorder may be. Also, the patientâ€™s complete medical history will be needed. Â It is of paramount importance for the patient to inform the physician the medications that he has used or is currently using. Thus, the specialist will be able to determine whether there are some other factors such medical condition or drug that may be causing the sleepwalking problem. Another method used for diagnosing sleepwalking involves the usage of polysomnogram. This is lab study that studies and analyzes the patientâ€™s brainwaves, heartbeat and other body functions. The process of sleeping is video recorded in order to track the patientâ€™s behavior while he is sleeping.
There are several ways in which the individual can prevent sleepwalking. Usually, children do not require treatment since this condition is seen as a normal part of development. Adults can rely on self-care or medical treatment.
- Self-care includes meditation or exercises for relaxation. Getting enough sleep is also one of the recommended remedies. It is a good advice to keep your room safe. Sharp objects and potential obstacles must be removed from the bedroom to avoid potential injury that sometimes may be serious. If you can, sleep in a bedroom that is on the ground floor to avoid any night journeys down the stairs. Try to cover your windows with heavy drapes that cannot be opened easily or blinds that will protect you from eventual falling out of the window. Additionally, you can place bells on the doors and windows which may wake you or someone up.
- Medical treatment is used when there are other factors triggering sleepwalking. As we have already mentioned, such conditions include gastroesophageal reflux, sleep apnea, seizures, etc. Medications are used as a last resort. Usually, benzodiazepines such as estazolam, tricyclic antidepressants and clonazepam are used.
- A behavioral therapist or hypnotist can help deal with sleepwalking. It is recommended to undergo such therapy before trying to treat this condition with drugs. Another method is the anticipatory awakenings. This method involves awakening of the patient every 15 or 20 minutes before the usual occurrence of the condition and the person must stay awake during the time when he usually sleepwalks to avoid its occurrence and gradually overcome it.
Killing Without Remembering?
Sometimes, sleepwalking can mean a fatal end for another person. There are cases where people commit homicide or other crimes while they are in the sleepwalking state. Sleepwalking is used as a legal defense, although it is difficult to prove whether the defendant was really sleepwalking while committing the crime. Here are some sleepwalking murderers:
He was charged with first-degree murder of his father. Mr. Lowe claimed that he had no memories of what have happened and how his father ended up dead on the driveway. The defense managed to prove that he fits into the profile of a sleepwalker and that he had a history of sleepwalking. However, he never showed aggressive attitude while sleepwalking. Furthermore, Mr. Lowe was on good terms with his father. It became clear that he committed the murder although he was not conscious while doing it. He was found not guilty and was sent to a psychiatric hospital.
In May 1997 in Toronto, Canada, Mr. Parks managed to drive his car 14 miles away from home while sleepwalking. He went to the house of his parents-in-law and attacked both of them, stabbing his mother-in-law to death while his father-in-law managed to survive. After committing the crime Mr. Parks went to the police station. He reported that he might have killed someone. He said he did not remember to have committed such a crime but found blood on his hands. He could not remember anything else. He had previous sleepwalking experience and no evidence of psychosis. The conclusion was that this was an isolated case and that there was no probability of a second occurrence. He was found not guilty.
Mr. Steinberg was accused of murdering his wife. He stabbed her to death. The horrible part of the crime is that he stabbed her 26 times. He claimed that he was sleepwalking and couldnnot recall anything at all. After proving that he was a sleepwalker and was not conscious during the murder, the court found him not guilty.
In 1977, Mr. Falater was accused of murdering his wife. His neighbor saw him committing the crime. The neighbor saw how Mr. Falater put on a pair of gloves and held the head of his battered wife underwater in the swimming pool in their yard. When the police arrived, the husband was oblivious and could not figure out why the police had arrived and he was not able to explain what happened. After long and thorough investigation, he was convicted of murder and was sentenced to life imprisonment.