Knowledge about Sleepwalking: Causes, Symptoms, and Treatment

This essay provides an overview of sleepwalking, its causes, symptoms, and treatment. It also discusses the prevalence of sleepwalking, legal and psychological effects, and prevention methods.

Running head: KNOWLEDGE ABOUT SLEEPWALKING
KNOWLEDGE ABOUT SLEEPWALKING
Name of the student
Name of the university
Author note

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Introduction
The aim of the essay is to present an elaborate discussion and analysis of ‘sleepwalking’,
a behavior disorder. The essay will first provide an overview of the disorder to find the actual
reasons for it to occur. In addition, the overview will also include numerous arguments about the
disorder. Then, it will include its causes, symptoms and treatment.
The essay will also include statistics regarding the prevalence of sleepwalking to find out
the level to which is present across nations. Further, the essay will attempt to find out whether
sleepwalking varies according to different factors like age, environment or gender. The legal and
psychological effects of sleepwalking will also be discussed.
Sleepwalking, known previously as somnambulism, originates at a time when a person is
in a stage of deep sleep during the early hours (Sleepfoundation.org, 2019). The person suffering
from this disorder performs complex behaviors apart from walking while asleep. The
sleepwalker might not even remember if she or he has done something or said something while
asleep. The symptoms include open eyes with glassy stare. Several causes of sleepwalking have
been identified including genetic causes. However, there is no effective treatment to prevent
sleepwalking although the sufferer could follow certain basic steps like sleeping adequately and
so on.
Discussion
Sleepwalking, as has been mentioned in the introduction section, is behavior disorder in
which people that suffers from it, walk or perform other activities while they are in sleep. The
normal cycle of sleep involves separate stages from light sleepiness to deep sleep. Sleep is also
categorized as REM – rapid eye movement sleep, NREM – non-rapid eye movement sleep. In

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the REM stage, the eyes move rapidly while sleeping while in NREM stage, the eyes do not
make rapid movements and sleepwalking occurs at this stage (Medlineplus.gov, 2019).
Sleepwalking occurs mostly in people of all ages but mostly in children. It has been established
through some studies that one in every five children have sleepwalking disorder at least once in
their lifetime. While most children come out of it with time especially by the age of puberty, it
stays in many children even in adulthood.
According to a latest study, it has been revealed that sleepwalking amongst adults is
potentially a severe condition that might cause violent behaviors and affect the quality of life in
terms of health. Dr. Yves Dauvilliers, the principal investigator of the study stated that they
found an increased frequency of daytime sleepiness, insomnia, fatigue, anxiety and depressive
symptoms in adult patients having sleepwalking (Aasm.org, 2019). Dr. Dauvilliers further stated
that although sleepwalking is considered a benign condition, it is very risky when diagnosed in
adults and hence, people must not ignore sleepwalking episodes. Some evidences have been
found that suggest sleepwalking occurring more in men than in women. Stallman and Kohler
(2016) find that sleepwalking that lead to violence occurs mostly in older age groups.
According to the National Sleep Foundation, around one to 15% of the general
population has been found as having the sleepwalking disorder (Sleepfoundation.org, 2019). This
shows that the disorder is quite prevalent amongst the population. When it comes to children, the
prevalence is quite higher than those in adults are. In another study conducted by Petit et al.
(2015), it was revealed that sleepwalking in children occur due to the early ages sleep terrors.
The data revealed that children between the age of one or one and half years experience sleep
terrors, which is at its peak. Sleepwalking has been observed mostly in children attaining the age

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of 10 years. More than one-third of children, who had experienced sleep terrors in early
childhood, were found to have developed sleepwalking in later ages.
Although the particular cause of sleepwalking is yet to be discovered, numerous research
reveal that it occurs due to genetic reasons amongst others. The National Health Service of
United Kingdom finds the following causes that could trigger sleepwalking (Nhs.uk, 2019):
 Lack of enough sleep
 Anxiety and stress
 Infection due to fever, particularly in children
 Too much consumption of alcohol
 Consumption of recreational drugs
 Medications of certain types like sedatives
 Startled with sudden touch or noise resulting in abrupt waking from sleep
Apart from the above-mentioned causes, genetic causes are also visible causes for
sleepwalking. It has been found that those whose parents, brother or sister sleepwalk, are ten
times more likely to inherit the disorder than others are. Some medical conditions apart from
fever have also been associated with sleepwalking. These include, heart rhythm issues,
heartburn, nighttime asthma and seizures, obstructive sleep apnea, post-traumatic stress disorder
(PTSD), panic attacks, restless leg syndrome and so on (Nhs.uk, 2019).
Sleepwalking is also known as parasomnic disorder. Parasomnia is a disorder in which
the person suffering has nervous systems that are behaving unusually or abnormally during sleep.
During parasomnic episodes, people are fast asleep and are not aware but their “actions appear
conscious” (Popat and Winslade, 2015). As these episodes pass the stage of innocuous and enter

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the world of homicide and rape, their level of significance and relevance boosts exponentially.
Parasomnia and sleepwalking hence, often causes the person suffering from it to commit illegal
activities as severe as murder.
Several instances of crime committed during sleepwalking could found in the United
States alone. One of the earliest cases occurred in 1846 where a person called Albert Tirrell was
accused and then acquitted of the murder of a prostitute on accounts of chronic sleepwalking
(Usnews.com, 2019). Tirrell murder a woman by slitting her throat and set the brothel on fire
before fleeing to New Orleans. In another more recent case that happened in 2001, Stephen Reitz
was charged of first-degree murder of his lover Eva Weinfurtner. In his defense, Reitz’ parents
claimed that he had long history of sleepwalking since childhood. This explanation did not save
Reitz as the jurors convicted him on murder charges going by his history of violence against
Weinfurtner. In one of the most known cases of sleepwalk murder, Kenneth Parks, a Canadian
young man had attacked his in-laws killing one and severely injuring another in 1987
(Usnews.com, 2019).. Parks was acquitted of the murder charges because strong evidence of his
history of sleepwalking was produced before the jurors.
These cases bring to light the ambiguity related to sleepwalking and the danger of it
being misused by perpetrators of crime to escape punishment while actual sufferers are
convicted. This leads to the fact that sleepwalking, which has been often neglected as a minor
behavior disorder occurring especially in children, has grave consequences when found in adults.
Popat and Winslade (2015) found in their study the overall prevalence rate of sleepwalking
amongst adults in a lifetime was 7% with 10.4% males and 3.5% females suffering from it. The
statistics reveal that adequate efforts must be made in order to detect early symptoms of
sleepwalking keeping in view the psychological effects along with physical and legal problems.

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While majority of studies and evidences hint towards genetic causes for the occurrence of
sleepwalking, mental disorders and psychological factors also have crucial contribution. It has
been found that psychotherapy often helps cure sleepwalking amongst those who had sleep
terrors during childhood. Although the treatment is based mostly on pharmacologic intervention,
it has been found ineffective in many patients. Conway, Castro, Lopes-Conceição, Hachul and
Tufik (2011) conducted two case studies to find the affects of psychology in sleepwalking and
psychotherapy in curing sleepwalking. In the first case, the scholars conducted 11 sessions for
33-year old black man who had complaints of recurring sleepwalks. After being on medication
for the initial period and finding no visible result, the patient was provided psychotherapy that
focused on his emotional triggers. After the end of the psychological treatment, the patient
reported remarkable improvement in his sleepwalking episodes.
The second case study involved a 39-year old white female who was admitted in 2005 to
the Sleep Institute after numerous reports of sleepwalking incidences that had occurred in her
lifetime. She was under pharmacology treatment for three months that showed no signs of
recovery. Then, she was given psychotherapy that revealed severe level of exhaustion and stress
causing sleepwalking. Along with that, severe depression and anxiety symptoms were also
found. After four sessions of psychotherapy, she revealed that her understanding of the relation
between emotional conflicts and sleepwalking had become clearer and this has helped her feel
better and reduced episodes of sleepwalking.
Sleepwalking involves varied symptoms based on age and causes of sleepwalking. The
basic symptoms of sleepwalking might include simple activities like sitting up in the bed and
stare as if the person is awake. Further symptoms include, moving furniture in the bedroom,
going to bathroom, dressing, undressing, and such. In some cases, people while sleepwalking

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even drive vehicles and travel to long distances. The episode might last for a few seconds or
could go as long as half an hour or even longer. The average duration for sleepwalking is ten
minutes given that the sleepwalkers are not disturbed while sleepwalking.
 The following are the most common symptoms of sleepwalking:
 Disoriented or acting confused when the individual wakes up
 Behaving aggressively while woken up by some other person
 A blank look on the face
 Opening eyes frequently while asleep
 Unable to remember the sleepwalking incidence after waking up
 Performing exhaustive actions of any kind during sleep
 Talking while asleep and say things that have no sense
As already stated earlier, sleepwalking has no medically or psychologically proven
treatment. Healthcare providers conduct exams and tests on sleepwalkers to rule out the
possibility of other disorders especially mental disorders and conditions like seizures and such.
Other than that, mental health evaluation of people having a history of emotional issues is also
conducted to find reasons related to excessive stress and anxiety.
Attarian and Zhu (2013) find that most people have no need to be given specific advice to
address sleepwalking because in most cases, the causes and symptoms are the same.
Nonetheless, these below suggested treatment are advised for people suffering from
sleepwalking:
 Make a fixed routine to go to bed every night
 Ensure that the bedroom is quiet and dark prior to going to sleep

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 Put a limit to alcohol and caffeine consumption especially before going to sleep
 Find techniques to relax before sleeping like reading, deep breathing or having a warm
bath
 In case of children sleepwalking at a fixed time every night, it would be effective to wake
them up 15 to 30 minutes prior to their fixed time of waking
Apart from treatment, those suffering from sleepwalking disorder should also make
efforts to prevent it from occurring. The first step towards prevention could be to avoid alcohol
consumption and depressants for central nervous system. Second would be to avoid too much
exhaustion, insomnia, minimize stress or avoid it if possible and emotional conflicts. Other ways
to prevent sleepwalking would be to adopt a healthy lifestyle with regular exercise and avoidance
of harmful drinks and food.
Conclusion
The essay aimed at providing a thorough discussion on sleepwalking that included its
causes, symptoms, treatments and other associated elements. The essay first provided an
overview of the disorder and found that sleepwalking is also known as somnambulism. Further,
the essay also revealed that sleepwalking is a type of parasomnia except that in parasomnia, the
actions or activities seem conscious. The essay then presented the causes of the disorder, which
revealed that there are no known causes of the disorder apart from genetic or environmental
causes. The essay also found that sleepwalking mostly occurs in children and rarely continue to
adulthood. Risks of sleepwalking in adulthood have been discussed in the essay as well.
Sleepwalking in adulthood often resulted in violence and even crime. Instances of cases where
sleepwalking has been responsible for crimes like those that murder has also been presented in

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the essay. The essay, in the end, provided possible treatments of the disorder and argued that
psychotherapy should be suggested along with pharmacotherapy for treating and reducing
sleepwalking.

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References:
7 Criminal Cases That Invoked the 'Sleepwalking Defense'. (2019). Retrieved from
https://health.usnews.com/health-news/family-health/sleep/articles/2009/05/08/7-
criminal-cases-that-invoked-the-sleepwalking-defense
Aasm.org. (2019). Adult sleepwalking is serious condition that impacts health-related quality of
life - American Academy of Sleep Medicine – Association for Sleep Clinicians and
Researchers. Retrieved from https://aasm.org/adult-sleepwalking-is-serious-condition-
that-impacts-health-related-quality-of-life/
Attarian, H., & Zhu, L. (2013). Treatment options for disorders of arousal: a case series.
International Journal of Neuroscience, 123(9), 623-625.
https://doi.org/10.3109/00207454.2013.783579
Conway, S. G., Castro, L., Lopes-Conceição, M. C., Hachul, H., & Tufik, S. (2011).
Psychological treatment for sleepwalking: two case essays. Clinics, 66(3), 517-520.
http://dx.doi.org/10.1590/S1807-59322011000300028
Medlineplus.gov. (2019). Sleepwalking: MedlinePlus Medical Encyclopedia. Retrieved from
https://medlineplus.gov/ency/article/000808.htm
Nhs.uk. (2019). Sleepwalking. Retrieved from https://www.nhs.uk/conditions/sleepwalking/
Petit, D., Pennestri, M. H., Paquet, J., Desautels, A., Zadra, A., Vitaro, F., ... & Montplaisir, J.
(2015). Childhood sleepwalking and sleep terrors: a longitudinal study of prevalence and
familial aggregation. JAMA pediatrics, 169(7), 653-658.
doi:10.1001/jamapediatrics.2015.127

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Popat, S., & Winslade, W. (2015). While you were sleepwalking: science and neurobiology of
sleep disorders & the enigma of legal responsibility of violence during
parasomnia. Neuroethics, 8(2), 203-214. 10.1007/s12152-015-9229-4
Sleepfoundation.org. (2019). Sleepwalking. Retrieved from
https://www.sleepfoundation.org/sleep-disorders-problems/abnormal-sleep-behaviors/
sleepwalking
Stallman, H. M., & Kohler, M. (2016). Prevalence of sleepwalking: a systematic review and
meta-analysis. PloS one, 11(11), e0164769. https://doi.org/10.1371/journal.pone.0164769