Sleepwalking – why it happens and how to stop it

If you’re worried about you, your child or your partner sleepwalking, the good news is it isn’t usually serious and it can be helped with self-care. But sometimes, advice and treatment from a doctor is needed.

Getting a good night’s sleep is so important for your health and wellbeing.

Find useful information on other areas of sleep with our

.

So here’s what you need to know about sleepwalking, what you can do about it and when to see a doctor.

Who is most likely to sleepwalk?

Sleepwalking can begin at any age but is more common in children – around 5% of children and 1.5% of adults sleepwalk. Sleepwalking is then less common as you become a teenager and usually stops when you’re a young adult.

Other things that make sleepwalking more likely include:

• a family history of sleepwalking – almost half of children will sleepwalk if 1 parent has a history of it, rising to 61% of children if both parents do
• if you’re an identical twin

How do I know if I sleepwalk?

Most people who sleepwalk don’t remember anything about it the next morning. The usual symptoms include:

• sitting up in bed with open eyes, but not responding to people who try speak to you
• getting up and walking around
• being difficult to wake up while sleepwalking
• getting confused before going back to sleep, if you’re woken up from sleepwalking

Some people might also get dressed, eat, try to leave the house or drive a car.

How sleepwalking affects your health

If you sleepwalk you may be more tired during the day, which is usually the main symptom of it, if you get any. The main risks of sleepwalking include:

• tripping or falling
• trying to use sharp objects
• trying to drive a car
• being violent to other people

There may also be embarrassing things that happen during a sleepwalking episode, such as peeing in the wrong place or masturbating without being aware of it. Sleepwalking can also affect your partner’s sleep.

What triggers sleepwalking episodes?

The exact cause of sleepwalking is unknown, but these risk factors make it more likely:

• lack of sleep (
  insomnia
  )
• stress
• drinking
  alcohol
  in the evening
• a high temperature (
  fever
  ) in children
• the sleep disorders obstructive
  sleep apnoea
  and
  restless legs syndrome
• certain medication including some
  sleeping tablets
  , lithium, quinine,
  beta blockers
  and antidepressants such as
  selective serotonin reuptake inhibitors (SSRIs)
  and
  tricyclic antidepressants

How can you stop sleepwalking?

There aren’t any specific ways of stopping sleepwalking altogether, but having a relaxing routine before going to bed and getting regular sleep will help. Good

measures include:

• not drinking alcohol or caffeine in the evening
• having a warm bath or doing deep
  breathing exercises
  before bed to help you relax
• having a comfortable, dark, quiet bedroom
• not eating a heavy meal before going to bed
• exercising earlier in the day rather than before bed
• going to bed at the same time every night

How to deal with a partner who sleepwalks

We know it can be worrying for you having to deal with a partner who sleepwalks. You’ll want to make sure they stay safe and don’t hurt themselves, and you might be worried about them getting confused or upset if you wake them up. Because sleepwalking can also disrupt your sleep as well as theirs, you may start to feel concerned about your sleep quality, too.

If your partner doesn’t know that they sleepwalk, it may be helpful to record their nighttime activity on your phone so they know it’s actually happening. You and your partner can also follow these simple tips to help reduce any stress and worry:

There are 4 key things to do:
1. The prevention method: If your partner tends to sleepwalk at the same time every night, using a technique called ‘scheduled waking’ may help. This alters their normal sleep cycle and interrupts their sleepwalking routine. It means waking them briefly – 15 to 30 minutes before they would normally sleepwalk – and then letting them go back to sleep. For best results, this should be done every night for 2 to 3 weeks.
2. Safety planning: Remove any breakable or fragile objects around them, and lock external doors and windows. (But don’t lock them in a bedroom in case there’s a fire).
3. On-the-spot care: If you find your partner sleepwalking, don’t wake them up, as this may cause them to feel scared and confused. Try to gently guide them back to bed, reassuring them as you do – they’ll often quickly go back to sleep again.
4. Communicate: If your partner sleepwalks and doesn’t know it (or doesn’t realise the impact it’s having on you), talk to them about your concerns and show them any recordings you have of them sleepwalking. This can get across how worrying and disruptive it is for you. These recordings will also be helpful to take with you if you both decide it’s best to see a doctor for advice.

Doctor’s top tip for sleepwalking

Answered by:

“Some people are more sensitive to caffeine and feel the effects of the coffee they've had at lunchtime late into the evening and night. Caffeine can be a trigger for sleep walking, so try cutting it out completely or just stick to one early morning coffee.”

How can a pharmacist help with sleepwalking?

A pharmacist won't be able to give you any medication that can stop you sleepwalking. But if your sleepwalking is due to a lack of sleep (insomnia) or poor sleep hygiene, you may want to ask your pharmacist for advice on how to sleep better and whether any medicines, such as

, or natural sleep aids, such as valerian or , can help you sleep.

But in some countries including the UK, it's not recommended that you use

like antihistamines regularly. This is because antihistamines can cause side effects, it's not known how effective they are and they won't solve your underlying sleep problem. Also, when it comes to most natural sleep aids, there’s a lack of strong evidence on how safe and effective they are.

To be on the safe side, always check with a doctor before taking anything to try to help you sleep better.

When to see a doctor about sleepwalking

Sleepwalking isn’t usually serious and in most cases you won’t need to see a doctor. But if it happens regularly, makes you tired during the day, starts when you’re an adult, or you’re concerned you, your partner or child may be at risk of injury from sleepwalking, then see a doctor.

If a doctor thinks that a sleep problem is causing your sleepwalking, they may refer you to a specialist sleep centre for more tests.

How is sleepwalking diagnosed?

When you see a doctor, you’ll usually have a very straightforward consultation. To get the most out of your appointment:

• think about any symptoms you’re having
• think about any recent life changes or any major stresses you have
• take a list of any medication,
  vitamins
  or supplements you’re using
• take your partner with you as they may be able to give more information about your sleepwalking than you’re able to
• take along any phone recordings you may have of the sleepwalking episodes
• you could also try keeping a sleep diary of your daily sleep habits to show your doctor at your appointment. To track your sleep patterns for your sleep diary, try using the
  Healthily app
  , which has a sleep tracker and a journal

Your doctor will:

• review your medical history and your symptoms – they may also ask you and your partner to fill out a questionnaire about your sleeping habits
• ask if you have a family history of sleepwalking – ask family members before your appointment if you don’t already know

If your doctor isn’t sure what’s causing your sleepwalking, they might refer you to a specialist sleep clinic for overnight sleep tests:

the main sleep test is a polysomnography – sensors are placed on your body to record and monitor the electrical activity in your brain, the oxygen level in your blood, your heart rate and breathing, as well as eye and leg movements while you sleep
you may also be filmed to document your behaviour during the different cycles of your sleep – this can be helpful to exclude other sleep disorders such as obstructive sleep apnoea

Medical treatments for sleepwalking

• cognitive behavioural therapy (CBT)
  – a particular type of CBT called CBT-I (CBT for insomnia) has been shown to be helpful for sleepwalking. This helps someone who sleepwalks change how they think about sleeping and helps reduce the stress and anxiety that can sometimes trigger sleepwalking
• hypnotherapy
  – this type of hypnosis treatment has been shown to be very effective in some people who sleepwalk. During the sessions, you’re given the strong (or hypnotic) suggestion that you’ll wake up as soon as your feet touch the ground when you sleepwalk, and then you’ll return to a peaceful sleep. You may also be taught self-hypnosis to practice every night before going to sleep to reduce the chances of you sleepwalking
• medication – this is usually only considered if lifestyle changes and treatments such as CBT or hypnotherapy haven’t worked, and your sleepwalking is either long-term (chronic) and/or severe enough to cause significant disruption to your sleep. If medication is needed, you may be prescribed
  benzodiazepines
  or tricyclic antidepressants. These medicines should be monitored by a specialist sleep consultant, started at a low dose and only be used for a short time

Your health questions answered

What tips have partners of a sleepwalker told you that can be helpful?

Answered by:

“Many partners of people who sleepwalk find they develop certain routines that seem to work for both of them. These include talking to the sleepwalker quietly and using a light touch to guide them back to bed, fitting gates to the top of the stairs to prevent them going down them or falling, removing anything in the bedroom they may trip over, and making sure there are no precious or breakable objects around their bed.”