sleepwalk

Sleepwalking, or somnambulism, is a parasomnia characterized by episodes of partial arousal during sleep, usually from non-rapid eye movement (NREM) sleep. People may perform complex behaviors while still asleep and often have limited or no memory of the episode the next day. Most episodes occur during the first third of the night when slow-wave sleep is more common.

During an episode, an individual may sit up, walk about, or perform routine tasks, sometimes in a confused or dazed state. Sight is often vacant, and movement may be automatic or clumsy. Episodes typically last a few minutes but can be longer. Afterward, the person may return to bed and sleep normally, with amnesia about the events.

Sleepwalking is more common in children than adults and often runs in families. Risk factors include sleep deprivation, fever, stress, jet lag, alcohol use, certain medications, and underlying sleep disorders such as sleep apnea or restless legs syndrome. It is important to differentiate sleepwalking from nocturnal seizures or other conditions that can mimic arousal disorders.

Diagnosis is usually clinical, based on history and description of episodes. Polysomnography or sleep studies may be used in complex cases to exclude other disorders or assess comorbid sleep conditions.

Management focuses on safety and addressing contributing factors. Safe sleep environments, removing hazards, and gentle redirection back to bed are recommended. Treating underlying conditions (e.g., sleep apnea, poor sleep hygiene) and ensuring adequate sleep often reduces episodes. In persistent or injurious cases, medical evaluation is advised. Most childhood sleepwalking resolves with age, though episodes can persist into adulthood for some individuals.