Half Asleep, Half Awake

Most of us have heard the terms sleepwalking and sleep-talking, but have you heard of other variants, such as sleep-running, sleep-driving, sleep-eating or sleep-bicycling?

One of my school-aged patients sleepwalked downstairs, out the front door and onto his bike – which he rode for two miles. Luckily, a neighborhood friend was driving home and wondered why the youngster was dressed in pajamas and pedaling full-speed at midnight. When the neighbor inquired about the situation, the boy replied, “I’m going to school.” Needless to say, his parents were surprised to see their neighbor and son at their front door that evening.

Partial arousal parasomnias occur when an individual is part asleep and part awake. Approximately a third of all children sleepwalk, and half of those who sleepwalk have episodes regularly. The peak ages for sleepwalking are between 4 and 12 years old; and the episodes usually discontinue or dramatically decline by adolescence, with only 5 percent continuing to sleepwalk in young adulthood.

Sleepwalking looks nearly identical to drowsiness and occurs during the first few hours of the night, when the brain is in the deepest nonrapid eye movement sleep. In this state, before dreams begin, the sleepwalkers’ eyes open and their bodies move, but they’re still technically asleep. Sometimes children clumsily meander around the house in a daze; other times, there’s a specific plan or purpose. Questioning a sleepwalker may instigate a vague response or intense agitation, depending on the person; either way, the sleepwalker won’t remember the short-lived event in the morning.

Because sleepwalkers don’t recall their antics, there’s no need to bring it up at breakfast. In fact, discussing the incidents may worry a young child or cause confusion; so parents might as well lay the issue to rest.

How to Handle a Sleepwalker
The most important thing parents can do is install safety precautions. Clear clutter; avoid the top bunk of bunk beds; make sure windows and doors are locked; and if there’s concern about stairs, invest in a safety gate. If the child attends an overnight camp or sleepover, alert adult supervision so that the responsible party is aware and prepared.

The myth that it’s dangerous to wake a sleepwalker is not true. No physiological damage is caused by rousing a child who’s moving while snoozing. On the other hand, because waking a sleepwalker can be difficult, and often only results in confusion or worry on the part of the child, it is best for parents to simply recognize the action for what it is, and then calmly guide the child back to bed.

Causes of Sleepwalking
I often refer to sleepwalking as an interesting but benign phenomenon. It’s not usually dangerous (unless a person walks into a dangerous location or situation), and we’re unsure of what causes it. Sleepwalking doesn’t point fingers to depression or traumatic events; it occurs in healthy, normal children. Though we don’t know what causes sleepwalking, research shows that if one parent was or is a sleepwalker, there’s a 50 percent chance that his or her child will sleepwalk as well.

Avoiding these triggers can decrease the amount of sleepwalking at home:

• Sleep deprivation.
• Sleep interruptions, such as snoring, restless limbs or loud external noises.
• Caffeine.
• Stress.
• Sickness.
• Changes in schedule.
• Changes in sleeping location.
• Screen time before bedtime.

If sleepwalking is interfering with your family’s rest, talk with a sleep medicine doctor. In certain cases, physicians can prescribe medications to stabilize sleeping patterns. Also, be sure to contact a doctor who specializes in sleep if your child sleepwalks and snores, because the combination is a risk factor for sleep apnea.

Dr. Carolyn Hart is a physician and sleep health counselor at Presbyterian Sleep Health.

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