What is sleepwalking?

Sleepwalking (somnambulism) is a type of sleep disorder. It means that you get up and move around while you are asleep. It happens during deep sleep.

During sleepwalking, you may sit up, walk around or do simple activities and then go back to bed. You will do these things without knowing about it. You usually can't remember what you have done.

Sleepwalking can sometimes be risky because you don't know where you are or what you're doing. It's important to keep the sleep area safe to avoid injuries.

Children are more likely to sleepwalk than adults. If sleepwalking happens a lot or causes problems, talk to your doctor for advice or treatment.

What happens when I sleepwalk?

Sleepwalking happens during deep sleep, usually in the first part of the night. When you sleepwalk, you are partly awake but still asleep.

During sleepwalking:

• a person might sit up, walk around or do simple things, such as opening doors
• their eyes may be open and they may look like they know what they're doing, but they aren't fully aware
• an episode may last from a few minutes up to an hour and they may return to bed on their own
• most people don't remember the episode or only remember parts when they wake up

Sleepwalkers may not feel pain, so they might not notice cuts or bruises until the morning. Some people may feel scared or confused, especially if they wake up suddenly.

In rare situations, sleepwalkers might bump into someone or act out their dreams. This does not happen on purpose. It's safest for family members to gently guide them back to bed without waking them.

What causes sleepwalking?

Sleepwalking is usually harmless and goes away on its own, especially in children. However, chronic sleepwalking can sometimes be linked to other problems. For example, sleep disorders, stress or behavioural issues.

You are more likely to sleepwalk if you:

• don't get enough sleep
• don't have regular sleeping hours
• feel stress or emotional pressure
• are sick or have a fever
• need to wee during the night
• take certain medicines
• have certain medical conditions, such as sleep apnoea or epilepsy

Many children who sleepwalk have night terrors as well.

When should I see my doctor?

You should see a doctor if:

• you or your child are sleepwalking often
• sleepwalking leads to injuries
• sleepwalking leads to daytime tiredness or emotional problems
• sleepwalking leads to dangerous or violent episodes
• you are worried about sleepwalking

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How is sleepwalking diagnosed?

Your doctor may diagnose sleepwalking by asking about your medical history and sleep habits. They will talk to you or your family to understand what happens during sleepwalking episodes.

Most of the time, no special tests are needed because sleepwalking is usually harmless. If the episodes seem unusual, frequent or dangerous, they might do tests. This is to rule out other conditions, such as epilepsy.

These tests may include:

• electroencephalogram (EEG) — a painless brain scan to check for seizures
• polysomnography — a sleep study that records brain activity, breathing and movement during sleep
• brain imaging — such as MRI or CT scans

Sleepwalking can sometimes run in families, so your doctor may ask about family health history. They may also do a physical examination to rule out other problems.

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How is sleepwalking treated?

Most children grow out of sleepwalking and many people don't need treatment.

Treatment may help if sleepwalking:

• happens often
• leads to injuries
• leads to daytime tiredness or emotional problems
• leads to dangerous or violent episodes

If sleepwalking leads to safety concerns or distress, 2 simple and safe treatments are often recommended:

• Scheduled waking — wake the sleepwalker briefly about 15 to 30 minutes before they typically sleepwalk. This can stop the sleepwalking pattern.
• Hypnosis — hypnosis may help by suggesting the sleepwalker will wake up if their feet touch the ground.

Managing triggers

Certain things can make sleepwalking worse, such as stress, poor sleep or certain medicines. Your doctor may suggest:

• following a consistent sleep schedule
• reducing stress or practicing relaxation techniques
• reviewing medicines to see if they may be triggering the sleepwalking

If sleepwalking is caused by other sleep problems, such as sleep apnoea, treating those conditions may help.

Sometimes, medicines may be prescribed as short-term treatment option if other treatment options don't help.

Living with sleepwalking

Most people who sleepwalk live normal lives without treatment. Manage your triggers, such as stress or poor sleep and make sure your home is safe. Lock your windows and clear any obstacles.

If sleepwalking leads to distress or injuries, ask your doctor for advice.

What to do when your child is sleepwalking?

If your child is a sleepwalker, the best thing to do is to calmly comfort them and return them to bed.

There are ways you can lower their risk of injury from sleepwalking.

• Lock windows and external doors to stop them from leaving the house.
• Remove sharp or breakable objects from their room.
• Clear the floor of any clutter or tripping hazards.
• Use baby gates near stairs or hazardous areas.
• You can use a monitoring system in your child's room. This can send an alert if there is movement in the room.

You should gently and calmly direct your sleepwalking child back to bed.

Don't try to wake them up. This could startle and distress them.

Don't lock anyone in their room as this could be a fire safety risk.

Read more about sleep tips for children.

What are the risks of sleepwalking?

Sleepwalking usually isn’t a big problem, but it can sometimes lead to injuries or embarrassment. For example, when you go outside without realising it.

Potential risks during sleepwalking may include:

• injuries, such as falling, walking into objects or going outside
• embarrassing situations, such as being found outside or inappropriately dressed
• rare situations of aggression or violence, especially when startled during an episode

Can sleepwalking be prevented?

While sleepwalking cannot always be completely prevented, managing triggers can help reduce episodes.

Avoid alcohol or drugs, as they can impact quality of sleep.

Keep the sleep area safe, such as locking windows and moving sharp objects. This can help avoid accidents.

Resources and support

• Sleep Health Foundation offers information on sleepwalking.
• Australasian Sleep Association offers information on parasomnias, including sleepwalking, night terrors, nightmares and REM sleep behaviour disorder.
• Royal Children's Hospital Melbourne offers information on sleepwalking in children.
• Raising Children offers information on night terrors in children.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available 24 hours a day, 7 days a week.