Things that go Bump in the Night: the Disorder of Sleepwalking

Imagine waking up in the middle of the night to find you are not in bed at all, but have a bag full of clothes on your shoulder, car keys at the ready, and your hand on the doorknob to your room. You cannot remember getting out of bed, getting dressed, or packing your bags, but the car keys in your hand are very real, and all you can do is count your lucky stars you woke up before you had a chance to use them. Sound unsettling? This is just one of countless stories of sleepwalking experienced by a friend of mine, and not only is her condition unsettling, but it causes a great disturbance to her sleep schedule. As a college student and busy individual, I often take sleep for granted, but for someone with a sleep disorder such as sleepwalking, a full-night’s rest can seem like a gift from the gods.

All of us have felt the effects of a poor night of sleep, whether it is due to a medical disorder or simply not going to bed early enough, so we have all felt firsthand the importance of sleep to our body. We have all experienced that message loud and clear from our body protesting a lack of sleep: the inability to stay alert and focused, the hazy “fog” of consciousness, irritability, and in some cases physical exhaustion. Studies show that lack of sleep leads to problems completing a task, concentrating, making decisions and unsafe actions. Recent research suggests that sleep deprivation impacts on aging and diabetes. Insufficient sleep may also make it difficult to exercise and can reduce the benefit of hormones released during sleep (1). Sleep is an essential restorative process for our bodies and our minds. Not only is it a time for rest and rejuvenation, but also a time during which the body secretes certain hormones, blood pressure is lowered, kidney secretions change, and perhaps even when memory is consolidated. Aside from its restorative qualities, an extreme lack of sleep can cause mental instability and even death. While these animals will normally live for two to three years, rats deprived of REM sleep survive an average of only five months. Rats deprived of all sleep survive only about three weeks. In humans, extreme sleep deprivation can cause an apparent state of paranoia and hallucinations in otherwise healthy individuals (2). Recognizing the great importance of sleep, as well detrimental effects of disrupted sleep, sleepwalking can be seen in a completely new light.

Sleepwalking, or somnambulism, is estimated to affect somewhere between 1% and 15% of the general population. It is characterized by a series of complex behaviors (not just walking) that are carried out while sleeping. Most sleepwalkers have no memory of the actions they carry out. Symptoms of sleepwalking disorder range from simply sitting up in bed and looking around, to walking around the room or house, to leaving the house and even driving long distances (1). Although sleepwalking is most prevalent among children, most of whom outgrow the condition, many adolescents and adults are also affected. The extreme disruption to the sleep cycle that a person who regularly sleepwalks experiences occurs because there is a simultaneous occurrence of incomplete wakefulness and NREM sleep (3). These episodes cause a person to reach levels of arousal during early sleep stages, keeping them from taking advantage of the more important REM cycles.

Scientists do not fully understand what causes sleepwalking. My research online has yielded many varied and contradictory statements regarding its origins. The cause of sleepwalking in children is entirely unknown, but because most childhood cases of sleepwalking disappear with adolescence, there are few recommendations other than to ensure the child’s safety during episodes and wait it out. On the other hand, there seem to be a plethora of theories regarding the cause of sleepwalking in adults. One site takes the extreme, stating “Sleep walking in adults can be associated with mental disorders, reactions to drugs and alcohol, or medical conditions such as partial complex seizures” (4), while another completely contradicts this, saying “The onset or persistence of sleepwalking in adulthood is common, and is usually not associated with any significant underlying psychiatric or psychological problems” (1). What is obvious is that the internal forces driving sleepwalking remain a mystery to the medical community. As such, there is no specific treatment for sleepwalking. Scientists have identified episode triggers, which include sleep deprivation, sedative agents (including alcohol), febrile illnesses, and certain medications (1). Treatments for adults must be performed on a case-by-case basis, but may include hypnosis, low-dose antidepressants and sedative-hypnotics (1).

Sleepwalking, with its surprisingly high rate of occurrence, is an important and relevant area of study and discussion. With so little known about its causes, and treatment often nothing more than a list of suggestions to cope with its effects, and triggers to avoid, sleepwalking can be a constant source of frustration and concern for those who are affected by the disorder. Additionally, the extreme disruption it causes to the quality of sleep of an affected individual leaves its mark long after an episode is over. The cycle of sleepwalking and resulting sleep deprivation can lend itself to even more episodes, leaving its sufferer struggling for answers and a solid night of sleep. With sleep already a challenge for most people in today’s fast-paced society, sleepwalking sufferers need answers, and soon.

1. “Let sleep work for you.” Avail 25 February 2007. <http://www.sleepfoundation.org/site/c.huIXKjM0IxF/b.2421185/k.7198/Let_Sleep_Work_for_You.htm>.

a very knowledgeable, rich site dedicated to spreading awareness about sleep

2. “Sleep – Information about sleep.” Avail 25 February 2007.
<http://science.education.nih.gov/supplements/nih3/sleep/guide/info-sleep.htm>.

an online textbook designed to teach a course on sleep, very information-rich

3. “Sleep Disorders.” Avail 24 February 2007. <http://www.sleepquest.com/s_sleeptopics_s.html>.

brief overview of sleepwalking and other disorders

4. “Medical Encyclopedia: Sleepwalking,” Avail 24 February 2007.
<http://www.nlm.nih.gov/medlineplus/ency/article/000808.htm>

a medical encyclopedia providing brief overview of disorder, sparse information, used to illustrate conflictive views of disorder