What is Somnambulism?
Somnambulism is a medical term used to describe a sleeping disorder known to the common man as sleep walking. It is a common behavioural disorder which originates in deep sleep among children as well as in adults. Somnambulism is characterised by a form of walking or other complex activities while being asleep. Most of these activities occur in the deep sleep, which makes it difficult to wake up and the person often cannot remember the occurrence of the incident when awake.
Causes of Somnambulism
Somnambulism or sleep walking may be caused due to multiple reasons. The most common causes of sleep walking are listed below:
- Genetic inheritance. It is commonly seen among identical twins or if there is a family history of Somnambulism or sleep walking.
- Sleep deprivation or lack of sleep
- Chaotic sleep schedule
- Stress and other psychological issues can also cause Somnambulism or sleep walking.
- Alcohol intake
Side effects of drugs and medications such as sedative hypnotics (drugs that promote sleep or relaxation), neuroleptics (used for the treatment of psychosis), stimulants (which may boost activity), antihistamines (commonly used for the treatment of allergy).
Other medical conditions which may cause somnambulism are:
- Heart issues
- Nocturnal asthma
- Night time seizures
- Obstructive sleep apnea (medical condition where one may stop breathing briefly)
- Restless leg syndrome
- Psychiatric issues such as post-traumatic stress disorder, panic attacks, dissociative states, multiple personality disorder etc.
Symptoms of Somnambulism
As the name suggests, somnambulism or sleep walking is characterised by walking while sleeping. Other common symptoms associated with Somnambulism include:
- Waking up in the middle of deep sleep
- Walking around the house while sleeping
- Sitting up in bed and looking around while in deep sleep
- Driving long distance while actually sleeping
- Leaving the house in deep sleep
- Feeling sleepy during the day
- Talking or screaming in the state of deep sleep (also known as somniloquy)
- Inability to recall the event of activity while sleeping can also be a symptom of Somnambulism.
- Injury associated with activities while sleeping
- Inappropriate behaviour such as urinating anywhere.
Risks Associated with Somnambulism
The most common risks associated with somnambulism or sleep walking is:
- Danger of not waking up during the sleep walking which may lead to accidents or injuries
- Difficulty waking up the sleep walker
- Physical attacks in form of counter-productive retaliation by the sleep walker.
Diagnosis of Somnambulism
Diagnosis of sleep walking involves obtaining a detailed case history including a detailed sleep history. It is important to identify the underlying triggering factor or any underlying medical or psychological issues giving rise to Somnambulism. Other factors which may cause Somnambulism or sleep walking includes fatigue, stress, medication, lack of sleep, alcoholism etc. Once identified, the treatment protocol is designed to manage the condition.
How is Somnambulism Treated?
Somnambulism or Sleep walking does not have a specific treatment and the treatment depends on the underlying cause of the condition. Treatment for Somnambulism or sleep walking is often done by a sleep specialist. In some cases, the condition is short lived and resolves by itself without any active treatment. Some of the commonly used treatment modality for Somnambulism includes:
- Providing reassurance to the patient and his or her family, that it is a passing phase which is benign in nature and will resolve gradually.
- Hypnosis and pharmacological therapy such as sedative hypnotics or anti-depressants.
- Sleep counselling for improving sleeping condition and sleep hygiene of the patient.
Besides this, it is advised to avoid any tactile, visual or auditory stimuli during the sleep cycle to avoid giving rise to such situation. Remove any obstacle around the sleeping area and keep the doors and windows locked to avoid any mishap or injury. It is also advised to remove any sharp objects from near the bed, and install gates on stairways. Children should not be allowed to sleep on bunk beds to avoid falls while sleeping. Triggering agents such as alcohol and caffeinated beverages should be strictly avoided before bedtime. It is advised to indulge in relaxing activities such as warm baths, listening to soothing music, drink herbal tea, or read a book before sleeping. Any activity that triggers the mind such as watching television, using cell phone, laptops etc. should be avoided before bedtime.
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