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Definition of Sleep Walking

Sleepwalking, also known as somnambulism, is a sleep disorder that involves performing various activities while in a state of deep sleep. People who sleepwalk typically move or perform activities as if they were awake, but they are actually asleep and usually have no memory of the event afterward.

Sleepwalking episodes can vary in duration and complexity. Some individuals may simply sit up in bed, while others might walk around the house, perform routine tasks, or even leave the house and engage in complex behaviors without being aware of their actions.

Sleepwalking usually occurs during the non-REM (rapid eye movement) stage of sleep, usually within the first few hours after falling asleep. Factors like sleep deprivation, stress, fever, medications, underlying sleep disorders, or genetics can contribute to sleepwalking tendencies. While sleepwalking itself may not be harmful, there is a risk of injury due to the unawareness of surroundings and potential engagement in hazardous activities during episodes.

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History of Sleep Walking

Sleepwalking has been documented throughout history, with mentions in ancient texts and folklore across various cultures. Here’s a brief overview of its historical aspects:\

Ancient References:

References to sleepwalking can be found in ancient texts. For instance, in ancient Roman and Greek texts, there are descriptions of individuals experiencing sleepwalking episodes. Roman physician Galen and Greek philosopher Aristotle discussed sleepwalking in their writings, attributing it to an imbalance in bodily fluids.

Middle Ages and Supernatural Beliefs:

During the Middle Ages, sleepwalking was often associated with supernatural or spiritual explanations. It was sometimes linked to possession or demonic influence, leading to various superstitions and beliefs.

18th and 19th Centuries:

As scientific inquiry progressed, there was a shift in understanding sleepwalking from being purely supernatural to a physiological phenomenon. Medical professionals started exploring sleep disorders more systematically. Sleepwalking was recognized as a sleep disorder rather than a supernatural occurrence.

20th Century and Beyond:

With advancements in sleep research and technology, scientists gained a better understanding of the sleep cycle and associated disorders. Sleepwalking was classified as a parasomnia, a category of sleep disorders characterized by abnormal movements, behaviors, emotions, perceptions, and dreams during sleep.

Researchers have identified various triggers and contributing factors to sleepwalking, including genetics, stress, sleep deprivation, medications, and other underlying sleep disorders. Treatment methods and interventions have evolved over time to manage and reduce the occurrence of sleepwalking episodes.

Throughout history, sleepwalking has been a subject of fascination and mystery, often depicted in literature, art, and media as a curious and sometimes eerie phenomenon. However, scientific understanding and advancements in sleep medicine have helped demystify sleepwalking to a large extent, providing insights into its causes and potential treatments.

DSM-5 Criteria of Sleep Walking

In the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), sleepwalking is categorized under the umbrella of “Non-Rapid Eye Movement (NREM) Sleep Arousal Disorders.” The DSM-5 outlines specific criteria for diagnosing sleepwalking disorder, which includes:

A. Recurrent episodes of incomplete awakening from sleep, usually occurring during the first third of the major sleep episode, and accompanied by the following:

Sleepwalking, which may range from simply sitting up in bed to walking around or performing complex activities.

The individual is difficult to awaken during the episode.

Amnesia for the episode.

B. The episodes cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

C. The disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.

D. Coexisting mental disorders and medical conditions do not adequately explain the episodes of sleepwalking.

E. The disturbance is not better explained by another sleep disorder, such as sleep-related seizure disorder, nightmares, panic attacks, or REM sleep behavior disorder.

It’s important to note that the DSM-5 provides criteria to help mental health professionals diagnose various disorders, including sleepwalking disorder. A diagnosis should be made by a qualified healthcare professional based on a comprehensive evaluation of an individual’s symptoms, history, and any potential underlying causes or contributing factors.

Etiology of Sleep Walking

The exact causes of sleepwalking (somnambulism) are not entirely understood, but several factors and potential contributors have been identified:


There appears to be a genetic component to sleepwalking, as it often runs in families. If a parent has a history of sleepwalking, their children are more likely to experience it as well.

Sleep Disruption or Fragmentation:

Certain disturbances in the sleep cycle, such as sleep deprivation, irregular sleep schedules, or interrupted sleep, can increase the likelihood of sleepwalking episodes.

Medical Conditions:

Some medical conditions can contribute to sleepwalking. These include fever, sleep apnea, restless leg syndrome, gastroesophageal reflux disease (GERD), and psychiatric disorders like anxiety or PTSD.


Certain medications, particularly those that affect the central nervous system, may trigger sleepwalking episodes. Examples include sedative-hypnotics, certain antidepressants, antipsychotics, and stimulants.

Stress and Fatigue:

Emotional stress, anxiety, or extreme fatigue can increase the likelihood of sleepwalking.

Developmental Factors:

Sleepwalking is more common in children and tends to decrease as they age. It is more prevalent in younger individuals, especially between the ages of 4 and 8, but can persist or begin in adulthood as well.

Sleep Disorders:

Conditions like sleep apnea, restless leg syndrome, and insomnia might be associated with an increased likelihood of sleepwalking.

Sleepwalking often occurs during the non-REM (NREM) sleep stages, particularly during the transition from deeper stages to lighter stages of sleep. Disruptions in this transition process can lead to incomplete arousals, triggering sleepwalking episodes.

Understanding the specific causes and triggers for an individual’s sleepwalking can often involve a detailed assessment by a healthcare professional. Identifying and addressing underlying factors, such as improving sleep hygiene, managing stress, or treating any associated sleep disorders, can help reduce the frequency and severity of sleepwalking episodes.

Theories related to Sleep Walking

Several theories have been proposed to explain the occurrence of sleepwalking (somnambulism). While none fully elucidates the phenomenon, these theories offer insights into potential mechanisms:

Physiological Factors:

Some researchers believe that sleepwalking may arise due to the brain’s incomplete transition between different stages of sleep, particularly between deep sleep (non-REM) and wakefulness. Disruptions in this transition can cause partial arousals, leading to sleepwalking behaviors.

Genetic Predisposition:

Studies have suggested a genetic component to sleepwalking. Individuals with a family history of sleepwalking are more likely to experience it themselves, indicating a potential genetic predisposition to the disorder.

Central Nervous System (CNS) Arousal Mechanisms:

Sleepwalking could involve malfunctioning arousal systems in the brain. The intricate balance between sleep and wake states might be disrupted, leading to motor behaviors characteristic of sleepwalking.

Sleep Deprivation and Fatigue:

Sleep deprivation or irregular sleep patterns may trigger sleepwalking episodes. When the body and brain are overly tired or fatigued, it might disrupt the usual sleep cycles, increasing the likelihood of sleepwalking.

Environmental and Psychosocial Triggers:

Stressful life events, anxiety, or emotional distress can be associated with an increased incidence of sleepwalking. These factors might disrupt sleep patterns and increase the chances of sleepwalking episodes.

Brain Development and Maturation:

Sleepwalking is more common in children and tends to decrease with age. It may be related to brain maturation, with the disorder diminishing as the brain matures and sleep patterns stabilize.

Neurochemical Imbalance:

Some researchers suggest that imbalances in neurotransmitters or neurochemicals in the brain could play a role in sleepwalking. Changes in the levels of certain neurotransmitters involved in sleep regulation might contribute to abnormal sleep behaviors.

Understanding these theories helps in exploring potential mechanisms underlying sleepwalking. However, it’s important to note that sleepwalking is a complex phenomenon, and a combination of factors—genetic, environmental, physiological, and psychological—likely contribute to its occurrence. Further research is necessary to fully comprehend the intricate mechanisms involved in sleepwalking.

Risk factors of Sleep Walking

Several risk factors can increase the likelihood of experiencing sleepwalking episodes. These include:

Family History:

Individuals with a family history of sleepwalking are more likely to experience it themselves. There appears to be a genetic predisposition to sleepwalking, suggesting a hereditary component to the disorder.


Sleepwalking is more prevalent in children, especially between the ages of 4 and 8, but it can occur in adults as well. It tends to decrease with age as the brain matures and sleep patterns stabilize.

Sleep Deprivation and Fatigue:

Lack of adequate sleep or irregular sleep patterns can disrupt the normal sleep-wake cycle, increasing the chances of experiencing sleepwalking episodes.

Stress and Anxiety:

Emotional stress, anxiety, or psychological distress can contribute to sleep disturbances and trigger sleepwalking in susceptible individuals.

Certain Medications:

Some medications, particularly those that affect the central nervous system or sleep patterns, may increase the likelihood of sleepwalking. These might include sedative-hypnotics, certain antidepressants, antipsychotics, and stimulants.

Sleep Disorders:

Conditions such as sleep apnea, restless leg syndrome, or insomnia might be associated with an increased risk of sleepwalking.

Fevers and Illnesses:

Some illnesses, especially those accompanied by fever, can trigger sleepwalking episodes.

Substance Use:

Alcohol consumption and drug abuse can disrupt normal sleep patterns and increase the likelihood of sleepwalking.

Other Factors:

Environmental triggers, such as noise or light disturbances during sleep, might contribute to sleepwalking episodes in susceptible individuals.

Identifying and managing these risk factors can help reduce the frequency and severity of sleepwalking episodes. Creating a conducive sleep environment, practicing good sleep hygiene, managing stress, and addressing underlying medical conditions or medication effects can all be beneficial in mitigating the risk of sleepwalking.

Treatment for Sleep Walking

Treating sleepwalking involves various approaches aimed at reducing the frequency and severity of episodes. Treatment strategies may include:

Improving Sleep Hygiene:

Establishing a regular sleep schedule, ensuring a comfortable sleep environment, and maintaining good sleep hygiene practices can help regulate sleep patterns and reduce the likelihood of sleepwalking.

Managing Stress:

Techniques to reduce stress and anxiety, such as relaxation exercises, meditation, or therapy, can be helpful in minimizing triggers for sleepwalking episodes.

Addressing Underlying Sleep Disorders:

Treating conditions like sleep apnea, restless leg syndrome, or insomnia that might be contributing to sleep disturbances can help reduce the occurrence of sleepwalking.


In some cases, doctors may prescribe medications to manage sleepwalking episodes, especially if the episodes are frequent, severe, or pose a risk of injury. Medications might include benzodiazepines or certain antidepressants to help regulate sleep cycles and reduce sleepwalking.

Scheduled Awakenings:

Controlled awakening prior to the typical occurrence of sleepwalking episodes might disrupt the sleep cycle enough to prevent the episode. However, this should be done under the guidance of a healthcare professional.

Hypnosis and Behavioral Therapy:

Some individuals might benefit from hypnosis or cognitive-behavioral therapy aimed at altering behaviors or addressing underlying psychological factors contributing to sleepwalking.

Safety Measures:

Implementing safety measures to reduce the risk of injury during sleepwalking episodes is crucial. This might involve securing doors and windows, removing obstacles, using gates or alarms, and ensuring a safe sleeping environment.

Monitoring and Recording Episodes:

Keeping a sleep diary or recording sleepwalking episodes can provide valuable information for healthcare professionals to better understand patterns and triggers, aiding in treatment planning.

It’s important to consult with a healthcare professional, such as a sleep specialist or a physician, for proper evaluation and guidance on the most suitable treatment approach. Treatment plans are often tailored to the individual based on the frequency, severity, and underlying causes of sleepwalking.

Therapies for Sleep Walking

Several therapeutic approaches can be employed to manage and reduce sleepwalking episodes. These therapies aim to address underlying causes, modify behaviors, and improve sleep quality. Here are some effective therapies for managing sleepwalking:

Cognitive-Behavioral Therapy (CBT):

CBT techniques, particularly those focused on stress reduction, relaxation training, and improving sleep hygiene, can be beneficial in managing sleepwalking. Addressing anxiety or stress-related triggers may help reduce the frequency of episodes.

Scheduled Awakenings:

This technique involves waking the individual before the typical time of a sleepwalking episode. It disrupts the sleep cycle and might prevent the occurrence of the episode. However, this should be done under the guidance of a healthcare professional.


Hypnotherapy might be utilized to access and address potential psychological triggers or underlying factors contributing to sleepwalking. It aims to promote relaxation and alter behaviors related to sleepwalking.


Biofeedback techniques can help individuals gain awareness and control over physiological processes related to sleep. It involves learning to control certain bodily functions, potentially reducing sleep disturbances.

Relaxation and Stress-Reduction Techniques:

Practices like progressive muscle relaxation, deep breathing exercises, mindfulness, or meditation can help reduce stress and promote relaxation, potentially decreasing sleepwalking episodes triggered by anxiety or stress.

Sleep Restriction Therapy:

Structured sleep schedules and restriction of time spent in bed might help regulate sleep cycles and reduce sleep disturbances, including sleepwalking.

Safety Measures and Environmental Modifications:

Creating a safe sleeping environment by removing obstacles, locking doors and windows, using safety gates, and minimizing potential hazards can reduce the risk of injury during sleepwalking episodes.

Family Education and Support:

Educating family members about sleepwalking, its triggers, and safety measures can be crucial in managing and supporting individuals who experience sleepwalking episodes, especially in children.

It’s important to note that the effectiveness of these therapies may vary among individuals. Consulting with a healthcare professional, such as a sleep specialist or therapist, is essential to determine the most appropriate therapy or combination of therapies based on the specific needs and circumstances of the individual experiencing sleepwalking.

Preventions of Sleep Walking

Preventing sleepwalking involves adopting strategies to minimize triggers and create an environment conducive to better sleep. While it may not completely eliminate episodes, these preventive measures can reduce the frequency and severity of sleepwalking:

Maintain Consistent Sleep Patterns:

Establish a regular sleep schedule by going to bed and waking up at the same time every day, even on weekends. Consistency in sleep patterns can help regulate the sleep-wake cycle and reduce the likelihood of sleepwalking.

Create a Relaxing Bedtime Routine:

Engage in calming activities before bedtime, such as reading, taking a warm bath, or practicing relaxation techniques like deep breathing or meditation. A relaxing routine signals the body to wind down and prepares it for sleep.

Ensure a Comfortable Sleep Environment:

Make the bedroom conducive to sleep by keeping it dark, quiet, and at a comfortable temperature. Use blackout curtains, earplugs, or white noise machines to minimize disturbances.

Limit Stimulants and Avoid Heavy Meals before Bed:

Reduce caffeine intake, particularly in the afternoon and evening. Avoid heavy or spicy meals close to bedtime, as they can disrupt sleep and potentially trigger sleepwalking.

Manage Stress:

Employ stress-reduction techniques such as mindfulness, yoga, meditation, or therapy to alleviate stress and anxiety, which can contribute to sleep disturbances.

Safety Measures:

Implement safety measures to prevent injury during sleepwalking episodes. This includes removing obstacles, securing doors and windows, using safety gates, and ensuring a safe sleeping environment.

Address Underlying Sleep Disorders:

If an underlying sleep disorder like sleep apnea, restless leg syndrome, or insomnia is present, seek appropriate treatment to manage these conditions, which can contribute to sleep disturbances.

Avoid Alcohol and Sedatives:

Alcohol and certain medications, especially sedatives or sleep-inducing drugs, can disrupt sleep cycles and increase the likelihood of sleepwalking. Avoid these substances before bedtime.

Regular Exercise:

Engage in regular physical activity during the day, but avoid vigorous exercise close to bedtime. Regular exercise can promote better sleep quality and overall health.

Educate Family Members:

Inform family members or housemates about sleepwalking and safety measures to take in case of episodes, especially if sleepwalking occurs in children.

These preventive measures can help reduce the frequency and severity of sleepwalking episodes. However, if sleepwalking persists or poses risks, it’s essential to seek guidance from a healthcare professional for further evaluation and appropriate management strategies

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