Sleep Walking
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Sleep Walking (Somnambulism)

Sleep walking is quite common. Medical reports show that about 18% of the population are prone to sleep walking. It is more common in children than in adolescents and adults. Boys are more likely to sleepwalk than girls. There seems to be some inherited component; children are more likely to sleep walk if their parents did. If a child begins sleepwalking at the age of 9, it often lasts into adulthood.

Sleepwalking is a series of complex behaviors that are initiated during slow wave sleep and result in walking during sleep. It usually happens in the first third of the night. During a sleepwalking episode, the brain is half-awake and half-asleep. Occasionally it can carry out simple tasks like avoiding obstacles, but sleepwalkers can be confused. They may fall down the stairs or mistake a window for a door. There are stories of sleep walkers driving cars, boarding planes, going swimming, and performing other complex actions. This is unlikely. Sleepwalkers do not have the fast reflexes and the comprehension needed for such complicated actions.


  • Walking during sleep (typically in the first third of sleep episode).
  • Difficulty in arousing the patient during an episode.
  • Amnesia following an episode.
  • Sleep study demonstrates the onset during deep sleep (stage 3 and 4).
  • Usually, children who sleepwalk are psychologically as healthy as children who do not. However, medical and psychiatric disorders can be present.
  • Children usually outgrow the problem as they get older.

How serious is sleep walking?

Most patients experience sleep walking infrequently (less than once per month) and those episodes do not result in harm to the patients. Others experience episodes more frequently. In its most severe form, the episodes occur almost nightly or are associated with physical injury. Sleepwalking may cause embarrassment, shame, guilt, anxiety and confusion to the patient. If the sleepwalker exits the house, or is having frequent episodes and injuries are occurring, it is time to seek professional help. There have been some tragedies with sleepwalkers; do not let it happen to your loved one. Sleepwalking in adults is more worrisome. Extreme anxiety, stress and occasionally epilepsy are possible causes. Therefore, adults with this problem should seek medical help.

Sleep Walking (Somnambulism)

What can be done about sleep walking?

There are general advises to be told to the sleepwalker:

  • Tiredness can trigger sleepwalking, therefore, make sure you get plenty of rest.
  • Anxiety, tension and stress are other triggers for sleepwalking, therefore, try to develop a calming ritual or do relaxation exercises.
  • Put away dangerous and sharp objects and car keys and consider putting a bell on the bedroom door and a grill on the windows.
  • The sleepwalker’s bedroom should be on the ground floor of the house and he/she should not have a high bed (to avoid falling).
  • If you have to spend some nights outside your house consider the same precautions and notify the people you are staying with (or the hotel receptionist) about your sleep problem.
  • An accurate psychiatric and medical evaluation could help to decide the need for psychiatric or medical intervention. The patient should reassured about the benign nature of the problem if the above precautions are applied.
  • In severe cases, some medications can be used to reduce the frequency of the episodes.


Ahmed BaHammam, FACP, FCCP
Professor of Medicine
Director, University Sleep Disorders Center
College of Medicine, King Saud University