On May 24, 1987, the media was sensationalized by a horrific sleepwalking episode when a sleepwalker drove 14 miles to his in-laws’ house and killed his mother-in-law. While this is probably one of the rarest occurrences of sleepwalking-turned-murder, it brings to mind the ultimate question, “What causes sleepwalking, and how can we stop it?”
Seemingly awake when you’re actually asleep sounds like a paradox, but that’s exactly what sleepwalking is. Some parts of your brain remain animated while others are asleep, such that your actions seem to be fully conscious even when you are not.
To demystify what causes sleepwalking, we dive deep into the scientific literature for the various risk factors you need to watch out for.
Sleepwalking is medically known as somnambulism. It’s a form of sleep disorder under the broad category of arousal parasomnias that also include sleep talking and sleep terrors (aka night terrors).
Sleepwalking episodes usually occur during the first third of the night. This stage of sleep is when non-rapid eye movement (NREM) sleep predominates. For the masses, non-REM sleep also goes by deep sleep, slow-wave sleep (SWS), or stages 3 and 4 of the sleep cycle.
Somnambulism usually begins with abrupt awakenings from deep sleep, in which the individual isn’t fully awake. Each sleepwalking episode can last from a few seconds to about 30 minutes.
During this stage of sleep, the sleepwalker may perform simple movements like walking around the bedroom to complex actions like washing dishes. Also, men and those with a history of sleepwalking are more prone to violence and self-harm during their episodes.
Common symptoms of sleepwalking include:
Perhaps the biggest irony is that the sleepwalkers themselves have no recollection. While the occasional sleepwalking incident isn’t a cause for concern, repetitive episodes suggest the need for an in-depth diagnosis and treatment options.
Currently, polysomnography (a comprehensive sleep study that diagnoses sleep problems) is the most reliable method for detecting sleepwalking. That said, it’s also expensive and time-consuming, given that it’s an overnight test done at a sleep clinic.
Fortunately, most sleepwalkers don’t need polysomnography to tell if they have somnambulism. Firsthand accounts from your partner, family members, or housemates will likely solve the mystery.
Despite being a common sleep disorder, sleep experts and healthcare professionals still can't pinpoint the exact causes of sleepwalking.
Some people suspect alcohol for their nighttime stroll out of bed, even though scientific evidence has confirmed that alcohol does not predispose or trigger sleepwalking. On a biochemical level, sleepwalking features diminished inhibitory activity of the brain chemical gamma-aminobutyric acid (GABA) to allow for mobility during sleepwalking. In contrast, alcohol consumption shows an opposite mechanism of action: It raises GABA, which represses motor activity during sleep.
So, what causes sleepwalking? Ahead, scientific evidence sheds some light on the common triggers for your nighttime wanderings.
Not meeting your sleep need (the genetically determined amount of sleep your body needs) has been blamed for almost everything under the sun, from excess cortisol levels to being tired on your period. Unsurprisingly, sleepwalking is on that long list of transgressions.
A 2008 study analyzed the effects of 25 hours of sleep deprivation on sleepwalkers. Not only did the researchers discover a greater prevalence of sleepwalking during the sleep recovery period (from 50% to 90%), but also noted “more complex forms of somnambulism” after sleep loss.
On a related note, circadian misalignment (an off-balanced body clock) often goes hand in hand with sleep deprivation. An erratic sleep schedule is usually to blame for indirectly causing sleepwalking. Common examples include travel jet lag, social jet lag, and shift work.
Stress often thwarts a good night’s sleep. So, it’s not unusual that it triggers somnambulism, too.
In a study involving 193 participants, stressful events and sleep loss incited more frequent and severe sleepwalking episodes than alcohol consumption and vigorous evening workouts.
If one or more family members experience somnambulism, the odds are in your favor of being a fellow sleepwalker.
“Many sleepwalking and sleep-terror cases run in families. Compared to the general population, first-degree relatives of sleepwalkers have a 10 times higher frequency of sleepwalking,” says Isabelle Arnulf in the research journal of Current Biology.
Diving into the genetic analysis, one 2011 study examined the family history of 22 individuals spanning four generations. The verdict was clear — genes largely influence the prevalence of sleepwalking. Out of the 22 individuals, nine of them experienced childhood sleepwalking, which continued into adulthood at a lower frequency.
The study’s researchers identified seven regions on chromosome 20 common among sleepwalkers. With that said, they also acknowledged that “sleepwalking can be inherited in different ways and is not linked to just one gene.”
Some medical conditions (both physiological and psychological) are closely linked to sleepwalking:
On a side note, science dispels the notion that restless legs syndrome (RLS) causes sleepwalking, as RLS symptoms aren’t affiliated with this behavior disorder.
Per a 2018 systematic review in the journal of Sleep Medicine Reviews, as many as 29 medications may induce somnambulism even if you have no history of sleepwalking. They include:
If you’re on any of the above medications and find yourself sleepwalking, consult your primary doctor to see if there are other alternatives that won't provoke somnambulism.
Sleepwalking isn’t a disease per se, as there are no health implications directly linked to it. That said, sleepwalking can be dangerous, both to yourself and others. Case in point: Tripping on an object on the bedroom floor, falling down the stairs or through an open window, and making violent or inappropriately sexual actions toward others.
Because sleepwalkers aren’t sure what they may do during their episodes, they may become reluctant to sleep. Predictably, they suffer from sleep loss and excessive daytime sleepiness if they aren’t already experiencing them.
Unfortunately, the trainwreck of somnambulism doesn’t stop here. Surviving on less sleep than you need downgrades every aspect of your life that matters — physiologically, emotionally, and cognitively. What’s more, it transforms you into a human-sized safety hazard, as evident from tragic cases of drowsy driving and workplace accidents.
If you recall, sleepwalkers rarely remember their night wanderings, making it more challenging to nail down the precise statistics.
But Arnulf says, “As many as 17% of children sleepwalk, and 2 to 4% of adults (mostly young adults, who often sleepwalked as children) still regularly ambulate or scream at night.” She suggests it could be due to changes in the arousal pattern or sleep depth as we age.
Indeed, the analysis of human sleep architecture has revealed a dramatic decline in deep sleep when you transition into adulthood. This limits the window of opportunity for sleepwalking, possibly explaining the significant drop in its prevalence among grown-ups.
Perhaps the reason you’re reading this post right now is that you want to learn how to stop sleepwalking.
The answer is a little complicated, depending on how frequent or severe your sleepwalking episodes are. You also have to factor in the causes behind your behavior disorders.
For example, if a lack of sleep is the culprit, prioritizing your sleep schedule will likely cut down on night walking. In contrast, if an underlying medical condition instigates your episodes, a licensed healthcare professional may recommend tackling the health issue to mitigate sleepwalking.
To illustrate, lifelong sleepwalkers with sleep-disordered breathing managed their sleepwalking episodes with nasal continuous positive airway pressure (CPAP). Those who successfully underwent surgery also resolved their sleep behavior disorder.
Causes aside, scientific research highlights the following ways to diminish the odds of sleepwalking.
You may have heard that it’s dangerous to wake up a sleepwalker during one of their episodes. Plot twist: The safest course of action is to gently rouse the person, reassure them, and guide them back to bed.
“Psychological interventions — scheduled waking and hypnosis — are potential first line interventions for evaluation,” says Helen Stallman and Mark Kohler, from the Center for Sleep Research at the University of South Australia, in the journal of Sleep and Hypnosis.
For scheduled wakings, sleepwalkers can ask their partner or housemate to wake them up about 15-30 minutes before they usually sleepwalk. Meanwhile, hypnosis plants the suggestion that the sleepwalker will wake up when their feet touch the ground.
The dangers of sleepwalking necessitate a safe sleeping environment. Try these guidelines to minimize harm to yourself and others:
Many of the triggers of sleepwalking — not getting enough sleep and being too keyed up from the day’s stress, for example — boil down to poor sleep habits. For that reason, brush up on your sleep hygiene to help reduce or eliminate this unwanted sleep behavior.
At this point, it’s useful to revisit the definition of sleep hygiene — it’s the upkeep of behaviors that influence the way you sleep. Sleep-promoting habits aren't just the activities you do right before bed; many of them actually occur during the day and don’t involve literal snoozing.
We share three tips to get you started on the road to healthy sleep hygiene with the RISE app:
From sleep deprivation to specific medications, various factors cause sleepwalking. Once you’ve pinpointed the exact trigger(s), you’re in a better position to cut down on your nighttime wanderings. From there, try scheduled wakings and hypnosis to manage your condition. Also, don’t forget to sleepwalk-proof your bedroom.
Therapeutic interventions and environmental tweaks aside, get a handle on your sleep hygiene. Our step-by-step Sleep Guide is a good place to start. For best results, pair it with the RISE app that features 20+ science-backed habits to help you sleep better at night for better energy during the day.
Sleepwalking isn’t dangerous in terms of medical implications, but it can cause self-harm and injuries to others, such as falling down the stairs or making inappropriate sexual actions.
Even though sleepwalking is far more common in children than adults, a minority of grown-ups (roughly 2-4%) still experience somnambulism.
To manage this sleep behavior disorder, you need to identify the exact triggers behind it. From there, healthcare professionals may recommend a mixture of therapeutic interventions like scheduled wakings, hypnosis, and sleep hygiene, on top of keeping your sleep environment safe.
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