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Table of Contents

Magill’s Medical Guide, 9th Edition

Sleepwalking

by Mary Hurd

Category: Disease/Disorder

Also known as: Somnambulism

Anatomy or system affected: Brain, musculoskeletal system, nervous system, psychic-emotional system

Specialties and related fields: Neurology, psychology

Definition: Repeated episodes of arising from bed during sleep and walking about, without being conscious of the episodes or remembering them.

Key terms:

electroencephalogram (EEG): a report of brain wave activity, achieved through attaching conductors to the scalp

parasomnia: normal waking behavior appearing within sleep (including sleepwalking) that is not caused by psychiatric illness

sleep stages: the division of sleep into rapid eye movement (REM) sleep, in which dreaming occurs, and non-REM sleep divided into four progressive levels, the first two being drowsiness and light sleeping and the last two involving deep sleep

CAUSES AND SYMPTOMS

Sleepwalking occurs during stages 3 and 4 of non-REM sleep and most frequently between one to four hours after falling asleep. Electroencephalograms (EEGs) indicate that children usually make a sudden transition into lighter sleep at the end of the first period of deep sleep. Some children do not make the transition rapidly and engage in parasomnia, or a simultaneous functioning of deep sleep and waking known as sleepwalking. An episode lasts from a few minutes to about an hour.

An estimated 40 percent of children ranging from six to sixteen years have reported sleepwalking, with twelve being the age of prevalence. While sleepwalking before the age of four is rare, partial wakings can affect toddlers and infants. Although sleepwalking usually ends around the age of seventeen, it can continue on into the early twenties. It is slightly more common in boys. Although most children sleepwalk infrequently, some sleepwalk frequently and for a period of five years or longer.

Sleepwalkers may have blank, staring faces and remain unresponsive to the attempt of others to communicate with them. They can be awakened only through great effort. Although sometimes sleepwalking children possibly see and walk around objects during their episodes, their behavior may involve leaving the bed violently and running without regard for obstacles. Partial awareness of their environment may be evident in their ability to negotiate hallway turns or objects on the floor. Some children stumble on stairs, crash into glass windows or doors, or walk out of the house into traffic. Serious injuries have occurred. While memory of these episodes is often absent, there may be a dim recall of the need to escape.

During sleepwalking, aggression toward others or toward objects in the vicinity is rare. The activity may be accompanied by sleeptalking that is characterized by poor articulation. Sleepwalkers also have increased incidence of other sleep disorders associated with non-REM sleep, such as night terrors.

Hormones or other biological factors may affect the character of these nighttime arousals. Statistics show that as many as 50 percent of sleepwalking children have close relatives with a history of similar phenomena. Although sleepwalking in very young children is developmental, many older children exhibit both a biological and an emotional predisposition for frequent sleepwalking. Some children who struggle to avoid expressing their feelings develop sleep problems.

TREATMENT AND THERAPY

Ensuring adequate sleep and providing a normal schedule are the best ways to treat partial wakings in young children. Although these remedies can help, some parents may have to learn to live with their children’s sleepwalking. Understanding what is happening will prevent the parents from intervening by attempting to awaken or question children or returning them to bed immediately. Instead, parents should talk quietly and calmly to sleepwalking children. If the children spontaneously awake after the episode, parents should avoid negative comments and treat the event matter-of-factly. In the case of agitated sleepwalking, restraint merely intensifies and increases the length of time of the episode. One should approach the child only to prevent injury, thus allowing the sleepwalking to run its course.

The child’s environment should be made as safe as possible to prevent accidental injury. Floors and stairs should be cleared, and hallways should be lit. For young children, gates may be installed at their bedroom doors or at the stairs, and should they attempt to leave the house, chain locks above their reach should be affixed to the doors.

Information on Sleepwalking

Causes: Developmental disorder, hormones, hereditary factors

Symptoms: Blank, staring face; unresponsiveness; running without regard for obstacles; poor articulation

Duration: Acute to chronic

Treatments: Monitoring in sleep clinic, drugs, technical aids, behavior modification

Richard Ferber, director of the Center for Pediatric Sleep Disorders in Boston and author of Solve Your Child’s Sleep Problems (1985), believes that older children whose sleepwalking may involve both psychological and inherited factors will benefit from psychotherapy. They may find it very difficult to express their feelings, especially if they are involved in situations in which things are happening outside their control. In the event of changes, losses, or an absence of warmth or love within a family, Ferber believes that children are often quite angry about the circumstances but do not express it outwardly. Psychotherapy or counseling will encourage children to believe that their feelings are not dangerous and will help them express these feelings. Medication is prescribed reluctantly-only to prevent self-injury-and is decreased as the benefits from psychotherapy increase.

PERSPECTIVE AND PROSPECTS

As late as the 1960s, sleepwalking was believed to be a neurotic or hysterical manifestation or an acting out of a dream. Contemporary studies have confirmed that sleepwalking is a sleep disorder that is not caused by psychiatric illness and is not a walking dream state.

Fortunately, sleepwalking can be outgrown by adulthood. Meanwhile, investigations into the nature of sleep, sleep and waking patterns, and biological rhythms continue to provide the best insight into this distressing family problem.

See also Nightmares; Psychiatry, child and adolescent; Sleep; Sleep disorders.

For Further Information:

1 

Ferber, Richard. Solve Your Child’s Sleep Problems. Rev. ed. New York: Simon & Schuster, 2006. This concise volume is illustrated and includes an index.

2 

McMillan, Julia A., et al., eds. Oski’s Pediatrics: Principles and Practice. 4th ed. Philadelphia: Lippincott Williams & Wilkins, 2006. A text that offers clear descriptions of diseases and illustrations.

3 

Parkes, J. David. Sleep and Its Disorders. London: W. B. Saunders, 1985. This volume is aimed at the medical professional and includes illustrations, bibliographical references, and an index.

4 

Reite, Martin, John Ruddy, and Kim E. Nagel, eds. Concise Guide to Evaluation and Management of Sleep Disorders. 3d ed. Washington, DC: American Psychiatric Press, 2002. Gives an overview of the symptoms and treatments available for different types of sleep disorders.

5 

Sutton, Amy L., ed. Sleep Disorders Sourcebook: Basic Consumer Health Information About Sleep and Sleep Disorders. 2d ed. Detroit, Mich.: Omnigraphics, 2005. Covers topics such as insomnia, sleepwalking, sleep apnea, restless leg syndrome, narcolepsy, and their treatment options.

Citation Types

Type
Format
MLA 9th
Hurd, Mary. "Sleepwalking." Magill’s Medical Guide, 9th Edition, edited by Anubhav Agarwal,, Salem Press, 2022. Salem Online, online.salempress.com/articleDetails.do?articleName=MMG2022_1252.
APA 7th
Hurd, M. (2022). Sleepwalking. In A. Agarwal, (Ed.), Magill’s Medical Guide, 9th Edition. Salem Press. online.salempress.com.
CMOS 17th
Hurd, Mary. "Sleepwalking." Edited by Anubhav Agarwal,. Magill’s Medical Guide, 9th Edition. Hackensack: Salem Press, 2022. Accessed September 16, 2025. online.salempress.com.