Somnambulism is characterized by an unconscious state of awakening during sleep. The sleepwalker can simply stay awake in bed, even get up, eat and do activities that can be more or less dangerous for him and for others.
Definition of sleepwalking
Somnambulism, or waking and walking during sleep, can be associated with a number of consequences. It is also one of the leading causes of night injury.
The identification of sleepwalking and its early management is important, in order to limit the risk of night-time injuries and the risk of violence related to the patient’s unconsciousness.
The traditional idea of sleepwalking is a state of excitability of body and mind, during sleep, causing awakening of certain cognitive functions only. In addition, physiological disorders associated with sleep, states of confusion or certain genetic factors can also be at the origin of sleepwalking.
Some cases of sleepwalking are like a momentary awakening. The person just sits in bed and look around. In other cases, the sleepwalker can get out of bed, walk, open cupboards, get dressed and even eat. The agitation is more or less important depending on the patient. In the most extreme cases, the person with sleepwalking can get out of the house, walk on the street or even start driving a car, ride a bike, and others. These last cases can prove very dangerous, as well for the life of the patient as for that of others.
In most cases of sleepwalking, the awake patient has open eyes. Nevertheless, some sleepwalkers can be awake cognitively, and then they keep their eyes closed. Nevertheless, whether for the first case or the second, the patient often has difficulty recognizing his relatives, in a state of sleepwalking. He can even go so far as to confuse a human person with an object.
A discussion with a sleepwalker is often difficult or impossible. The conversation may not make sense and the patient’s speech difficult.
In most cases, the sleepwalking episodes do not last, on average about ten minutes. However, in other cases, these periods may be longer.
Following these sleepwalking episodes, the patient may wake up by himself or, conversely, return to bed without waking up and remembering nothing.
The sleepwalker usually has no memory of these episodes. In addition, an awakening during a sleepwalking episode can lead to confusion and vague memories.
The causes of sleepwalking
The exact cause of sleepwalking is usually unknown. Nevertheless, a genetic origin (hereditary within the same family) can be associated with it.
Some factors may, however, lead to sleepwalking or aggravate it:
- lack of sleep
- stress and anxiety
- an infection leading to a consequent fever (especially in children)
- heavy alcohol consumption
- drug addiction
- taking certain medications, including sedatives
In addition, sleep-related pathologies can also lead to sleepwalking: sleep apnea or “restless leg syndrome”.
Who is affected by sleepwalking?
Any person, regardless of age, may be concerned with a sleep-walking state.
How to treat somnanbulism?
Occasional episodes of sleepwalking do not require an emergency medical care. Sleep interruptions are not usually the result of serious underlying causes and improve over time.
Nevertheless, if the sleepwalking episodes are frequent and the sleepwalker performs activities, in a state of unconsciousness, which may be dangerous for himself or for others, consultation with the doctor is recommended.
The general practitioner will usually refer the patient to a sleep specialist. This specialist will then try to find the original cause of somnambulism, to thus act on the source and limit the episodes of unconscious awakening.
There is no specific treatment for sleepwalking. However, methods and means are possible to avoid sleepwalking episodes:
- to go to bed at regular hours every day
- make sure the room is dark and quiet
- limit the consumption of energy drinks and caffeine before going to bed
- Promote relaxing activities before falling asleep: reading, hot bath, breathing exercises, and others.
Medication treatments are rarely prescribed as part of sleepwalking. In addition, some such as benzodiazepines or antidepressants may be prescribed. These treatments make it possible in particular to improve the quality of sleep as well as to facilitate falling asleep.