Sleepwalking: why people walk in their sleep — and whether it is dangerous

Midnight. The house is silent. Suddenly, you notice your child or partner getting out of bed, opening the door and calmly walking into the kitchen. Their eyes are open, but their gaze is blank. You speak to them, but they do not respond. You gently guide them back to bed, and in the morning, they remember nothing.

This is somnambulism. Although such a situation may resemble a scene from a horror film, the explanation is much simpler and, at the same time, very interesting.

What is somnambulism?

Somnambulism, also known as sleepwalking, is a sleep disorder belonging to the group of parasomnias. Parasomnias involve unusual behaviours that occur during sleep.

During a sleepwalking episode, a person may sit up in bed, walk around, speak, open cupboards, eat or even try to leave the house. This most commonly happens during deep sleep, when the person is difficult to wake.

It is important to understand that a person who is sleepwalking is not pretending and is not acting consciously. They are genuinely asleep. Part of the brain remains in a state of deep sleep, while the systems responsible for movement become active. As a result, the person can move without being aware of their actions.

Why does it happen?

The exact causes of somnambulism are not fully understood. However, several factors are known to increase the likelihood of an episode.

Genetics

A tendency to sleepwalk can be inherited. If one or both parents experienced sleepwalking episodes during childhood, their child may be more likely to experience them as well.

This suggests that certain characteristics of sleep regulation may be passed on genetically.

Age

Somnambulism is much more common in children than in adults. Many children have walked in their sleep at least once.

Most grow out of the condition during adolescence, as the structure of sleep and the functioning of the nervous system change. Somnambulism is less common in adults, so if it begins for the first time in adulthood, it is worth consulting a doctor.

Lack of sleep

Sleep deprivation is one of the most important factors that can trigger sleepwalking episodes.

When someone sleeps too little for several nights, the body later attempts to compensate for the lack of rest with longer and more intense periods of deep sleep. This can make sleep more unstable and increase the likelihood of a sleepwalking episode.

Episodes may become more frequent after a stressful working week, travelling, changing time zones or experiencing long-term sleep deprivation.

Stress and anxiety

Emotional tension can affect the structure of sleep and increase the likelihood of parasomnias.

For some people, sleepwalking episodes become more frequent during examinations, work-related crises, conflicts or other difficult periods of life.

Fever

Fever, particularly in children, can disrupt the normal stages of sleep. For this reason, a sleepwalking episode may sometimes occur even in a child who has never walked in their sleep before.

Certain medications

Some sleeping tablets, antihistamines, antidepressants and other medicines can affect sleep and encourage unusual behaviour during the night.

If sleepwalking began after starting a new medication, it is advisable to consult a doctor or pharmacist. Prescribed medicines should not be stopped without professional advice.

Alcohol

Alcohol can reduce sleep quality and disrupt sleep cycles. In people who already have a tendency to sleepwalk, drinking alcohol may increase the likelihood of an episode.

What does a sleepwalking episode look like?

Somnambulism can appear in many different ways. In some cases, the person only sits up in bed briefly. In others, they may perform more complex actions.

Mild episodes

The person sits up in bed, mumbles something, looks around and soon lies down again. Such an episode usually does not last long.

Moderate episodes

The person gets out of bed, walks around the room, opens cupboards and goes to the bathroom or another part of the home. Their eyes may be open, but their gaze is usually blank and unfocused.

Complex episodes

The person may go to the kitchen, eat, get dressed or try to leave the house. In very rare cases, even more complicated behaviours may occur.

During an episode, the person usually responds very little to their name or surroundings. Their speech may be unclear or incoherent, and their movements may not always be coordinated. In the morning, they usually remember nothing or recall only isolated fragments.

Is somnambulism dangerous?

There are many myths surrounding sleepwalking. Some of them may prevent people from responding appropriately in a dangerous situation.

Myth No. 1: You must not wake a person who is sleepwalking

This is not true. A sleepwalking person can be woken, particularly if they are in a dangerous situation.

After waking, they may be briefly confused, frightened or unsure of where they are. This disorientation usually passes quickly.

If there is no immediate danger, it is generally best to guide the person calmly back to bed.

Myth No. 2: A sleepwalking person automatically avoids danger

Unfortunately, this is not the case. During an episode, the person may fall down the stairs, walk into furniture, injure themselves on sharp objects, open a door or go outside.

The greatest risk associated with sleepwalking is not the disorder itself, but the possibility of injury during an episode.

Myth No. 3: Somnambulism is a mental illness

Somnambulism is not, in itself, a mental illness. It is a disorder related to sleep regulation. It occurs particularly frequently during childhood and, in many cases, disappears on its own.

The main genuine risks are injury during an episode and poorer sleep quality when episodes occur frequently.

What should you do if you notice sleepwalking?

When a child walks in their sleep

First of all, do not panic. Childhood sleepwalking often disappears as the child grows older.

The most important step is to create a safe environment.

Lock external doors and windows.

Secure staircases.

Remove sharp, breakable and dangerous objects.

Clear away objects from the floor that the child could trip over.

If necessary, attach an alarm or bell to the door so that you will hear if the child leaves the room.

A bunk bed is not the best choice for a child who experiences sleepwalking episodes because of the increased risk of falling.

It is advisable to consult a doctor if episodes occur several times a week, the child injures themselves, leaves the house, feels very sleepy during the day or experiences long and intense episodes.

When an adult walks in their sleep

Sleepwalking in adults requires greater attention, particularly if it begins unexpectedly.

Possible causes may include sleep deprivation, severe stress, alcohol, medication or another sleep disorder. In such cases, it is worth consulting a general practitioner or sleep specialist.

How should you respond during an episode?

Remain calm and avoid sudden movements.

If the person is not in danger, gently guide them back to bed.

Do not shout or shake them, as waking suddenly may frighten them.

If the person approaches stairs, a window, an external door or another dangerous place, stop them and, if necessary, wake them gently.

After they wake, stay nearby until they are fully oriented.

Sleep environment and somnambulism

The sleeping environment is discussed less frequently, but it can affect overall sleep quality.

Sleepwalking episodes may be encouraged by various factors that disturb sleep, including noise, an unsuitable room temperature, overheating, uncomfortable bedding, stress before bedtime and an irregular sleep schedule.

It is important to maintain a regular sleeping routine, allow enough time for rest and avoid intense activity and alcohol before going to bed.

Breathable SAVAS Home bedding made from natural fabrics can help maintain a comfortable body temperature and create a more pleasant sleeping environment. However, bedding itself does not treat somnambulism. It is simply one part of good sleep hygiene.

When should you definitely consult a doctor?

Somnambulism is not usually a medical emergency, but in certain situations, professional advice is important.

You should consult a doctor if:

episodes occur frequently;

the person injures themselves or poses a danger to themselves or others;

sleepwalking begins for the first time in adulthood;

the person leaves the house or performs dangerous actions;

episodes are accompanied by loud snoring, pauses in breathing, severe daytime sleepiness or other unusual symptoms;

sleepwalking began after starting a new medication;

episodes significantly disrupt the life of the person or their family.

A doctor may recommend polysomnography. This is a sleep study during which brain activity, eye movements, muscle activity, heart rhythm and breathing are monitored. The examination can help rule out other sleep disorders and determine the cause of the problem more accurately.

Summary

Somnambulism is one of the most interesting and frequently misunderstood sleep disorders. It is not pretending, a mental illness or a mystical phenomenon. It is a feature of sleep regulation that, in many cases, particularly in children, disappears over time.

There are three main things to remember. First, a safe environment must be provided. It is also worth reducing factors that can trigger episodes, such as sleep deprivation, stress and alcohol. If the episodes are frequent, intense or dangerous, a doctor should be consulted.

Most importantly, do not be frightened. A person who walks in their sleep is genuinely asleep. Their sleep is simply a little more active than that of other people.