Definition Sleepwalking is purposeless sitting up or walking while asleep. It is a fairly common childhood sleep disorder. A child will have no memory of the event afterward.
What is going on in the body? Sleepwalking is one of a group of fairly common, related sleep disorders in children. Also among this group are:
night terrors
sleep talking
bedwetting not linked to a physical problem, which is called primary nocturnal enuresis
A child can experience any or all of these disorders. They occur more commonly among boys than girls.
Sleepwalking is often combined with sleep talking. Usually, it happens when a child is between 5 and 12 years old. Episodes occur at a particular point in the sleep cycle, generally 70 to 120 minutes after sleep begins. The child does not remember the event the following day.
Often, others in the family have had related sleep disorders. Sleepwalkers are likely to also experience bedwetting not linked to problems with kidney or bladder function. As many as 15% of children have at least one sleepwalking episode. Sleepwalking occurs repeatedly in 1% to 6% percent of children.
Sleepwalking in childhood is a normal variation on the sleep pattern. Most children who are affected by it do not have frequent episodes. It is not linked to mental disorders in children and usually disappears by the time the child reaches adolescence. Parents should be aware, however, that children can accidentally injure themselves while sleepwalking.
What are the signs and symptoms of the condition? Typically, the sleeping child suddenly sits up. His or her movements are clumsy. There may be repetitive movements of the fingers and hands. The child's eyes may be open, but with a blank stare.
Sometimes the child gets out of bed and walks around purposelessly. More often, he or she simply lays down again after a period of restless motion. He may perform clumsy, purposeful activities such as trying to open a door or to get dressed.
The child usually cannot be awakened during one of these episodes. If anyone tries to talk to the child, he or she may answer with mumbling and slurred speech. An episode can last 5 to 20 minutes. Afterward, the child lays down and goes back to sleep.
What are the causes and risks of the condition? Sleepwalking is more likely to occur if a child has had night terrors as a preschooler or if others in the family have had sleep disorders.
Being overly tired or stressed may affect the child's sleep pattern. That could make an episode of sleepwalking or one of the other common sleep disorders more likely to occur.
What can be done to prevent the condition? Sleepwalking cannot be completely prevented. Parents should ensure that school-age children get enough sleep and are helped with any stressful situations at school or home.
How is the condition diagnosed? Sleepwalking is usually diagnosed on the basis of the report of an episode. A polysomnogram is rarely ordered. When ordered, the polysomnogram includes a test to record brain activity called an electroencephalogram or EEG.
What are the long-term effects of the condition? Sleepwalking and related disorders have no long-term effects. Usually, these sleep disorders stop by the time a child is 15 years old.
What are the risks to others? Sleepwalking is not contagious, so there are no real risks to others. Some caregivers may feel tired during the day if they need to listen for the child at night.
What are the treatments for the condition? Medications are not used to manage sleepwalking in children.
To make sure that a child does not fall down the stairs or wander outside, a parent should accompany the sleepwalker. The child should be guided back to bed after a trip to the bathroom. No one should try to awaken the child. Once back in bed, the child usually goes back to sleep.
For safety, parents should put gates at the entrance to stairways and a lock out of the child's reach on the house doors leading outside. Sleepwalkers should not sleep in upper bunks.
If a child repeatedly sleepwalks, changing the sleep pattern may help. A parent should awaken the child about 15 minutes before the time he or she would be expected to start a sleepwalking episode. The child should be kept awake for 5 minutes or so. Carrying this out for a week to 10 days might alter the sleep pattern enough to stop the sleepwalking.
What are the side effects of the treatments? There should be no side effects to the above treatments. Any unusual symptoms should be discussed with the child's paediatrician.
What happens after treatment for the condition? Sleepwalking should improve after treatment. However, safety items should be left in place to protect the child in case sleepwalking starts again.
How is the condition monitored? Sleepwalking generally goes away by the time the child is 15 years old. A doctor should be consulted if the sleepwalking persists beyond that age.
Author: John Wegmann, MD Reviewer: eknowhow Medical Review Panel Editor: Dr John Hearne Last Updated: 7/02/2005 Contributors Potential conflict of interest information for reviewers available on request
