Somnambulism

If you’ve known to getting up from bed in the middle of the night and walking around while you’re still asleep and then going back to bed without ever remembering what happened then you somnambulate – you walk in your sleep.  Somnambulism is another word for sleepwalking.  Someone who walks in their sleep is called somnambulant.   It is a relatively common problem, particularly of children. It occurs during non-REM sleep so it is not exactly the same thing as acting out your dreams although it may look like it. In cases of sleepwalking, it is as though the cortical or thinking parts of the brain have turned themselves off and only the more basic brain activities like sex or eating have been retained. Because there is a disconnect between the thinking part of the brain and the deeper acting out parts of the brain, there is no conscious knowledge of what has happened while they have been asleep.

What is somnambulism like?

In sleep walking, you exhibit unwanted behaviors for which you have no memory of. It involves many episodes of being incompletely awakened from sleep and walking around in spite of being asleep. It is more likely to occur in the first third to first half of the sleep state.

People who sleep walk generally have blank facial expressions that do not change when you try to awaken them. Their eyes stay straight ahead as if staring at something. When the person awakens from this state, they do not generally recognize that they have had a dream and instead have little recall of anything they might have dreamed of during the sleep walking episode. They tend to be difficult to awaken from this state. Sleepwalking can be frightening for the person doing the sleep walking and the people around them who must cope with someone who wanders around the house at night unable to get out of their sleep state.

Types of somnambulism

Sleep-related eating disorder is a type of somnambulism. In this situation, the sufferer often heads to the kitchen to eat varying quantities of food, including bazaar types of foods they would not normally eat during the day. As it occurs during non-REM sleep, there is really no dream associated with the behavior. Once awakened from a sleep-walking cycle, the individual is confused about where they are and does not know what they have been doing.

In sleep-related eating states, the person can binge eat while sleeping and, the behavior can be complex and is associated with no memory of having eaten in their sleep. These episodes usually happen within 3 hours of going to sleep and involves eating hurriedly, with the consumption mainly of high carbohydrate foods. People who have sleep-related eating states also tend to have restless legs syndrome in the evening (which involves the uncontrollable need to move one’s feet and legs just before retiring.

Night Eating Syndrome

The sleep-related eating state should be differentiated between another sleeping disorder known as night-eating syndrome. In night-eating syndrome, the individual is fully awake and tends to remember that they have gotten up; people with this disorder often consume large amounts of food at one time. Night-eating syndrome is also described as being four times as common in women as it is in men and tends to begin in the later teenage years. People with night-eating disorder, unlike sleep-related eating, do not eat much during the day, especially in the morning hours and often suffer from insomnia.

Who does somnambulism affect?

Sleep-walking is more common in children and young adults. While it has no known origin, it is believed to run in families, meaning there may be a genetic predisposition to getting the disorder. When it involves sexsomnia, it is possible to unwittingly rape someone, which has been used as a defense against rape charges. Unfortunately, the perpetrator has no knowledge of what they have done and tends to have other episodes of non-sex related somnambulism as proof that they may not have consciously raped the other person at all.

Diagnosing Somnambulism

When trying to determine whether or not the person has this sleep disorder, the doctor will ask you various questions such as what happens during the event, such as whether or not you remember anything about the event, how awake you are when awakened during a sleepwalking event, how sleepy you feel during the day, when at night these episodes occur, family history of sleepwalking and about any injuries you have had during an episode.

As a sleepwalker, you may be unaware of anything or you may experience times where you have awakened out of your bed. Some describe their episodes as having the feeling they are running away from some type of danger. Others around you can add that, when it happens, you have a calm, impassive look on your face and that you are hard to awaken after such a state. Somnambulism can be very embarrassing when people tell you what you have done. This is especially true of more sensitive adolescent sleepwalkers who feel out of control of what they do during sleep.

There are no specific lab tests that can identify a person with this disorder. Sometimes a polysomnogram is recommended, in which you sleep at a sleep disorders center and are observed when and if the attacks occur. During a polysomnogram, you will be hooked up to electrodes (which does not hurt). The electrodes may be able to pick up certain times in your sleep cycle in which your brain waves show small episodes in which your brain is aroused (called micro-arousals) that are typical of sleep walkers.

Somnambulism Causes

Somnambulism causes fatigue, sleep deprivation, stress and anxiety. Sleep walking is not the same as sleep terrors, which tend to occur in younger children and are accompanied by tears and extreme anxiety during an episode. It is also not the same as other types of confusional arousal states, in which it is difficult for you to awaken from sleep in any setting other than your sleep walking during the attempt to wake you up.

Somnambulism Treatment

somnambulant rarely require treatment. If you encounter someone who suffers from sleep walking, make sure they know that this is generally not a dangerous condition. Find out if there are any precipitating environmental stimuli which trigger an episode of sleep-walking. Parents of children who sleepwalk should make sure the sleep environment is devoid of stimuli which can contribute to sleep walking. The parents should also make sure that all doors and windows are locked and that obstacles are removed from the room where the person sleeps. The child, once in this state, should be reassured in their sleep and gently ushered back to bed. Do not try to awaken the child from sleep as this can confuse them. There are no drugs that appear to affect sleep-walking. People who practice meditation or visualization techniques before going to sleep tend to have fewer episodes of somnambulism.