September 2020 | Reviewed by: Seema Khosla, MD and Imran Shaikh, MD

What is sleepwalking?

Sleepwalking is also called “somnambulism.” It is a parasomnia. A parasomnia involves undesired events that come along with sleep.

Sleepwalking occurs when you get up from bed and walk around even though you are still asleep. It can also involve a series of other complex actions. Before walking, you might sit up in bed and look around in a confused manner. At other times, you may bolt from the bed and walk or run away. You may be frantic to escape from a threat that you dreamed or imagined.

You might talk or shout as you are walking. Your eyes are usually open and have a confused, “glassy” look to them. You might begin doing routine daily actions that are not normally done at night.

Sometimes, sleepwalking involves actions that are crude, strange, or in the wrong place. This might include urinating in a trash can, moving furniture around, or climbing out of a window. It can also result in hostile and violent behavior although this is rare.

In rare cases, a patient will get in the car and drive away. He or she might even go for a very long distance. Adults might dream or hallucinate while they sleepwalk. Some people will eat.

It can be very hard to wake a sleepwalker up. When you do wake up, you can be very confused. This is because you normally have no memory of the event. You may sometimes recall bits and pieces of what took place. Less often, you will have a very clear memory of all that happened.

At times, you might even attack the person who wakes you. Men, especially, can be violent during these episodes. The walking can also suddenly end by itself. This might leave the individual in a very awkward place. At other times, the individual may return to bed while still asleep. He or she will have never awakened during the event.

Sleepwalking most often occurs in the first third of a night’s sleep or during other long sleep periods. This is during the slow-wave cycle of sleep. Every now and then, it can occur during a daytime nap.

Episodes can occur rarely, or very often. They can even happen multiple times a night for a few nights in a row. The main risk is injury to self, the bed partner, or others in the same home. It can also disrupt the bed partner’s sleep.

Sleepwalking can usually be seen as a fairly normal part of a child’s early sleep patterns. The child with calm sleepwalking may quietly walk toward a light or to the parents’ bedroom.

At times, kids will walk to a window or door, or even go outside. This can put them at great risk. Older children may be more vocal and active as they sleepwalk. Children who sleepwalk will often experience sleep talking and have sleep terrors.

What are symptoms of sleepwalking?

Sleepwalking can involve strange, inappropriate and even violent behaviors. Someone who is sleepwalking may:

Get out of bed and walk around
Sit up in bed and open their eyes
Have a glazed, glassy-eyed expression
Do routine daily actions
Be difficult to wake up
Be confused
Quickly return to sleep
Not remember what happened
Have sleep terrors

In rare cases someone who is sleepwalking may:

Leave the house
Drive a car
Engage in unusual behavior, such as urinate in a closet
Get injured
Become violent

What are risk factors for sleepwalking?

Sleepwalking is more common in children and affects both boys and girls. It can begin as soon as a child is able to walk. The rate of it in children is as high as 17%. It peaks by the time they are eight to 12 years old. Most children with it also had confusional arousals at a younger age.

Rarely, sleepwalking may begin at any time in adult life, even when someone is in their seventies. Up to 4% of adults sleepwalk. In adults, men are more likely to display aggressive behavior when they sleepwalk.

There is a strong genetic and family link to having it. Your chance of having it can double or almost triple if one of both parents had sleepwalking episodes as a child or adult.

Episodes of sleepwalking and sleep terrors share many of the same causes. These include the following:

Sleep deprivation
Hyperthyroidism (overproduction of thyroid hormones)
Migraine headaches
Head injury
Encephalitis (brain swelling)
Stroke
The premenstrual period
Bloated stomach
Physical or emotional stress
Sleep apnea
Other sleep-related disorders or events
Travel
Sleeping in unfamiliar surroundings
Some medications
Alcohol use and abuse
Noise or light
Fevers in children

How to diagnose sleepwalking?

Sleepwalking in children is fairly normal. It does not usually need medical treatment. Parents should simply keep a close watch on their child. An adult who continues or begins to sleepwalk is at a greater risk of injury. In this case, it would be a good idea to seek the advice of a sleep doctor.

A sleep doctor will often ask you to complete a sleep diary for two weeks. This will give the doctor clues as to what might be causing your problems. You can also rate your sleep with a simple questionnaire. This will help show how your sleep is affecting your daily life. The doctor will need to know your complete medical history. Be sure to inform her of any past or present drug and medication use. Also, tell the doctor if you have ever had any other sleep disorder.

A sleep doctor will try to determine if there is something else that is causing your sleepwalking or making the symptoms worse, such as:

Another sleep disorder
A medical condition
Medication use
A mental health disorder
Substance abuse

The sleep doctor may want to examine your sleep using a sleep study. Also known as polysomnography, a sleep study records your brain waves, heartrate, and breathing as you sleep. It also looks at how your arms and legs move and records your behavior during sleep on video. This will help show if you get out of bed and do anything unusual during your sleep study.

How to treat sleepwalking?

For children, sleepwalking tends to go away on its own as they enter the teen years. You can try to prevent your child from getting hurt while sleepwalking with the following steps:

Keep windows and doors locked at night so your child cannot get outside.
Make sure your child does not sleep in an elevated bed (bunk bed).
Keep sharp, breakable and dangerous items away from your child’s bed and out of the bedroom.
Put a safety gate in the doorway of your child’s bedroom or at the top of the stairs.
Keep the floor clean of clutter or other objects that could make your child trip and fall.

If your child sleepwalks do not try to hold your child down or wake them but instead gently guide them back to their bed. Making sure your child gets enough sleep can sometimes prevent sleepwalking. In general children 3 to 5 years old should get 10 to 13 hours of sleep, older children should get 9 to 12 hours of sleep and teens should get 8 to 10 hours of sleep.

Sleepwalking can occur when sleep is fragmented by other sleeping problems. Sleep apnea is a common medical problem that can lead to frequent arousals from sleep. This may increase the risk of parasomnias such as sleepwalking. Symptoms of sleep apnea include snoring, waking up gasping for air, and daytime sleepiness. Treatment of sleep apnea may improve sleepwalking.