Six year old Rahul was tucked cozily in his bed by his mommy, but after 2 hours of sleep, he slowly got up and opened his eyes. He started walking out of the room. Luckily, his mother noticed him, and slowly guided him back to his bed without waking him up. Rahul suffers from sleepwalking.
Sleepwalking or somnambulism occurs mostly in children between the ages 6 years to 12 years, and it is not a symptom of any serious health problem. However, it can get dangerous at times, when children sleepwalk through stairs or try to climb out of the window. Our brain goes through five stages of sleep which are stages 1,2,3,4 and REM (rapid eye movement). This makes one complete sleep cycle which lasts for 90 minutes to100 minutes. Sleepwalking occurs in stages 3 and 4 which are the deep stages of sleep. It can last from few seconds to 30 minutes duration.
During sleepwalking, the child may sit up in bed and open eyes with a dazed expression. He or she may then start rubbing eyes or fidgeting with the clothes. The child may get out of bed and start walking. The speech may not be clear and the child may not respond to questions. Sleep walking occurs mostly in deep sleep, and usually this behavior disappears during the teens.
Sleepwalking may be cause due to many factors. The child may sleep walk when tired, or stressed, or has not slept well. Sleepwalking may also happen during fever and anxiety. Some children may sleepwalk if they have to sleep in a new place. Taking medications like zolpidem may also cause sleepwalking. Sleepwalking also occurs due to underlying medical problems like
- Restless leg syndrome(uncontrollable urge to move body)
- Sleep disordered breathing
- Migraine headaches
- Head injury
- Medications like sleeping pills, antihistamines and antibiotics.
Safety of a Sleepwalker
A sleepwalking child can get hurt by walking into things or falling. It is important for parents to ensure safety of their sleepwalker child. One must not wake up a sleep walking child as it will only scare the child. Instead, the child should be slowly guided back to the bed. A bunk bed should be avoided for a sleepwalking child. It is necessary to lock all the doors and windows of the house, and install child safety locks in the house to prevent the sleep walking child from venturing out. Sharp objects, breakable objects, and clutter should be removed as the child may trip over them and get hurt. A safety gate is essential at the top of the stairs to prevent the child from stumbling down the stairs.
There is no specific treatment for sleepwalking. Maintaining a sleep diary in which one records the time and duration of sleepwalk by the child is essential to study the sleepwalking pattern. Once this is done, every night 15 minutes before the usual time of sleepwalk, the child must be awakened and kept awake for 5 minutes. This has to be followed for a week (7 nights). If there is no improvement, then it should be repeated for another week. If the sleepwalking is due to any other underlying health problem or mental problem, then the treatment is aimed at curing the underlying cause first.
During bed time it is advised that the parents relax the child by playing soft music, playing a relaxation tape, singing a lullaby or reading the child’s favorite bedtime story. It is important that a fixed bed time and nap time is maintained. Urinating before going to bed is important for the child as a full urinary bladder may result in sleep walking. The child should not be allowed to drink lots of fluids before sleeping. The child’s bed should be cozy and comfortable.
It has been observed that sleepwalking is seen more in boys than girls for reasons unknown. The parents should contact the doctor immediately when the sleep walking episodes are becoming more frequent leading to dangerous situations of injury or if it is continuing into the teens.