Sleepwalking, formally known as somnambulism, is a common sleep disorder where a child partly wakes up and moves around while remaining asleep. This behavior is most frequently observed in children between the ages of four and eight, with up to one-third of children experiencing at least one episode. Though it can be alarming for parents to witness, childhood sleepwalking is generally considered a benign condition that most children naturally outgrow by their teenage years. The primary concern for parents is ensuring the child’s safety during an episode, as the child has limited awareness of their surroundings.
The Mechanics of Sleepwalking
Sleepwalking is classified as a parasomnia, an undesirable event that occurs during sleep. It originates during the deepest stage of Non-Rapid Eye Movement (NREM) sleep, specifically Stage N3. This stage, characterized by slow-wave activity, typically happens within the first few hours after falling asleep.
The episode results from an incomplete arousal from this deep sleep state. The child’s brain cannot fully transition to wakefulness, leaving them in a dissociated state where parts of the brain are awake and parts are asleep. The motor cortex, which controls movement, may be active, leading to complex behaviors like walking. However, the prefrontal cortex, responsible for conscious awareness and memory, remains asleep. This partial arousal explains why the child’s eyes are often open but appear glazed, and why they will not remember the event in the morning.
Identifying Common Triggers and Contributing Factors
The underlying failure in the sleep-wake cycle is often provoked by various external and internal factors. A lack of sufficient sleep or an inconsistent sleep schedule is the most common trigger for sleepwalking episodes. When a child is overtired, the body spends more time in the deep NREM sleep stage, increasing the likelihood of an incomplete arousal event.
Periods of illness, especially those involving a fever, can also precipitate an episode. Certain medications, including some stimulants and antihistamines, have been identified as contributing factors. High levels of psychological pressure, such as stress or anxiety from school or changes in the family environment, can also disrupt sleep and lead to somnambulism.
There is also a strong genetic component to sleepwalking, indicating that a family history may predispose a child to the condition. If one parent had a history of sleepwalking, the child has a significantly increased chance of developing it. While these factors do not cause sleepwalking directly, they create the physiological conditions that make the partial arousal event more probable. Managing these triggers, particularly by maintaining a consistent and adequate sleep routine, is the most effective preventative measure a parent can take.
Immediate Safety Protocols During an Episode
The primary concern during a sleepwalking event is preventing accidental injury, as the child is unaware of potential dangers. Parents should secure the home environment by installing safety gates at the top and bottom of staircases. All doors and windows, particularly those leading outside, should be locked or fitted with alarms that alert parents if opened.
If an episode occurs, the recommended response is to remain calm and gently guide the child back to bed. While there is no danger in waking a child, an abrupt or aggressive awakening is strongly discouraged. Startling the child may cause confusion, disorientation, or agitation, potentially leading to a fall or injury.
A gentle, non-confrontational approach, such as quietly leading the child by the hand, is the safest way to redirect them. Once the child is safely back in bed, they should be allowed to return to sleep naturally without discussion about the event.
When Professional Intervention Is Necessary
While most cases are temporary, certain signs warrant a consultation with a healthcare provider, such as a pediatrician or a sleep specialist. Professional intervention should be considered if episodes occur frequently, such as multiple times per week, or if they result in significant injury to the child.
Parents should also seek medical advice if sleepwalking begins after the age of 10 or 12, as later onset can suggest an underlying issue. A consultation is necessary if the child exhibits other co-occurring symptoms, including loud snoring, gasping for breath during sleep, or excessive daytime sleepiness. These symptoms may indicate another sleep disorder like obstructive sleep apnea. Any signs of seizure activity, such as drooling or jerking of the body, during an episode require prompt medical evaluation.