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August 05, 2022

Sleepwalking: symptoms, causes and treatment

Sleepwalking: symptoms, causes and treatment

Brazilians who follow Big Brother Brazil had a surprise during its 2021 edition. Juliette Freire, the eventual winner of the R$1.5 million prize, confessed to her housemates that she suffers from sleepwalking.

She had already talked about it during a pre-show interview, but with little public repercussion. 

As a sleepwalker, she sometimes talks in her sleep and even makes her bed without being aware of what she is doing.

Juliette is not alone. Despite the difficulties in determining how many people sleepwalk, since the episodes are almost never remembered when waking up, 5% of children and 1.5% of adults are estimated to suffer from this sleep disorder.

What is sleepwalking?

Sleepwalking is a type of sleep disorder known as parasomnia. Parasomnias are unusual behaviors during sleep and represent a threshold state between being awake and falling asleep. For this reason, parasomnia actions are considered non-normal.

Sleepwalking episodes occur during the non-REM (NREM) stage of sleep, usually during slow-wave sleep. They are most common in the first hour or two after a person has gone to sleep and can last from a few seconds to half an hour or more. After that, you go back to sleep normally. 

Causes of sleepwalking

There are several factors that can trigger a person in deep sleep to end up partially awake and perform actions without realizing it. Here are some:

– Genetics – Studies show that 47% of children whose fathers or mothers sleepwalk also develop the disorder. The percentage rises to 61% if both parents sleepwalk.

– Brain Injuries – Encephalitis, or swelling of the brain, can be a sleepwalking trigger.

– Stress – One of the consequences of stress on sleep is its fragmentation, that is, constant disruptions that are often unnoticed. This difficulty sleeping ‘straight through’ can trigger cases similar to sleepwalking.

– Medications – Sedatives and medications that interfere with sleep patterns.

– Alcohol – Like certain medications, alcohol has a sedative effect that disrupts sleep.

– Other sleep disorders – Both sleep apnea and restless leg syndrome can cause partial sleep disruptions that lead to sleepwalking events. 

– Respiratory conditions – Asthma can also be associated with sleepwalking.

How does this disorder occur?

Sleepwalking does not happen like in movies, where the sleepwalker walks around like a zombie, with arms raised in front of the body.

During an episode, the sleepwalker can perform different motor activities, from talking or sitting in bed to more complex actions such as walking, trying to drive, having sex (sexsomnia), changing clothes and even eating. 

Juliette told her Big Brother Brazil housemates that she has had cases in which she made the bed while sleeping.

Recently, Canadian businesswoman Celina Myers went viral on TikTok by posting videos of her sleepwalking episodes. In addition to chatting with her cats, she once began tossing soda cans out the door, as if handing them to someone. In all, her videos have already amassed 363 million likes and one of them has already surpassed 54 million views.

From these two examples, it is evident that there is no pattern of activities of what a sleepwalker may or may not do. Episodes manifest differently in each person, and they can appear in a different way even for the same patient.

Exactly for this reason, sleepwalking can be dangerous, since, without being aware of what they are doing, the person may handle sharp objects, drive or open the door and go out into the street. Thus, it is recommended that the houses of people who suffer from this parasomnia have security locks on drawers, keep the doors locked overnight with the key stored elsewhere and have screens placed on the windows, among other precautions.

Can I wake a sleepwalker up?

Who in this room has never heard that waking a sleepwalker is dangerous, raise a hand. This is false. It is recommended to calmly redirect the person to bed, but if this cannot be done, waking them up will not harm them either.

On the contrary, waking someone up in the middle of a sleepwalking episode can prevent them from placing themselves in dangerous situations without realizing it. Just try to do it gently and subtly, avoiding the scare.

Points for Juliette, who gave this same explanation to her fellow Big Brother Brazil housemates.

How is sleepwalking diagnosed?

Since, in many cases, sleepwalking episodes are not remembered in the morning, reports from roommates or housemates are essential for the diagnosis. Therefore, when consulting a sleep doctor, it is important to bring along someone who can present facts that the patient alone would not be able to.

Discussing symptoms is the next step for the physician to determine the sleepwalking diagnosis. Daytime sleepiness and a family history are signs that a person has this disorder.

Polysomnography and electroencephalogram, a test that shows brain waves, are also used in diagnosis.

Treatment for people with sleepwalking

As with any disease or disorder, sleepwalking treatments are particular for each case. After all, each patient has their own needs, comorbidities and specificities.

Some of the treatments that may be recommended are:

Sleep hygiene, creating an environment and state of mind in preparation for sleep in order to improve its durability and quality.

– Treatment of external causes, since issues such as apnea and stress can lead to sleepwalking. When this is the case, treating the original disease can solve or at least reduce cases.

– Cognitive therapy, which is also recommended in other cases of conditions that cause or result in troubled sleep.

For more severe cases, with more frequent episodes, medications that improve sleep quality, such as antidepressants, may be prescribed.

Always ask your physician for guidance on individualized treatment for your case of any disease or disorder.

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