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Sleep Walking 

Introduction
Sleepwalking is a disorder that causes people to sit up in bed, walk, or perform tasks while sleeping.  The person’s eyes may be open, and they may appear to be awake.  Sleep walking occurs more frequently among children.  Sleep walking occurs for many reasons, and correcting the cause may help reduce episodes.  A main concern is to ensure a person’s safety during an episode.  Some children outgrow sleep walking as they grow older.

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Anatomy
Sleep is vital for life, just like eating and breathing.  Sleep allows your body to rest.  It is believed that during sleep your brain performs important functions, such as storing memory and processing brain chemicals.

In a way, your body goes on “auto-pilot” while you sleep.  Your brain regulates automatic functions for you, such as breathing, heart rate, and blood pressure.  Each night you go through several cycles of sleep that consist of stages of sleep, from "light" sleep (Stages 1 and 2) to "deep" sleep (Slow Wave Sleep or Stage 3/4) and "dream" sleep (Rapid Eye Movement (REM) sleep).  Although sleep is a complex process that is not fully understood, it is known that a good night’s sleep is important for optimal health and functioning. 

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Causes
The exact cause of sleepwalking is unknown.  It occurs more often during slow wave sleep (SWS), typically during the first half of the night when SWS is more common.  Exceptions do occur as sleepwalking has also been seen to arise out of light sleep (Stages 1 and 2) at any time throughout the night.  Sleepwalking occurs most frequently in children between the ages of three and eight, although it may happen to people of all ages.  Excessive tiredness, anxiety, mental illness, medications and seizures appear to contribute to sleepwalking.

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Symptoms
People that sleep walk may appear to be awake and have their eyes open.  They may sit up and have a blank expression.  They may get out of bed and walk around the house.  People may perform activities, such as going to the bathroom.  Experiencing an injury while sleepwalking is a concern.  It is especially dangerous for people that leave their home or drive while sleepwalking. 

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Diagnosis
You should let your doctor know if you or a member of your household sleepwalks.  Your doctor will review your medical history and medications and ask you questions about your sleep patterns.  Your doctor may refer you to specialists to rule out other conditions that may contribute to sleep walking, such as seizures or psychiatric disorders.  You may be referred to a sleep medicine doctor at a sleep clinic to learn more about how your body functions during sleep.

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Treatment
Children may outgrow sleepwalking as they grow older and their sleep patterns change.  Some people may not need treatment for sleep walking, but all safety measures should be taken to ensure that they remain in the house and do not fall.  It is okay to wake a person up that is sleep walking.  The person may appear confused or disoriented at first.

Any underlying medical conditions or sleep disorder should be treated.  If a particular medication you take causes sleepwalking, your doctor may be able to substitute a similar medication that does not.  In some cases, prescription medication may be used to help reduce the number of sleepwalking episodes.

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Prevention
You may help prevent sleepwalking injuries by making changes in your home environment to ensure that a person does not leave or fall.  It can be helpful to install additional locks.  You may prevent falls by removing throw rugs, cords, or other items on the floor that may be potentially hazardous.

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Am I at Risk

Risk factors for sleepwalking include:


_____ Alcohol increases the risk of sleepwalking.
_____ Sleeping pills or sedatives increase the risk of sleep walking.
_____ People with seizures that are caused by a high fever are at risk for sleepwalking.
_____ Being excessively tired or sleep deprivation can lead to sleepwalking.
_____ People that have sleep terrors have an increased risk for sleepwalking.
_____ Children that wet the bed have an increased risk of sleepwalking.
_____ Children with sleep apnea have an increased risk of sleepwalking.

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Complications
People that sleep walk may be at risk of accidental injury during an episode.  People are at greater risk for injury if they leave their home or drive.

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Advancements
Studies of the brainwaves of sleepwalkers show instability in the non REM sleep stages and an abnormal cyclic alternating pattern (CAP) rate.  The CAP is a very slow brain rhythm proposed to regulate the sleep and wake promoting systems in the brain. 

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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.

The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on April 13th, 2016. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.