By Evangeline T. Capuno
In some movies, you see people walk in their sleep but how many times have you seen someone doing so? Probably not too many have that opportunity. If you think it’s not possible, sleepwalking does exist.
“In normal conversation, the term sleepwalking may be used casually and figuratively as a way of describing a lack of energy or focus,” writes Eric Suni of US Sleep Foundation. “But for a number of children and adults, sleepwalking is a real condition that can have considerable consequences.”
Known in the science world as somnambulism, sleepwalking involves getting up from bed and walking around while in a state of sleep.
There are no statistics available for the Philippines. No one actually knows how many Filipinos walk in their sleep. But in the United States, “four percent of Americans have experienced sleepwalking in the past year, and 30% of adults say they’ve had an episode of sleepwalking at least once in their lives,” writes psycom.net’s Dr. Kathleen Smith.
Sleepwalking is more common in children than adults. Generally, sleepwalking is outgrown by the teen years. The onset in adulthood is more likely related to other underlying conditions. Men and women are equally likely to sleepwalk but the risk of the condition does decrease as they get older.
Sleep stages, sleep behaviors, and sleep disorders
As a sleep disorder, sleepwalking falls under parasomnia. “Parasomnias are abnormal behavior during sleep,” Suni writes. “In fact, parasomnias straddle a border between sleep and wakefulness, which is why the actions that occur during parasomnia episodes are abnormal.”
Sleep is a very complex behavior. People usually don’t know what really happens when they sleep.
A person experiences four stages first before he or she goes into deep slumber. Sleep experts call this non-REM sleep. REM stands for rapid eye movement, and refers to the stage of sleep characterized by rapid saccadic movements of the eyes.
In the first stage, according to Jayne Leonard of Medical News Today, the person is between being awake and asleep.
In the second stage, he goes through to a slightly deeper sleep; his body temperature drops and heart rate slows down.
In the third and fourth stages, the person is in a state of deep and restorative sleep, known as slow-wave sleep. During these stages, the muscles relax, the supply of blood to the muscle increases, and the body repairs and grows tissue. Hormones are released, and energy stores are replenished. It is also said that memory consolidation occurs during these stages.
Sleepwalking and other activities during deep sleep
Sleepwalking usually happens between stage 3 and stage 4 of non-REM sleep. “Sleepwalking originates during deep sleep and results in walking or performing other complex behaviors while still mostly asleep,” Suni writes.
Usually, sleepwalking occurs early in the night – often one to two hours after falling asleep. “It’s unlikely to occur during naps,” the Mayo Clinic states. “A sleepwalking episode can occur rarely or often, and an episode generally lasts several minutes, but can last longer.”
According to the Mayo Clinic, someone who is sleepwalking may get out of bed and walk around; sit up in bed and open his or her eyes; have a glazed, glassy-eyed expression; not respond or communicate with others; and be difficult to wake up during an episode.
Sometimes, a person who is sleepwalking will do routine activities, such as getting dressed, talking or eating. He or she may engage in unusual behavior, such as urinating in a closet. The person may also engage in sexual activity without awareness.
After being awakened, he or she is disoriented or confused for a short time. The person won’t remember the episode in the morning. He or she will have problems functioning during the day because of disturbed sleep.
“If anyone in your household sleepwalks, it’s important to protect him or her from potential injuries related to sleepwalking,” urges the Mayo Clinic.
There are sleepwalkers who leave the house or drive a car. Others get injured by falling down the stairs or jumping out a window. There are those who become violent during the period of brief confusion immediately after waking or, occasionally, during sleepwalking.
Causes
Suni enumerates several causes of sleepwalking. For one, genetics and family history play a significant role. “Studies show a clear pattern in which certain people are genetically predisposed to sleepwalking,” he writes. “About 22% of children whose parents have no history of sleepwalking will experience this condition. In contrast, 47% of children sleepwalk if one parent has a history of it, and 61% of children sleepwalk if both parents do.”
Sleep deprivation is another cause. “A lack of sleep has been correlated with an elevated risk of sleepwalking, which may be due to more time spent in deep sleep after a period of sleep deprivation,” Suni writes.
What a person takes into his or her mouth also plays a role in increasing the risk for sleepwalking. For instance, drinking alcohol in the evening can create instability in a person’s sleep stages, and may heighten the risk of sleepwalking. Medications that have a sedative effect may also push people into a type of sleep that increases their chances of having a sleepwalking episode, Suni contends.
Brain injury, fever, and stress are also possible causes. “Conditions that affect the brain, including swelling of the brain, may be a trigger for sleepwalking,” Suni states. “In children, fever has been found to make sleepwalking more likely. Various types of stress can affect sleep, including causing more fragmented or disrupted sleep that can increase the propensity for sleepwalking.”
Two sleeping disorders – obstructive sleep apnea (OSA) and restless leg syndrome (RLS) – can also trigger sleepwalking. “OSA is a sleep disorder in which the airway gets blocked, causing short lapses in breath during sleep. These pauses, which can occur dozens of times per night, create sleep interruptions that may give rise to sleepwalking.”
As for RLS, Suni writes: “RLS is a type of sleep disorder that causes a powerful urge to move the limbs, especially the legs, when lying down. It causes nighttime arousals from which a person may enter into a sleepwalking episode.”
How to manage sleepwalking
Sleepwalking is no cause for alarm. However, “it’s important to talk with your doctor if you are experiencing sleepwalking, as you are likely to sleepwalk again,” urges Dr. Smith. “Most people don’t require treatment for sleepwalking, but your doctor may want to rule out other medical conditions such as seizures.”
Adults who experience sleepwalking may be linked to a neurocognitive disorder such as dementia. “Getting treatment for other sleep disorders can also eliminate sleepwalking. Be sure to tell your doctor what medications you’re taking, whether you use drugs or drink alcohol and whether there is a history of sleepwalking in your family,” Dr. Smith writes.
Typically, doctors don’t prescribe medications for sleepwalking, but may sometimes prescribe a short-acting tranquilizer. Early research has indicated that melatonin may be helpful in addressing sleepwalking as well. “Your doctor may also refer you to a mental health professional who can work with you to help you lower stress and anxiety,” writes Dr. Smith.
There are several lifestyle changes you can do to reduce your risk of sleepwalking. “Limit your use of alcohol, and try to get at least seven hours of sleep every night,” Dr. Smith suggests. “Engage in daily or weekly relaxation activities (medication can be helpful) to reduce stress, or consider meeting with a mental health professional to address your anxiety. Above all, it’s important to not be discouraged in your efforts.”
Sleepwalking crime scene investigation
Sleepwalking is an uncommon defense for murder and other crimes, but it has been used successfully. Kenneth Parks, a young Canadian man, was acquitted in the 1987 murder of his mother-in-law after using the sleepwalking defense.
The US News and World Report recalled the incident: “On the night of the death, (Parks) arose from bed, drove 14 miles to the house of his in-laws –with whom he was said to be close – and strangled his father-in-law until the man passed out. He bludgeoned his mother-in-law with a tire iron and stabbed them both with a kitchen knife. The woman died; the man barely survived.
“Parks then arrived at a police station. Police said he seemed confused about what had transpired, and they noted something odd: Parks appeared oblivious to the fact that he’d several tendons in both hands during the attack. That obliviousness to pain, along with other factors, including a strong family history of parasomnias, led experts to testify that Parks had been sleepwalking during the attack. Not conscious, not responsible, not guilty.” – ###
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