How do you treat somnambulism?

This question was asked in Saint Paul, Minnesota on 12/26/2012.
I have been diagnosed with parasomnia syndrome and somnambulism as major components of my sleep disorder. How would a sleep doctor treat this condition?

Doctors Answers (3)

J. Douglas Hudson, MD, DABSM
Answered on: 1/7/2013 5

Somnambulism, better known as sleep walking, is difficult to treat. Treatment with medication is often ineffective and if the events are infrequent patients often stop taking any medication after going for awhile without symptoms. The best approach is to protect the patient during the event. If they drive their car then hide the keys. Keep things out of their way which could cause a fall. Sleep walking generally occurs in the deepest stage of sleep, Stage N3. It is often difficult to awaken the subject as opposed to those who act out their dreams in REM sleep and are easily awakened.

Jana P. Kaimal, MD, FCCP
Answered on: 1/7/2013 5

Somnambulism or sleepwalking is part of a broader spectrum of sleep disorders called Parasomnias. Sleepwalking can occur during stages of non-REM sleep (deep stages of sleep in which we are not dreaming...most often during the firrst few hours of sleep) as well as during stages of REM sleep (dream sleep). It can occur during childhood as well as persist throughout adult years. Fatigue, lack of sleep or fragmented sleep, as well as stress or anxiety can trigger episodes of sleepwalking. Not getting adequate or sufficient sleep as well as having one's sleep "broken up" during the night with frequent awakenings or restlessness can be a result of an underlying sleep disorder such as Obstructive Sleep Apnea. In instances such as this, the untreated Sleep Apnea was the underlying trigger for the sleepwalking. It is important to note that sleepwalking has also been associated with alcohol consumption, sedative medication as well as other medical conditions such as seizure disorder. It is not necessary to have any formal sleep studies performed in order to diagnose sleepwalking or parasomnias unless the patient is suspected of having an underlying sleep disorder such as Sleep Apnea. A thorough sleep evaluation by a Sleep Specialist can examine in detail the need for any specific testing as well as all treatment options. Treatment of sleepwalking and other Parasomnias is based in each individual's situation. If no underlying sleep disorder is contributing to the sleepwalking, it can be treated with medications to suppress the patient's ability to "act out the dream" or sleepwalk. Not all patients require medication therapy. This is often based on the presence or history of patient injury during sleepwalking incidents as well as risk of injuring a bed partner (if kicking or thrashing occurs). Treatment of sleepwalking or any other Parasonnia should include regular follow up evaluations with a sleep specialist to ensure good response, resolution of the behavior, and monitoring of any potential side effects of medication.

Jeannine Louise Gingras, MD
Answered on: 1/2/2013 2

There are potentially many causes of Sleep Walking. Mostly it is a "normal" phenomenon. This is likely if there is a family history of sleep walking, talking, teeth grinding, night terrors..Some sleep disorders can trigger sleep walking. So, the first thing I would recommend is to have an evaluation by a board certified sleep physician...he/she then could recommend diagnostic evaluations if necessary or treatment options.