Children's Health: Sleepwalking

Children's Health: Sleepwalking

About Sleepwalking
Hours after bedtime, do you find your little one wandering the hall looking dazed and confused? If you have a sleepwalking child, you're not alone. It can be unnerving to see, but sleepwalking is very common in kids and most sleepwalkers only do so occasionally and outgrow it by the teen years. Still, some simple steps can keep your young sleepwalker safe while traipsing about.

Despite its name, sleepwalking (also called somnambulism) actually involves more than just walking. Sleepwalking behaviors can range from harmless (sitting up), to potentially dangerous (wandering outside), to just inappropriate (kids may even open a closet door and urinate inside). No matter what kids do during sleepwalking episodes, though, it's unlikely that they'll remember ever having done it!

As we sleep, our brains pass through five stages of sleep — stages 1, 2, 3, 4, and REM (rapid eye movement) sleep. Together, these stages make up a sleep cycle. One complete sleep cycle lasts about 90 to 100 minutes. So a person experiences about four or five sleep cycles during an average night's sleep.

Sleepwalking most often occurs during the deeper sleep of stages 3 and 4. During these stages, it's more difficult to wake someone up, and when awakened, a person may feel groggy and disoriented for a few minutes.

Kids tend to sleepwalk within an hour or two of falling asleep and may walk around for anywhere from a few seconds to 30 minutes.

Causes of Sleepwalking
Sleepwalking is far more common in kids than in adults, as most sleepwalkers outgrow it by the early teen years. It may run in families, so if you or your partner are or were sleepwalkers, your child may be too.

Other factors that may bring on a sleepwalking episode include:

lack of sleep or fatigue
irregular sleep schedules
illness or fever
certain medications
stress (sleepwalking is rarely caused by an underlying medical, emotional, or psychological problem)


Behaviors During Sleepwalking
Of course, getting out of bed and walking around while still sleeping is the most obvious sleepwalking symptom. But young sleepwalkers may also:

sleeptalk
be hard to wake up
seem dazed
be clumsy
not respond when spoken to
sit up in bed and go through repeated motions, such as rubbing their eyes or fussing with their pajamas
Also, sleepwalkers' eyes are open, but they don't see the same way they do when they're awake and they often think they're in different rooms of the house or different places altogether.

Sometimes, these other conditions may accompany sleepwalking:

sleep apnea (brief pauses in breathing while sleeping)
bedwetting (enuresis)
night terrors

Is Sleepwalking Harmful?
Sleepwalking itself is not harmful. However, sleepwalking episodes can be hazardous since sleepwalking kids aren't awake and may not realize what they're doing, such as walking down stairs or opening windows.

Sleepwalking is not usually a sign that something is emotionally or psychologically wrong with a child. And it doesn't cause any emotional harm. Sleepwalkers probably won't even remember the nighttime stroll.

How to Keep a Sleepwalker Safe
Although sleepwalking isn't dangerous by itself, it's important to take precautions so that your sleepwalking child is less likely to fall down, run into something, walk out the front door, or drive (if your teen is a sleepwalker).

To help keep your sleepwalker out of harm's way:

Try not to wake a sleepwalker because this might scare your child. Instead, gently guide him or her back to bed.
Lock the windows and doors, not just in your child's bedroom but throughout your home, in case your young sleepwalker decides to wander. You may consider extra locks or child safety locks on doors. Keys should be kept out of reach for kids who are old enough to drive.
To prevent falls, don't let your sleepwalker sleep in a bunk bed.
Remove sharp or breakable things from around your child's bed.
Keep dangerous objects out of reach.
Remove obstacles from your child's room and throughout your home to prevent a stumble. Especially eliminate clutter on the floor (i.e., in your child's bedroom or playroom).
Install safety gates outside your child's room and/or at the top of any stairs.

Other Ways to Help a Sleepwalker
Unless the episodes are very regular, cause your child to be sleepy during the day, or your child is engaging in dangerous sleepwalking behaviors, there's usually no need to treat sleepwalking. But if the sleepwalking is frequent, causing problems, or your child hasn't outgrown it by the early teen years, talk to your doctor. Also talk to your doctor if you're concerned that something else could be going on, like reflux or trouble breathing.

For kids who sleepwalk often, doctors may recommend a treatment called scheduled awakening. This disrupts the sleep cycle enough to help stop sleepwalking. In rare cases, a doctor may prescribe medication to help a child sleep.

Other ways to help minimize sleepwalking episodes:

Have your child relax at bedtime by listening to soft music or relaxation tapes.
Establish a regular sleep and nap schedule and stick to it — both nighttime and wake-up time.
Make your child's bedtime earlier. This can improve excessive sleepiness.
Don't let kids drink a lot in the evening and be sure they go to the bathroom before going to bed. (A full bladder can contribute to sleepwalking.)
Avoid caffeine near bedtime.
Make sure your child's bedroom is quiet, cozy, and conducive to sleeping. Keep noise to a minimum while kids are trying to sleep (at bedtime and naptime).
The next time you encounter your nighttime wanderer, don't panic. Simply steer your child back to the safety and comfort of his or her bed.

Reviewed by: Larissa Hirsch, MD