Is Sleepwalking Real and How Dangerous Is It?

Reviewed by: Dr. Steven Knauf, D.C.

By Martha Michael

Sleepwalking can be a bit of a nightmare brought on by stressful circumstances, though rarely as nefarious as the source of Lady Macbeth’s nocturnal wanderings. Most cases aren’t as dramatic as Shakespeare’s depiction, but recurring episodes of sleepwalking are worth looking at more closely for several reasons.

Sleepwalking can put you or other members of the household in harm’s way or signal the existence of a mental health issue. It is a very real thing and not confined to cartoons or a cheap laugh on the big (or small) screen. The good news is that modern times have brought about strategies and treatment options to reduce symptoms.

What Is Sleepwalking?

You may be worried because one of your kids is found frequently walking the floor at night and you have trouble snapping them out of it. Sleepwalking behaviors vary from person to person and from episode to episode, much like other sleep habits, and there are mysterious aspects to it. For instance, people don’t necessarily even walk when they sleepwalk, says an article on VerywellMind.

About 18 percent of people sleepwalk at some point in life, though it’s more common in childhood and you usually grow out of it. Approximately 3.6 percent of adults in the United States, or 8.4 million people, report having an episode of sleepwalking in the last year, according to studies at Stanford University School of Medicine.

Also known as somnambulism, sleepwalking can occur infrequently or become an acute, long-term problem. There are often different causes for adults than for children with recurring sleepwalking tendencies, but many of the symptoms are the same, according to the Mayo Clinic.

Symptoms of sleepwalking include:

• Unresponsiveness
• Difficulty waking from the episode
• Glassy-eyed expression
• Getting out of bed to wander
• Sitting up and opening their eyes
• Problems functioning during the day
• Confusion

There are extreme and sometimes surprising behaviors exhibited by sleepwalkers during an episode including:

• Getting dressed
• Eating
• Leaving home
• Driving a car
• Engaging in sex
• Becoming violent

“Parasomnia,” or sleep disruption, is a classification that professionals use to describe its effect, identifying it as a negative experience during your sleep cycle. It’s defined as a disorder of arousal during a stage of deep sleep.

What Causes Sleepwalking?

Walking in your sleep typically occurs at night -- rarely while napping. It is generated during the deepest stage of sleep -- non-rapid eye movement, or NREM, the period following REM sleep.

Causes of sleepwalking can be tied to disruptive circumstances such as:

• Stress
• Fever
• Sleep deprivation
• Travel or sleep interruptions

Stress is considered one of the main experiences that trigger sleepwalking. Sometimes there’s a medical condition or mental health challenges that contribute to sleepwalking tendencies. They trigger sleep interference and set the sleeper in motion.

Conditions that can add to the risk of sleepwalking include:

• Restless legs syndrome
• Gastroesophageal reflux disease, or GERD
• Obstructive sleep apnea or other sleep-disordered breathing issues
• Medications such as sedatives, hypnotics, or certain psychiatric medications

Sleepwalking and Children

If you have children, you may have witnessed sleep terrors, also called night terrors, an intense reaction that sometimes occurs along with sleepwalking, says an article by Nemours KidsHealth. It’s a parasomnia that’s similar to a nightmare, but much more dramatic. Sleep terrors co-occur with sleepwalking because they both emerge from the same stage of sleep.

Symptoms of night terrors may include:

• Shouting and screaming in distress
• Sitting upright
• Breathing faster
• Rapid heartbeat
• Sweating
• Running from the bed

Experts report a genetic component to sleepwalking. It’s not uncommon for a child who sleepwalks to have one or both parents with the same condition.

There are more children who sleepwalk than adults but it can be dangerous at any age, according to an article by Johns Hopkins. Research shows approximately 1 percent of preschoolers and 2 percent of school-aged children sleepwalk more than once per week. If episodes of sleepwalking occur in your house, you probably want to look into child safety locks and definitely stow sharp or dangerous objects so they don’t get hurt. Because of the potential for accidents, you want to take precautions and one suggestion is to refrain from the use of bunk beds; set up a sleeping arrangement that’s closer to the ground instead.

Kids typically begin sleepwalking just a few hours after falling asleep, but they usually outgrow it and they rarely remember the episode. Research shows that 29 percent of kids between ages 2 and 13 years old have walked in their sleep and the highest incidence rate was between ages 10 and 13.

Is Sleepwalking a Mental Health Issue?

Sleepwalking can certainly be physically hazardous, from the risk of falling down stairs to stepping on sharp objects such as glass. It’s a fairly common experience and treating sleepwalking is unnecessary for most people; however, it can be tied to serious mental health concerns.

According to the journal for the American Academy of Neurology, a 2012 study involving nearly 20,000 participants found a connection between nocturnal wandering and the presence of mental and organic disorders. Researchers found that 3.6 percent of the sample suffered from somnambulism and 1 percent had at least two episodes per month.

Participants with the highest risk of sleepwalking episodes were individuals with:

• Circadian rhythm sleep disorder
• Sleep apnea syndrome
• Major depressive disorder
• Obsessive-compulsive disorder
• Insomnia disorder
• Alcohol abuse/dependence
• Use of over-the-counter sleeping pills or antidepressants

The connection between mental health and sleepwalking is clear, says an article by the Sleep Foundation. Because it’s an in-between state of being, a disorder of arousal, it’s considered an abnormal sleep behavior. Other parasomnias include:

• Sleep talking
• Confusional arousals
• Sleep terrors

It’s a behavior disorder that’s difficult to study, partly because the subject often has no recollection of the experience, but experts agree there’s a strong link between mental health and a href="https://www.sleepfoundation.org/parasomnias/sleepwalking" target="_blank" title="Sleepwalking: What is Somnambulism?">mental health and sleepwalking good sleep hygiene.

How Do You Cure Sleepwalking?

Research is ongoing for a variety of sleep disorders. Treatment for somnambulism varies according to the sleepwalker’s age, frequency of the behavior, and severity of their actions, according to the Sleep Foundation. If you have a nocturnal wanderer in the household, it’s a good idea to make sure there’s some oversight to keep the ambulatory person safe. It’s natural to wonder, “Should you wake a sleepwalker?” They are so resistant to waking, it probably wouldn’t work. Many times the issue resolves itself, which you can see if episodes become less frequent or less intense over time. If they accelerate, consult a doctor.

To reduce the potential for injury, you can:

• Close and lock doors and windows
• Install motion sensor lights
• Remove hazards near the floor to reduce tripping
• Keep weapons and sharp objects out of reach
• Set up an alarm system

You don’t need to have blood on your hands to know that sleepwalking can be murder, but we’ve come a long way since the 16th century. Modern depictions -- such as Will Ferrell in Step Brothers -- show it can be a challenge for the whole household. Not only can sleepwalking be a detriment to your own sleep cycles, it can seriously affect the well-being of your bedfellows.

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