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What Causes Sleepwalking? Your Questions Answered

Sleepwalking, scientifically known as somnambulism, is a disruptive and potentially dangerous condition that sometimes takes years to shake. 

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Few things are as disconcerting—and sometimes terrifying—as sleepwalking. I can still vividly recall one summer night when it happened to me: I was about six years old, and I woke up standing outside the locked front door of my house at three o’clock in the morning. Shivering in my nightgown, I cried and cried as I rang the doorbell, until my mother, still practically asleep herself, finally heard me and came downstairs to let me back inside. Fortunately for me, that was an isolated incident, but some people aren’t so lucky.

What Causes Sleepwalking?
The National Sleep Foundation estimates that 1 to 15 percent of Americans sleepwalk. This disorder, which occurs during the deepest stages of sleep, is most common among children, especially those with obstructive sleep apnea or those who wet their bed. However, after the habit peaks when those kids are eleven or twelve, they tend to outgrow it naturally.

When people begin to sleepwalk in their adult life, it happens largely because they’re either sleep deprived or, conversely, taking relaxation- or sleep-promoting medications, as well as antipsychotic drugs or antihistamines. In addition, WebMD highlights a wide variety of medical conditions that have been linked to increased likelihood of sleepwalking, among them arrhythmias, gastroesophageal reflux, nighttime asthma and seizures, and psychiatric disorders. Our genetic makeup is another plausible cause: Identical twins have a higher incidence of sleepwalking than non-multiple children do, and someone who has a first-degree relative with a history of sleepwalking is a whopping ten times more likely to sleepwalk herself.

At first glance, sleepwalkers might appear to be awake: their eyes may be wide open, and they may be talking. But closer inspection will reveal that their gaze is glassy and unfocused, and that they’re actually babbling incoherently and are either slow to respond to direct questions or completely unresponsive. Sleepwalkers who return to normal slumber without having been awakened rarely remember anything they did during the episode. 

Cautionary Tales
The word sleepwalking is actually somewhat of a misnomer, as it generally involves more than merely walking, and often bizarre, injurious, or even aggressive acts. Sleepwalkers’ seemingly benign activities, wrote Shelly R. Gunn in a report entitled “Are We in the Dark About Sleepwalking’s Dangers?” and published by the Dana Foundation, include “purposeful acts such as eating half a bag of chips and putting the rest in the microwave, taking all their shoes from the closet and lining them on the windowsill, [and] rearranging furniture.” However, keep in mind that these tasks take on an entirely new level of risk when the person performing them is not awake. Sleepwalkers may also demonstrate inappropriate conduct that, while not directly harmful to themselves or others, can strain their personal relationships, such as urinating frequently in closets or other non-bathroom-related areas of their home. 

Even more frightening, though, are the cases in which sleepwalkers engage in behavior that is self-destructive or threatens the safety of others. In June 2005, for instance, a fifteen-year-old girl in London sleepwalked from her home to a nearby construction sight, ascended a 130-foot crane, and climbed out onto its arm, where she curled up and remained sleeping until, miraculously, firefighters rescued her unscathed. In a similarly chilling episode, Shelly Gunn’s son, Stewart, sleepwalked out of the window of his dorm room at St. John’s College in Oxford, England, and fell two stories onto the cobblestone street below, fracturing his spine and his wrist. His experience inspired Gunn to write her Dana Foundation article, which casts sleepwalking as a nebulous condition that neither physicians nor the general public know much about.

Additionally, Gunn reported, “increasing numbers of so-called ‘sleepdriving’ cases are being reported, in which somnambulists get in their cars and drive sometimes long distances … and, after waking up, hav[e] no memory of what they did.” More often than not, the prescription sleep aid Ambien appears to be at the root of this trend. In her 2006 New York Times article “Some Sleeping Pill Users Range Far Beyond Bed,” Stephanie Saul stated that more and more traffic-related arrests were being linked to the drug, and that some of the offending drivers were asleep under its influence when they got behind the wheel. Dubbing these individuals “Ambien drivers,” Saul underscored their anomalous habits, including “driving in the wrong direction or slamming into light poles or parked vehicles, as well as seeming oblivious to the arresting officers.”

Never Wake a Walker?
As if those dangerous deeds weren’t enough to keep us all on guard, there’s a widespread belief that waking a sleepwalker can literally scare that person to death. On the contrary, however, experts agree that if someone in your home is a somnambulist, you could actually save her life by rousing her during an episode. In 2007, Scientific American declared that “the chances of killing a sleepwalker due to the shock of sudden awakening … [are] about as likely as somebody expiring from a dream about dying.” The most effective method of handling a sleepwalker is to approach her carefully, take her gently but firmly by the arm, and guide her slowly back into bed while she’s still asleep. 

A Better Night’s Sleep
Although no cure-all for sleepwalking exists, avoiding alcohol, ensuring that you’re getting enough shut-eye, and adhering to a consistent sleeping schedule can help mitigate the problem. If it persists, consult a physician or a sleep specialist who can analyze your sleep patterns, stress levels, and overall physical health. Be prepared to provide full disclosure about any medications or other controlled substances you’re using. To curb young sleepwalkers of the habit, waking them forty-five minutes after they first fall asleep sometimes does the trick. If your child continues to sleepwalk, take preventive measures to make your house as safe as possible at night by locking all doors and windows, stashing sharp and breakable objects, and installing gates on stairways. 

Don’t Walk the Walk
At best, somnambulism is a strange but harmless habit that results in silly incidents, such as someone’s taking the trash out in the middle of the night or waking up on the couch instead of in her bed. But other times—particularly given the increasing prevalence of powerful prescription medications, coupled with adults’ rising stress and sleep-deprivation levels—sleepwalking is a high-risk disorder that can lead to serious injuries and, in the most extreme cases, death. If you or someone you know is a chronic sleepwalker, don’t delay in taking every precaution to avert a catastrophe.

Updated March 16, 2011

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