Somnambulism

Definition

Somnambulism is also known as sleepwalking. It is a common disorder among children that involves getting out of bed and moving about while still asleep.

Description

Somnambulism is similar to pavor nocturnus ( night terrors ) in that it occurs during the non-dreaming stage of sleep , usually within an hour or two of going to bed. The sleepwalking child feels an intense need to take action and may appear alert, purposeful, or anxious as he or she moves about. For many years, people believed that it was dangerous to awaken a sleepwalker, but there is no basis for this view. There is, however, little reason to awaken a sleepwalking child, and it may be impossible to do so. Episodes of sleepwalking may be signs of a child's heightened anxiety about something.

Demographics

Somnambulism, or sleepwalking, affects an estimated 15 percent of children in their early school years. It decreases in frequency with increasing age. It is very uncommon among adults.

Causes and symptoms

The root cause of sleepwalking is not known. Anxiety and stress are the most commonly given reasons for sleepwalking.

If sleepwalking is common among family members, it is more likely that the child may respond to even slight increases in anxiety with sleepwalking behavior.

When to call the doctor

A doctor or other health care provider should be called when episodes of sleepwalking cannot be comfortably managed in the home.

Diagnosis

A diagnosis of somnambulism is made by observation and history. There are no laboratory tests. An electroencephalogram may be used as a part of an analysis in a sleep laboratory, but this is the exception rather than the rule.

Treatment

Sleepwalking children should be gently guided back to bed. They will usually be cooperative in this effort.

Prognosis

The prognosis for sleepwalking is good. Most children experience a few episodes of somnambulism and then simply stop, often when a source of stress or anxiety is removed. Sleepwalking rarely affects persons outside of one's own family circle.

Prevention

There is no known way to prevent episodes of sleepwalking.

Nutritional concerns

There is no known link between sleepwalking and nutrition .

Parental concerns

Parents should give careful consideration to events and environmental changes that may have triggered the onset of sleepwalking. Potential hazards that may injure children should be removed from their sleeping areas.

Resources

BOOKS

Carney, Paul R. et al. Clinical Sleep Disorders. Philadelphia: Lippincott Williams & Wilkins, 2004.

Hertz, Grett J. J. et al. Olie's Bedtime Walk. Long Island City, NY: Star Bright Books, 2002.

Lee-Ching, Teofilo L. et al. Sleep Medicine. Amsterdam: Elsevier, 2002.

Silber, Michael H. et al. Sleep Medicine in Clinical Practice. London: Taylor & Francis, 2004.

PERIODICALS

Cartwright, R. "Sleepwalking violence: a sleep disorder, a legal dilemma, and a psychological challenge." American Journal of Psychiatry 161, no. 7 (2004): 1149–58.

Guilleminault, C, et al. "Sleepwalking and sleep terrors in prepubertal children: what triggers them?" Pediatrics 111, no. 1 (2003): e17–25.

Kantha, S.S. "Is somnambulism a distinct disorder of humans and not seen in non-human primates?" Medical Hypotheses 61, no. 5–6 (2003): 517–18.

Lecendreux, M., et al. "HLA and genetic susceptibility to sleepwalking." Molecular Psychiatry 8, no. 1 (2003): 114–17.

Remulla, A., and C. Guilleminault. "Somnambulism (sleepwalking)." Expert Opinion on Pharmacotherapy 5, no. 10 (2004): 2069–74.

Zadra A, et al. "Analysis of postarousal EEG activity during somnambulistic episodes." Journal of Sleep Research 13, no. 3 (2004): 279–84.

ORGANIZATIONS

American Academy of Family Physicians. 11400 Tomahawk Creek Parkway, Leawood, KS 66211-2672. (913) 906-6000. fp@aafp.org. http://www.aafp.org

American Academy of Pediatrics. 141 Northwest Point Boulevard, Elk Grove Village, IL 60007-1098. (847) 434-4000, Fax: (847) 434-8000. kidsdoc@aap.org. http://www.aap.org/default.htm

American Academy of Sleep Medicine. 6301 Bandel Road NW, Suite 101, Rochester, MN 55901. (507) 287-6006. Fax: (507) 287-6008. info@aasmnet.org. http://www.asda.org

American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106-1572. (800) 523-1546, x2600 or (215) 351-2600. http://www.acponline.org

OTHER

"Sleep Disorders and Sleep Problems in Childhood." American Academy of Family Physicians. Available online at http://www.aafp.org/afp/20010115/277.html.

"Sleep Walking." Family Practice Notebook. Available online at http://www.fpnotebook.com/PSY142.htm.

"Sleep Walking." National Library of Medicine. http://www.nlm.nih.gov/medlineplus/ency/article/000808.htm

"Somnambulism (Sleep Walking)." eMedicine. Available online at http://www.emedicine.com/neuro/topic638.htm.

L. Fleming Fallon, Jr., M.D., Dr.PH.