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Trouble sleeping?

Somnambulism, or sleepwalking, is a disorder that falls under the category of parasomnias. These are undesirable motor, verbal or experiential events that occur during sleep.

health and fitness Updated: Apr 29, 2010 18:18 IST
Lynda Shrager

My college roommate had a very disconcerting disorder. I would be sitting on my bed intensely studying neuroanatomy and she, after falling asleep, would begin talking. After a few minutes of dialogue, however, the trouble began.

She would sit straight up with eyes glazed, get out of bed and start walking toward the door of our co-ed hallway. Oh, I forgot to mention the disconcerting part. Susan slept naked.

What is it?
Somnambulism, or sleepwalking, is a disorder that falls under the category of parasomnias. These are undesirable motor, verbal or experiential events that occur during sleep.The first of the four stages of sleep is non-rapid eye movement (non-REM) and the last is REM. This cycle repeats throughout the night and sleepwalking typically occurs in stage 3 or 4 (deep sleep or REM).

Why it happens?
Sleepwalking is much more common in children and it is usually outgrown by the teen years. The causes are unknown but may be related to anxiety, lack of sleep and a genetic predisposition. In adults, there may be underlying conditions such as seizures, migraines, sleep apnoea and psychiatric disorders. Other types of paediatric parasomnia disorders include confusional arousals and night terrors.

Other symptoms
Confusional arousals are characterised by disorientation, inconsolable crying and thrashing around in bed. They last from around three to 13 minutes. Night terrors can be very anxiety-provoking for parents, as they often begin with a blood-curdling scream with accompanying panicked, wide-open eyes.

Children may run around the room and hit themselves or other objects. They are inconsolable by parents, but this usually is of shorter duration than confusional arousals. Sleepwalkers could walk around the house with eyes staring blankly and have been known to eat large meals or even take a drive. Talk does not make sense and the episode is usually not remembered upon waking.

Treatment
Most often, the only treatment needed is reassurance, as the behaviour disappears with age.Getting adequate sleep and treatment of underlying medical conditions if there are any (such as sleep apnoea) will help.

Medications may be used if the situation is severe, and non-pharmacological measures include relaxation techniques or scheduled wakening where the child is woken up a few minutes before she usually experiences the event and kept awake to disrupt the sleep cycle.

Safety tips
Lock windows and doors throughout the house, should the sleepwalker wander.
Hide the car keys.
Move objects that may be a tripping hazard, such as electrical cords or clutter on the floor.
Block stairways with a gate.

Although it is a misconception that sleepwalkers should not be wakened, attempts to wake them may lengthen the episode and cause them to become confused or violent. It is better to lead them back to bed, and be sure they continue their sleep in a safe environment. In my case, I slept with one eye open and made sure Susan wore pajamas.