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Sleepwalking…

By Christian Rios
3/13/09
Names, Names…

• Common: “sleepwalking”
• Formal: Sleep Disorder
• Medical: somnambulism, noctambulism
What is it?
Sleepwalking includes intricate behaviors
while still asleep, with amnesia for the
event.

Episodes occur during stage 3 or stage 4


sleep and in the first third of the night and
in REM sleep in the later sleep hours. In
REM sleep, your brain is active while your
body isn’t.
The Sleep Cycle:
Who does it affect?
• Children: Most common.
Usually within the first 6-12 years of age.
• Adults: Idiosyncratic reactions to drugs
(marijuana, alcohol) and medical
conditions may be causative factors in
adults.
• Elderly: This may be a feature of
dementia.
Symptoms:
• You leave your bed while sleeping. Others find it difficult to wake you during an
episode of sleepwalking.

• When you do wake up from an episode, you're confused or you can't remember what
happened while you were sleepwalking.

• Episodes range from quiet walking about the room to agitated running or attempts to
"escape."

• Typically, the eyes are open with a glassy, blank expression on their face as the
person quietly roams the house.

• They might look awake but act clumsy.

• On questioning, responses are slow or absent. If the person is returned to bed without
awakening, the person usually does not remember the event.

• Older children, who may awaken more easily at the end of an episode, often are
embarrassed by the behavior (especially if it was inappropriate).
Diagnosis:
• Most frequent in identical twins.
• 10 times more likely to occur if an immediate relative has
a history of sleepwalking. It is thought the condition can
be inherited.
The Causes:
• Sleep deprivation
• Alcohol
• Chaotic sleep schedules
• Stress

• Drugs:
- sedative/hypnotics (drugs that promote relaxation or sleep),
- neuroleptics (drugs used to treat psychosis),
- stimulants (drugs that increase activity),
- antihistamines (drugs used to treat symptoms of allergy)

• Studies suggest a child's brain is too immature to completely understand the cycles of waking
and sleeping.

• It may be a symptom of another disorder.

• May be caused by underlying medical conditions:


- gastroesophageal reflux
- obstructive sleep apnea
- seizures
- periodic leg movements
- restless leg syndrome
In which sleepwalking episodes should stop once the underlying medical condition is treated.
Treatments:
• Medication.
• Relaxation.
• Anticipatory Awakenings:
waking the child or person approximately
15-20 minutes before the usual time of an
event, and then keeping them awake
through the time during which the
episodes usually occur.
How to Prevent:
• Limit stress.
• Get adequate sleep.
• Meditate or do relaxation exercises.
• Avoid any kind of stimuli, auditory and/or visual, prior
to bedtime.
Sleepwalkers Should:
• Sleep in a bedroom on the ground floor, if
possible.
• Lock the doors and windows.
• Cover glass windows with heavy drapes.
• Keep a safe sleeping environment, free of
harmful or sharp objects.
• Consult a sleep specialist if injuring him or
herself or showing violent behavior.
Interesting & Curious Facts:
• Occurs most often in
children. Most often in boys.
• A 17-year-old sleepwalker
who stepped out of a fourth-
storey window of his
apartment in Demmin, in
Germany, fell 10 metres to
the ground, where he
continued to sleep, despite
having a fractured limb.
• Sleepwalkers are capable of
performing a variety of
activities. Cases of
sleepwalkers driving a car,
cooking, writing e-mails,
playing a musical
instrument, and painting
have been reported.
Lady Macbeth
• It used to be thought that sleepwalkers
acted out their dreams, desires, and
fears.
• Shakespeare used a sleepwalking
scene in "Macbeth" to expose an
element in Lady Macbeth's character:
her ruthless ambition leads her to
concoct a murder plot.
• Her gentlewoman brings a doctor to
see Lady Macbeth as she walks the
castle in her sleep, confessing her
sins. Sleep takes away the mask she
wears during the day and calls forth
her confessions without her
permission- the sleeping body rebels
against the waking mind.
• Doctor: You see, her eyes are
open.
Gentlewoman: Ay, but her sense is
shut.
- Macbeth, Act V Scene 1
Sleepwalking Murderers:
• Scott Falater, an Arizona resident,
claimed the sleepwalking defense
after he was accused of stabbing
his wife 44 times -- he was found
guilty.
• A man in Manchester named Jules
Lowe murdered his father while
sleepwalking and was acquitted.
• The earliest mention of someone
being acquitted of murder on the
grounds of sleepwalking in the
United States appears to be that
of Albert Tirrell, who was accused
of murdering his lover in 1846
• Psychiatrist Peter Fenwick reports cases
of sleepwalking murderers going back to
the year 1600, when a knight stabbed his
friend to death and was found guilty.
Sources:
• http://sleep.health.am/sleep/parasomnias/#3
• http://www.webmd.com/sleep-disorders/guide/sleepwalking-symptoms
• http://www.webmd.com/sleep-disorders/guide/sleep-disorders-living-managing
• http://health.howstuffworks.com/sleepwalking.htm/printable
• http://www.sleepdisorderchannel.com/sleepwalking/index.shtml
• http://www.emedicinehealth.com/sleepwalking/article_em.htm
• http://www.neurology.org/cgi/content/abstract/48/1/177
• http://www.livescience.com/mysteries/080509-llm-sleepwalk.html
• http://en.wikipedia.org/wiki/Sleepwalking_scene_(Macbeth)
• http://en.wikipedia.org/wiki/Sleepwalking#Explanation
• http://en.wikipedia.org/wiki/Albert_Tirrell
• http://sleepdisorders.about.com/cs/sleepwalktalk/a/sleepmurder.htm
• http://www.livescience.com/mysteries/080509-llm-sleepwalk.html
• http://www.telegraph.co.uk/news/newstopics/howaboutthat/3743289/Zzz-mail-What-happen
• http://www.youtube.com/watch?v=B9_NOEZRak4&feature=related
• http://www.youtube.com/watch?v=VpIKX8VIaT8