Sleepwalking is a common condition that occurs in children, but what underlies this behavior? You may wonder not only about the causes of sleepwalking, but whether it requires treatment.
What is Sleepwalking?
Sleepwalking is the purposeful movement of walking that occurs in a sleep-like state. It is sometimes called somnambulism. Sleepwalking is one of the parasomnias, which is a class of sleep disorders that includes abnormal movements and behaviors that occur during sleep.
Why Do Children Sleepwalk?
Children of all ages may sleepwalk, and the cause is not fully understood. It is estimated that about 10% of children sleepwalk at least once between the ages of 3 and 10. It is most common at 5 years old and becomes less common into adolescence.
Of those children who sleepwalk, about a quarter will continue into adolescence, however, and this is associated with "confusional arousals." These confusional arousals consist of seeming to awaken but remaining in a subconscious state. They occur out of deep sleep, are not usually remembered by the child, and may overlap with sleep terrors.
There are a few conditions that may provoke sleepwalking. It is thought that sleep-disordered breathing, such as sleep apnea, may make it more likely for a child to have sleepwalking episodes. In addition, movement disorders, such as restless legs syndrome (RLS) and periodic limb movement disorder, may also provoke the behavior.
Similarities to Sleepwalking
There are other conditions that may appear similar to sleepwalking. These conditions include:
- Nocturnal frontal lobe epilepsy (causing seizures)
- Non-REM parasomnias, such as sleep terrors
- Psychiatric disorders
How to Treat Sleepwalking
Most sleepwalking episodes are over in a few minutes, and as such, they may not require treatment. However, children may get themselves into dangerous situations inadvertently, so the most important thing is to keep the child safe from harm. As children often sleepwalk early in the night, it may be necessary to monitor them during this time. This may be especially important in situations where they have been known to sleepwalk in the past (such as during illness).
In general, it is best to redirect sleepwalking children back to bed without fully waking them. Children who are awakened during this state may seem confused and upset and may have difficulty getting back to sleep.
If the sleepwalking behavior is particularly frequent, prolonged, or dangerous, additional interventions may be necessary. In some cases, therapy can help reduce the number of sleepwalking episodes. Therapy may target poor sleep habits, sleep deprivation, anxiety, and stress. Some children may require bed alarms to awaken themselves or others should they get up. If sleep-disordered breathing or movement disorders are suspected, appropriate treatment of these condition may improve the sleepwalking.
Finally, the use of the medication clonazepam may be helpful. Clonazepam is one of the benzodiazepine medications and can be used to suppress the nervous system. With its use your child is less likely to get up during sleep. As there is a risk of side effects, you should carefully discuss the risks and benefits with your child's pediatrician.
Guilleminault, C et al. "Sleepwalking and sleep terrors in prepubertal children: what triggers them?" Pediatrics 2003;111(1)e17-25.
Laberge, L et al. "Sleep and circadian rhythm phase characteristics of adolescent and young adult males in a naturalistic summertime condition." Chronobiol Int 2000;17(4):489-501.