sleepwalker

Sleepwalking, or somnambulism, is a parasomnia in which a person arises and performs activities while largely asleep. It most commonly occurs during non-REM sleep, especially in the first third of the night when slow-wave sleep predominates. Episodes may include sitting up, walking with a dazed expression, or completing routine tasks, sometimes with little or no memory of the event afterward.

Somnambulism is more common in children, with estimates varying by study, and most cases resolve with age. Risk factors include a family history, sleep deprivation, stress, irregular sleep schedules, fever, or the use of certain medications. It can be linked with other sleep disorders such as sleep apnea or restless legs syndrome, and may occur more often after minor illnesses.

During an episode, the person is difficult to awaken and may appear confused upon waking. There is a real risk of injury from falls or wandering into dangerous areas. Safety measures include ensuring a safe environment (clear floors, locked doors, removing sharp objects) and guiding the person back to bed gently if possible.

Diagnosis is usually clinical, based on observed episodes or caregiver reports. Polysomnography is reserved for unclear cases or when other sleep conditions must be excluded. Management emphasizes safety and good sleep hygiene: consistent bedtimes, adequate total sleep, limited caffeine and alcohol, and stress reduction. For frequent or injurious episodes, a clinician may consider scheduled awakenings or, in rare cases, pharmacologic treatment under specialist supervision.

Most children outgrow sleepwalking; in adults the condition often persists but tends to be less frequent. Ongoing management focuses on preventing harm and improving sleep quality.