Pediatric sleepwalking (also called somnambulism) is when a child gets up during sleep but is unaware of his or her actions. Sleepwalking most often occurs in children between the ages of 4 and 8 (Mayo, 2011)
Most children who sleepwalk do so an hour or two after falling asleep. Sleepwalking episodes usually last from five to 15 minutes. This behavior is typically harmless and most children grow out of it. However it can be dangerous, and it is important to protect your child from injury as a result of sleepwalking.
There are a number of factors that can contribute to sleepwalking. Common causes include:
- fatigue or lack of sleep
- irregular sleeping habits
- stress or anxiety
- being in a different sleep environment
- illness or fever
- certain medications, including sedatives, stimulants, and antihistamines
Though uncommon, sleepwalking can be a symptom of an underlying condition. These conditions may include:
- sleep apnea (when a person stops breathing for short periods during the night)
- night terrors (dramatic nightmares that occur in deep sleep)
- restless leg syndrome (RLS)
- head injuries
Walking during sleep may be the most common symptom of sleepwalking, but there are other actions associated with this condition.
Sleepwalking symptoms may include:
- sitting up in bed and repeating motions
- talking or mumbling during sleep
- not responding when spoken to
- making clumsy movements
- urinating in inappropriate places
- performing routine or repetitive behaviors, such as opening and closing doors
Usually, a doctor can diagnose sleepwalking based on other family member’s accounts of the child’s behavior. Generally, no treatment is needed. Your doctor may wish to conduct a physical and psychological exam to rule out other conditions that can cause sleepwalking. If another medical issue is causing your child’s sleepwalking, treatment is needed for the underlying issue.
If the doctor suspects another sleep problem, such as sleep apnea or night terrors, a sleep study (polysomnogram) may be ordered. A sleep study involves spending the night in a sleep lab. Electrodes are attached to certain parts of the child’s body to measure heart rate, brain waves, breathing rate, muscle tension, eye and leg movement, and oxygen level in the blood. A camera may also record the child as they sleep.
If sleepwalking is troublesome, your doctor may recommend using a technique called scheduled awakening. This involves monitoring your child for a few nights to determine when the sleepwalking usually occurs and then rousing your child from sleep 15 minutes before the expected sleepwalking. This can help reset the child’s sleep cycle and control sleepwalking behavior.
If sleepwalking is causing dangerous behaviors or excessive fatigue, a doctor may prescribe medication, such as benzodiazepines (psychoactive drugs typically prescribed to treat anxiety) or antidepressants.
If you notice your child sleepwalking, try to gently guide him or her back to bed. Do not try to wake the sleepwalker, as this could aggravate them. Instead, simply reassure your child with words and help steer them back to bed.
There are also safety measures that can be applied around the house to help keep your child safe. These include:
- closing and locking all doors and windows at night
- installing alarms on doors and windows or installing locks out of your child’s reach
- removing items that could be a tripping hazard
- removing sharp and breakable objects from around your child’s bed
- not letting your child sleep in a bunk bed
- installing safety gates in front of stairs or doorways
- turning down the temperature on the hot water heater to prevent burns
- keeping keys out of reach
Helping your child develop good sleep habits and relaxation techniques can help prevent sleepwalking.
The Cleveland Clinic recommends:
- going to bed at the same time every night
- establishing a relaxing bedtime routine, such as taking a warm bath or listening to soothing music
- creating a dark, quiet, and comfortable sleep environment for your child
- lowering the temperature in your child’s bedroom (to less than 75 F)
- limiting liquids before bedtime and ensuring your child empties his or her bladder before going to bed
- avoiding caffeine and sugar before bedtime (Cleveland Clinic, 2009)