Sleepwalking disorder Health Article

Definition

Sleepwalking disorder, also called somnambulism, is characterized by repeating episodes of motor activity during sleep such as sitting up in bed, rising, and walking around, among others. The person appears to be awake because their eyes are usually open and they can maneuver around objects, but is considered asleep.

Sleepwalking disorder is one of several sleep disorderslisted in the Diagnostic and Statistical Manual of Mental Disorders, often called DSM-IV-TR, produced by the American Psychiatric Association and used by most mental health professionals in North America and Europe to diagnose mental disorders.

Description

Sleepwalking episodes usually occur during the first third of the night during the deepest phase of sleep. The episodes can last anywhere from a few minutes up to one hour, with five to 15 minutes being average. Sleepwalkers appear to be awake but are typically unresponsive to individuals who attempt to communicate with them. Persons who sleepwalk typically have no memory or awareness of their actions or movement upon waking.

Causes

There appears to be a genetic component for individuals who sleepwalk. The condition is 10 times more likely to occur in close relatives of known sleepwalkers than in the general public. These families also tend to be deep sleepers.

Sleepwalking may also be triggered by fever, which directly affects the nervous system, general illness, alcohol use, sleep deprivation, and emotional stress. Hormonal changes that occur during adolescence, menstruation, and pregnancy can be also be triggers for sleepwalking. Sleepwalking episodes are more likely during times of physiological or psychological stress.

Certain classes of medication have also been shown to precipitate sleepwalking episodes in some individuals. These include: Anti-anxiety or sleep-inducing drugs, antiseizure medications, stimulants, antihistamines, and anti-arrhythmic heart drugs.

Symptoms

The DSM-IV-TRspecifies six diagnostic criteria for sleepwalking disorder:

• Repeated episodes of rising from bed during sleep: These episodes may include sitting up in bed, looking around, and walking, and usually occur during the first third of the night.
• Is unresponsive to attempts at communication: During sleepwalking, the person typically has eyes open, dilated pupils, a blank stare, and does not respond to another's attempts at communication. Affected persons typically are only awakened with great difficulty.
• No recollection of the sleepwalking incident: Upon waking, the person typically has no memory of the sleepwalking events. If the individual does awaken from the sleepwalking episode, they may have a vague memory of the incident. Often, sleepwalkers will return to bed, or fall asleep in another place with no recall as to how they got there.
• No impairment of mental activity upon waking: If an individual awakens during a sleepwalking episode, there may be a short period of confusion or disorientation, but there is no impairment of mental activity or behavior.
• Causes significant distress to life situations: Sleepwalking causes significant disruption of social and occupational situations, or affects other abilities to function.
• Not due to substance use or abuse: Sleepwalking disorder is not diagnosed if the cause is related to drug abuse, medication, or a general medical condition.