Is Sleepwalking (Somnambulism) a Mental Disorder?

Symptoms of sleepwalking (somnambulism) may include:

• Getting out of bed and walking around
• Sitting up in bed and opening the eyes
• Having a glazed, glassy-eyed expression
• Doing routine daily actions
• Incoherent speech
• Difficulty being woken up 
• Confusion
• No memory of what happened
• Sleep terrors
• Quick return to sleep

Sleepwalking does not always just involve walking. Other actions may occur. Rarely, people who sleepwalk may:

• Get dressed
• Leave their house
• Drive 
• Move furniture
• Engage in sexual behavior 
• Act unusually, such as urinating in inappropriate places such as a closet
• Injure themselves
• Become violent

Causes of sleepwalking (somnambulism) include:

• Sleep deprivation
• Overactive thyroid (hyperthyroidism)
• Physical or emotional stress
• Migraines
• Abdominal bloating 
• Head injury
• Brain swelling (encephalitis)
• Stroke
• The premenstrual period
• Sleep apnea
• Other sleep-related disorders or events
• Travel
• Sleeping in unfamiliar surroundings
• Some medications, especially those with a sedative effect
• Drug or alcohol abuse
• Noise or light
• Fevers in children

Risk factors for sleepwalking include:

• Age
  • More common in children; often peaks between ages eight to 12 
• Genetics
  • The risk of sleepwalking doubles or triples if one or both parents were sleepwalkers
• Post-traumatic stress disorder (PTSD)
• Other medical disorders, such as congestive heart failure and Parkinson’s disease

Sleep disorders are diagnosed with a patient history and physical exam. Tests or procedures that may be used to diagnose sleep disorders or to rule out other underlying conditions include: 

• Daily sleep log
• Sleep study (polysomnography)
• Record of activity and movement with a monitor or motion detector, generally worn on the wrist throughout the day and night (actigraphy)
• Core body temperature measurements 
• Hormone tests
• Electrocardiogram (“ECG”) 
• Computerized tomography (CT) scan 
• Magnetic resonance imaging (MRI) of the brain 

Sleepwalking in children often goes away on its own as children enter adolescence and the teen years. Until then, it is important to create a safe environment so the child does not get injured while sleepwalking. 

• Remove clutter or other tripping hazards that could cause a child to trip and fall
• Install a safety gate in the doorway of the child’s bedroom or at the top of the stairs
• Lock windows and doors at night so a child cannot get outside
• Children should not sleep in an elevated bed (bunk bed)
• Keep sharp objects or weapons locked away and out of reach
• Install lights with motion sensors
• Consider use of door alarms or a bed alarm that goes off if a person gets out of bed

Treatment for sleepwalking includes:

• Improve sleep hygiene to get adequate sleep 
  • Keep a consistent sleep schedule
  • Avoid caffeine or alcohol close to bedtime
  • Make sure the mattress is comfortable
• Treat other sleep problems, such as sleep apnea or restless leg syndrome 
• Education to avoid triggers 
• Cognitive behavioral therapy (CBT) 
• Relaxation techniques for stress-related episodes of sleepwalking
• Medication
  • Benzodiazepines 
  • Antidepressants
  • Melatonin