How to Handle Sleepwalking

Your child or partner walks around glassy-eyed, starring straight through you with no idea you’re there.

Somnambulism, or sleepwalking, is a parasomnia, a disruptive event that occurs during sleep. Classic sleepwalking occurs during the first few hours of sleep, in what is known as stage 3 or slow-wave sleep. This is the deepest stage of sleep.

That explains why it’s so hard to get sleepwalkers to snap out of it. They simply can’t. In fact, even when they injure themselves during an episode, most sleepwalkers don’t feel any initial pain and don’t wake up from the injury. A 2015 French study published in the clinical journal SLEEP found that nearly half of the 100 sleepwalkers who complained of chronic pain had experienced at least one violent episode of parasomnia, but nearly 80 percent of those sleepwalkers perceived no pain during the episode, remaining soundly asleep.

If you have a sleepwalker in your home, the American Academy of Sleep Medicine (AASM) recommends guiding the sleepwalker back to bed. If sleepwalking happens often, make sure the area around the sleepwalker’s bed is free of obstacles, sharp objects and tripping hazards. Lock the outside doors and windows before going to bed, and hide the car keys.

If you are successful at waking a sleepwalker, they’ll likely experience sleep inertia—grogginess and confusion—for a good half hour after. In this state of mind, they may lash out at you verbally or physically. A French study, also published in SLEEP, concluded that adult sleepwalkers with early onset sleepwalking—they first began sleepwalking as children— also may be more prone to violent, erratic behavior while sleepwalking, potentially injuring both themselves and others.

Sleep talking often comes with sleepwalking. It’s mostly babble, but sometimes it really sounds like the sleeper wants to have a conversation. Resist the urge to talk back. According to the AASM, most sleepwalkers don’t recall anything they did or said during an episode. And the misconception that you’re actually getting through to them could add to your frustration.

Use your discretion when telling the sleepwalker what they did or said the night before. Sleepwalking often causes embarrassment, and those funny conversations you had with them the night before might not be so funny to the person going through it.

Children are more likely to sleepwalk — up to 17 percent of school-aged children do, peaking between the ages of 8 and 12 . Most children will outgrow sleepwalking. Four percent of adults experience sleepwalking.

If sleepwalking occurs in an adult, or if it occurs during the later REM stages of sleep, when it is known as REM sleep behavior disorder, there may be an underlying cause. For example, a 2009 study by Loyola University Health System found nearly one in ten patients with obstructive sleep apnea also experience parasomnia, including sleepwalking.

Patients who experience REM sleep behavior disorders may be at an increased risk for dementia, according to a 2013 Mayo Clinic study. The study found that men who act out their dreams while asleep, by walking, talking or hitting, were five times more likely to have dementia with Lewy bodies, a progressive form of dementia caused by abnormal deposits that damage brain cells. Those with this disease exhibit symptoms similar to Parkinson’s disease, marked by a decline in cognition and mobility. The researchers believe REM sleep behavior disorders could be a significant marker for identifying both dementia with Lewy bodies and Alzheimer’s.

Keeping a sleepwalking diary will help identify whether there’s cause for concern. Write down what time your child or partner started to sleepwalk, how long the episode lasted and what happened during the episode. The resolution may be as simple as maintaining proper sleep hygiene and getting a good night’s sleep. While researchers don’t yet know the exact underlying mechanism that causes sleepwalking, and the research on sleepwalking itself is fairly limited, sleep deprivation is often a main factor. Other potential causes, according to AASM, include a rare reaction to medication, hyperthyroidism, migraine, stroke, stress, head or brain injury, sleeping in unfamiliar surroundings, premenstrual period and consuming alcohol.