Sleep is a safe, peaceful place, that time of day when we take refuge in our own dreams and put our worries aside. But for some, nights can become the terrain of strange behaviors, which happen involuntarily, without the person being aware of them. Sleepwalking or sleepwalking is one of the most enigmatic and fascinating sleep disorders. From simple episodes, in which someone gets out of bed and stands for a few seconds, to more complex cases in which people can walk around the house, open doors, eat or even leave the house – all of this can happen without any memory of what happened. The phenomenon raises natural questions: why does it occur, who is more prone, how dangerous can it be and what to do when someone close to you suffers from this?
What is sleepwalking and how does it manifest itself?
Sleepwalking is a category of parasomnias – abnormal behaviors that occur during sleep. It usually occurs during the deepest stage of sleep, known as slow-wave sleep or N3 sleep. This stage occurs mostly in the first third of the night, which is why sleepwalking episodes are more common in the early hours of sleep.
What is interesting is that the person in a sleepwalking episode appears awake, with their eyes open and sometimes even with an expressive or alert face. However, in reality, they are in a partially conscious state, between sleep and wakefulness, unable to respond coherently to stimuli or process what is happening around them. Behaviors can range from simple movements – such as sitting, talking in their sleep, or walking – to more elaborate actions, such as getting dressed, using the toilet, eating, or, in rare cases, even driving a car.
A common feature of all cases is post-episode amnesia: most people do not remember anything they did. To an observer, the behavior seems strange, but the affected person is completely unaware of what they did during the night. Although most episodes last only a few minutes, sometimes they can be longer or involve real danger, especially if the person ends up outside the home or in an unsafe environment.
Who and why ends up being a sleepwalker?
Sleepwalking is more common in childhood, affecting between 10% and 30% of children at some point, usually between the ages of 4 and 12. Many of them "cure" themselves naturally by adolescence, without treatment. In adults, only 1-4% continue to have regular episodes, and in these cases the causes can be more complex and sometimes associated with other disorders or psychological factors.
Researchers believe there is a significant genetic component. If one of the parents was a sleepwalker as a child, the child is more likely to exhibit the same behaviors. But genes are not the only culprit. Certain factors can trigger or worsen episodes:
- Lack of sleep or extreme fatigue
- Stress and anxiety
- Fever, especially in children
- Sudden changes in sleep routine (e.g., travel or shift work)
- Consumption of alcohol or certain medications
- Sleep apnea or other sleep disorders
In adults, episodes can also occur in the context of more serious neurological or psychiatric problems, such as epilepsy, depression, or personality disorders. Therefore, if sleepwalking occurs in old age or suddenly worsens, it is important to be evaluated by a sleep medicine specialist or neurologist.
Is sleepwalking dangerous?
Most of the time, sleepwalking is harmless, especially in childhood, and does not require complicated treatments. However, the danger arises due to involuntary behaviors that can put the person or those around them in danger. For example, there are cases in which sleepwalkers have fallen down the stairs, hit hard objects or left the house in the middle of the night, in their pajamas, without knowing where they are going. Some may even turn on the stove, open doors or try to drive the car, which can obviously become extremely risky.
There is also an emotional risk. Both the affected person and their family may experience a state of restlessness or anxiety about what happens at night. Sleepwalkers may feel embarrassed or scared when they find out what they have done, especially if the episodes are frequent or bizarre. And for partners, parents or roommates, it can be difficult to manage a situation in which someone appears awake but is not responding coherently and doing unexpected things.
However, in very rare cases, extreme sleepwalking can lead to aggressive behavior, especially if the person is suddenly awakened or feels "threatened" during the episode. These cases are exceptions, but have been documented in the medical literature.
How can you manage sleepwalking?
The management of sleepwalking depends largely on age, frequency of episodes, and overall health. In children, careful supervision, establishing a regular sleep routine, and eliminating potential sources of stress are often sufficient. It is important for parents not to be alarmed unnecessarily, as it may seem strange, for most children sleepwalking is a transient phase.
One of the most useful interventions, especially for frequent episodes, is the scheduled wake-up technique. This involves a parent or partner noticing when episodes occur and waking the person up a few minutes earlier than usual to “reset” the sleep cycle. It is a simple method, but one that works well in many cases.
For adults, management can be more complex. First, it is essential to identify the triggers. Sometimes a simple adjustment to the sleep schedule, reducing stress, or changing a medication can completely eliminate the problem. If the episodes are frequent, intense, or dangerous, an evaluation at a sleep center is recommended, where specific tests (such as polysomnography) can be done to rule out other conditions.
In some cases, doctors may recommend drug treatments, especially benzodiazepines or antidepressants, but these are used with caution and only when other methods do not work. In parallel, psychotherapy can help, especially if there is underlying anxiety or unresolved trauma.
Safety is an important consideration. In the home, obstacles that could be dangerous at night should be removed – for example, door locks can be secured, windows can be blocked, sharp objects can be hidden. The bedroom can become a protected, risk-free space where the sleepwalker cannot hurt himself or put himself in danger.
Myths, curiosities and what else we know about sleepwalking
Sleepwalking has always been surrounded by myths and legends. In the past, some saw it as a mystical manifestation or a sign of spiritual possession. Others believed that sleepwalkers should never be awakened, as they could suffer serious psychological shocks – an exaggerated idea, but not entirely untrue. In fact, it is not dangerous to awaken a sleepwalker, but it is difficult, and the person can often wake up confused, scared, or disoriented.
Another myth is that sleepwalking means that the person is "dreaming" intensely. In reality, sleepwalking does not occur during the dreaming phase (REM), but rather during deep sleep, when brain activity is low. Therefore, it is not about dreams or repressed desires, but rather about a dissociation between body and consciousness.
We also know that sleepwalking has a clear neurophysiological component. Research over the past few decades has shown that during an episode, certain regions of the brain—such as the motor cortex—become active, while the areas responsible for conscious thought remain “asleep.” It’s as if the brain is “half-awake,” and the body acts without the mind being fully present.
The role of family and loved ones in managing sleepwalking
When faced with a sleepwalking episode, it is not only the affected person who needs support, but also those around them play an essential role. Often, a life partner, a parent or a roommate is the first to notice the bizarre behaviors during the night. Therefore, understanding, patience and information are essential.
The first important thing is to avoid panic. It is natural for a sleepwalking episode to seem alarming, especially if the person suddenly gets up, speaks incoherently or walks around the house. But it is crucial that the reaction of those around them is calm. A calm tone, a light touch on the shoulder or gentle guidance back to bed are the best solutions. It is not recommended to shout, shake the person or scare them, as this can intensify the confusion or even cause an uncontrolled defensive reaction.
The family can also help a lot by providing a safe environment. This means locking doors and windows at night, removing dangerous objects from the room, possibly installing a discreet door alarm system, or using a low bed to avoid falls. If the person frequently sleepwalks, it may even be helpful to sleep in a room on the ground floor.
Another essential aspect is tracking and recording the episodes. Keeping a sleep diary, with details such as the time of the episodes, their duration, the observed behavior or any triggers (fatigue, stress, alcohol) can be extremely useful. This information helps the doctor in establishing a correct diagnosis and choosing the best treatment strategy.
Last but not least, the family must provide emotional support. People affected by sleepwalking can become ashamed, frustrated, or even scared by what is happening to them. Encouraging them to talk about their episodes, without judging or ridiculing them, gives them a sense of safety and acceptance.
Sleepwalking is a real disorder, but most of the time it is transient, harmless and manageable. It is important not to give in to prejudice or fear, but to understand with empathy what is happening during these episodes. With a little attention, support from family and, if necessary, medical help, sleepwalking can be kept under control and does not have to overshadow the quality of life.
If you are experiencing sleepwalking episodes or someone you love is experiencing them, don't hesitate to seek professional advice. Every sleep deserves to be peaceful and every night, a safe haven.
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