Sleep walking

Sleepwalking

Sleepwalking, also known as somnambulism, is a sleep disorder characterized by walking or performing other complex behaviors while in a state of sleep. It is classified as a parasomnia, which is an undesirable physical event or experience that occurs during sleep. Sleepwalking typically occurs during the non-rapid eye movement (NREM) stages of sleep, particularly during the slow-wave sleep (SWS) stage.

Epidemiology

Sleepwalking is more common in children than in adults, with an estimated prevalence of 1% to 15% in children and 1% to 4% in adults. The condition tends to run in families, suggesting a genetic component. It is also more prevalent in individuals with a history of sleep deprivation, stress, or certain medications.

Pathophysiology

The exact pathophysiology of sleepwalking is not fully understood, but it is believed to involve a partial arousal from deep sleep. During this state, the brain is partially awake, allowing for motor activity, but the individual remains in a state of sleep. This dissociation between the brain's motor and cognitive functions leads to the characteristic behaviors of sleepwalking.

Clinical Features

Sleepwalking episodes can vary in complexity and duration. They may involve simple behaviors such as sitting up in bed or walking around the room, or more complex activities such as leaving the house or driving a car. During an episode, the sleepwalker typically has a blank expression, is unresponsive to external stimuli, and is difficult to awaken. Upon awakening, the individual usually has no memory of the episode.

Diagnosis

The diagnosis of sleepwalking is primarily clinical, based on the history provided by the patient or witnesses. A detailed sleep history and a review of the patient's medical and psychiatric history are essential. In some cases, a polysomnography (sleep study) may be conducted to rule out other sleep disorders.

Management

Management of sleepwalking involves ensuring the safety of the sleepwalker and addressing any underlying causes. Safety measures may include securing the sleep environment, such as locking doors and windows, and removing dangerous objects. Behavioral interventions, such as scheduled awakenings, may be effective in reducing the frequency of episodes. In some cases, medications such as benzodiazepines or antidepressants may be prescribed.

Prognosis

The prognosis for sleepwalking is generally good, especially in children, as many outgrow the condition by adolescence. In adults, the condition may persist but can often be managed effectively with appropriate interventions.

Also see

• Parasomnia
• Sleep disorder
• Polysomnography
• Rapid eye movement sleep