Usually sleepwalking (somnambulism) is neither bad nor dangerous. But it is nonetheless important to arrange the sleeping environment in a way to prevent the sleepwalker from hurting him- or herself.

What is sleepwalking?

Sleepwalking is a so-called parasomnia, a condition characterized by abnormal symptoms or behaviors during sleep. Other forms of parasomnia include nightmares, talking in sleep, nighttime anxiety attacks and teeth grinding. Sleepwalking occurs in the first part of the night, one to three hours after falling asleep, in the phase of deep non-REM sleep, when it is difficult to wake up but not during REM or dream sleep. So it has nothing to do with dreams. It is assumed that this is an incomplete thought reaction (arousal) during (deep) sleep.

Is sleepwalking common?

Sleepwalking can occur at any age. But it is most common in children between the ages of four and twelve years? About 15 to 20 percent of children would sleepwalk at least once. One in 30 children regularly suffer from sleepwalking. Boys sleepwalk more often than girls. In adults, estimates range from 1 to 4 percent.

In most children, sleepwalking gets less common as they get older and eventually disappears. It can also start in adulthood, in which cases the disorder usually persists.

What happens when you sleepwalk?

Two forms of sleepwalking are distinguished:

• Abortive: the person sits upright in bed and makes random movements;
• Manifest: the sleepwalker effectively gets out of bed and goes for a walk.

Sleepwalking usually occurs one to three hours after falling asleep. The episodes usually last no longer than 10 to 15 minutes. It can sometimes repeat itself during the same night. During sleepwalking there is a reduced awareness and the sleepwalker does not respond to stimuli from the environment.

The eyes may be open, but it is not clear whether the sleepwalker can actually see. Sleepwalking can be accompanied by mostly unintelligible talking or shouting.

While sleepwalking, children can do certain things, such as putting on their clothes, opening a door, turning on the TV, eating something, walking out… Also, sometimes aggressive and violent expressions that can lead to self-harm or to injury of others.

In the morning, the sleepwalker remembers nothing or almost nothing of the nocturnal escapades.

The causes of sleepwalking

The exact causes of sleepwalking are not known. It is likely that several factors play a role at the same time.

• Hereditary predisposition: Often there are several people in the family who suffer from sleepwalking. Ten to twenty percent of sleepwalkers have family members who also sleepwalk. There is probably a genetic predisposition, but the exact details are not yet fully known.
• Age: Sleepwalking is more common in children than in adults. Children usually sleep very deeply but on the other hand show great restlessness. It may be a kind of maturation phenomenon.
• Environmental factors such as intense emotions and stress during the day, may play a role. A change in the sleep-wake rhythm, fatigue and a lack of sleep may also play a role.
• Fever can be an inciting factor of sleepwalking in children who have a predisposition to this.
• Sleepwalking can also be provoked by excessive alcohol or drug use, and by some medicines such as tranquilizers.
• People suffering from obstructive sleep apnea syndrome (OSAS) may also exhibit nocturnal episodes of confusion and disorientation and leave the bed in this state, resulting in sleepwalking.
• Nocturnal restlessness and wandering in the elderly may be reminiscent of sleepwalking, but usually indicate a brain disorder such as dementia.

Is sleepwalking dangerous?

Sleepwalking in itself is usually not a dangerous thing and the children have little or no inconvenience from it. Normally it disappears automatically from puberty. A fixed sleep ritual for relaxing and a fixed sleep time can help to help.

The most important thing is to prevent the sleepwalker from doing dangerous things and having an accident or injuring him- or herself. To avoid accidents, you can take a number of measures.

• Remove unnecessary furniture and loose rugs and clean up the room before bed, so you can prevent the sleepwalker from tripping or bumping into something.
• Put caps around the corners of cabinets and tables.
• Do not let the sleepwalker sleep in a bunk bed at the top.
• Close the stairs.
• Close all windows and lock the doors. This way, the sleepwalker can’t leave the house by accident.
• If necessary, hang a bell on the bedroom door so that you can hear when the child goes out.

Try not to wake a child who is sleepwalking. If you wake the child up, chances are he or she will wake up agitated or confused. Better to guide the child to his or her bed. Most children will then go to sleep peacefully.