DEAR DOCTOR K: My eight-year-old son has started sleepwalking. I'm worried he will hurt himself in his sleep. Is there anything I can do to stop him from sleepwalking?
DEAR READER: A person who is sleepwalking walks or makes other movements while being still largely asleep. A sleepwalker can be difficult to awaken fully and typically has no memory of the episode in the morning. I hope it will ease your worry to know that episodes of sleepwalking are usually brief and harmless.
Some sleepwalkers simply sit up in bed and move their legs. Others carry out more complex tasks. These may include dressing and undressing, eating or urinating. Sleepwalking episodes usually occur one to two hours after going to sleep. They last from one to 30 minutes. A sleepwalker has open eyes and a blank expression. At first, their eyes make them appear to be awake, but the blank expression makes it clear that nothing is registering.
Sleepwalking is common in children, particularly preschoolers. It probably occurs because children's brains have not yet mastered the regulation of sleep and waking. The tendency seems to run in families and is more common in boys. Children usually stop sleepwalking during adolescence, as their nervous systems mature.
To help a sleepwalking child return to normal sleep, gently lead him back to bed. You don't need to wake your child. You may not even be able to.
Treatment is not usually necessary. But if your son sleepwalks frequently, a technique called prompted awakenings may help. For several nights, record the length of time between when your son falls asleep and sleepwalking begins. Then, for seven nights in a row, awaken your son 15 minutes before the expected time of the episode. Keep him fully awake for five minutes.
Children are more likely to sleepwalk when they are overtired or anxious. Provide a relaxing bedtime routine for your child and set an early bedtime. Counselling may help if your child is dealing with stress. Some children benefit from hypnosis or biofeedback.
In some cases, a doctor may prescribe short-acting sleep or anti-anxiety medications to reduce or eliminate sleepwalking episodes.
For now, focus on keeping your son safe when he is sleepwalking. You can help him avoid sleepwalking injuries by making the bedroom and house as safe as possible. For example:
- Don't let your son sleep in a bunk bed, at least not on the top bunk.
- Make sure there are no sharp or breakable objects near his bed.
- Install gates on stairways.
- Lock doors and windows (to protect him, not the neighbours).
When my sister was in college, she had a roommate with what sounds like a kind of sleepwalking issue. The roommate didn't get out of bed and walk. She would just, in the middle of the night, suddenly cry out, "oh, oh, Oh, OH! MY GOD!", sit bolt upright in bed — and then lie down, sound asleep. When she awoke in the morning, she had no memory of this. She also felt rested. However, my sister did not.
Dr Anthony L. Komaroff is a physician and professor at Harvard Medical School.
