Sleepwalking - Symptoms, Causes and Therapy

Sleepwalking, somnambulism, refers to a behavior in which sleepers get up, walk around and often do other things, even driving. This condition usually lasts for a few minutes, but may take longer. Today he falls under the disturbances that occur between sleep stages.

contents

• A parasomnia
• A behavioral disorder
• Orientation to light sources
• Do sleepwalkers have a guardian angel??
• The main victims are children
• Forms of somnambulism
• Typical symptoms of sleepwalking
• Dreamless change
• Genes and psyche
• Psychosocial causes of sleepwalking
• The environment
• Mental causes of somnambulism
• Night walking and other sleep disorders
• Sleepwalking in children: When will it be critical?
• loss of control
• Therapy for somnambulism
• Attention: risk of confusion

A parasomnia

Parasomnias are behavioral disorders and motor disorders between the different phases of sleep and when changing from sleep to waking. Somnambulism is one of the disorders before waking up, and usually to the disturbances during the NREM phase, in which our eyelids do not move and we show little dream activity. It is an intermediate phase; the transducer is between sleep and wakefulness without the alarm being triggered.

Sleepwalkers are in a state between sleep and wakefulness. (Image: Africa Studio / fotolia.com)

A behavioral disorder

Somnambulism can be a behavioral disorder, especially in adults. This does not necessarily mean that those affected are mentally ill. Especially older sleepwalkers who walk around while having nightmares often suffer from REM sleep behavior disorder, a special case insofar as nightwalking occurs during the dream phase. It is not sleepwalking that occurs during the Non REM sleep phase.

In the REM phase, they show a strong activity of the muscles, while the muscles except the respiratory muscles are usually paralyzed in the dream sleep phase. The cause is unknown, but obviously it is a disorder of the nervous system.

Orientation to light sources

Our ancestors called sleepwalkers moonlit and believed that the full moon triggered their behavior. Like many mystical ideas, it was based on real observations.

Today we know that sufferers are guided by light sources. In the darkness of the pre-electronic past this was the moon, but today they are also led by neon signs. This involves dangers in that even the headlights of cars at night are such a source of light, and those affected do not, as falsely suspected, have a "guardian angel".

Do sleepwalkers have a guardian angel??

We talk about sleepwalking security, which means the ability to do something right or wrong, just right. This phrase is based on the misconception that sleepwalkers have an "infallible compass" that protects them from harm.

The nightwalker, who balances on the roof, but falls down while awake, is an urban myth. However, the reality is different: A converter goes around, but he can orient himself only very bad. As a rule, he always goes straight ahead. In his apartment he encounters objects whose position he knows very well when he is awake, and if he gets lost on a roof, the danger of falling is many times higher than when he is awake.

During sleepwalking, sufferers can only orient themselves very badly and usually only go straight ahead. They collide with objects whose position they know exactly when they are awake. (Image: Africa Studio / fotolia.com)

The lack of orientation sometimes leads to grotesque actions: Thus, an adult sleepwalker opened the glass door of his stereo and peed on his records instead of going to the bathroom. Very rarely, however, the insufficient orientation also leads to serious accidents.

The main victims are children

Sleepwalking affects mainly children, and is usually not a sign of a serious disorder in these. In about half of those affected, it starts between the ages of 4 and 6 and affects at least 15% of all 5 to 12-year-olds. It often lasts until puberty, but ends mostly from the age of 15 years.

For adults, the estimates are only 2.5%. A special feature is the somnambulism, which occurs only in adults. This is very rare and often chronic.

Forms of somnambulism

Most common is subclinical sleepwalking. In the process, those affected usually stay in bed, sit up, mumble or look around. The most common form of fully developed night walking includes the described behavior: those affected walk around, performing actions such as going to the bathroom or even cooking. Here is a danger that those affected hurt themselves. Very rare, however, is aggressive sleepwalking. Here, those affected become violent when they meet other people.

Typical symptoms of sleepwalking

Certain symptoms indicate whether it is really a somnambulism:

1. The reactions in the "state of change" are limited compared to the waking state.
2. The affected people behave awkwardly.
3. After waking up you have no memory of the nocturnal activity, or the memory is similar to the fragments of a dream.
4. The face is deprived of expression, the eyes rigidly point the affected person forward without focusing objects.
5. But they perform targeted actions.
6. The affected people first sit up in bed and repeat movements. Either they either stop or they walk around, opening doors or closets. You can even eat or drink.
7. Those affected are approachable and answer questions, but their language is unclear.

Nightwalkers go around and open, for example Doors and cabinets - but usually can not remember after waking up. (Image: Africa Studio / fotolia.com)

Dreamless change

Sleepwalkers walk outside of their dream phases. Her eye movements, her muscles and brain waves indicate deep sleep. They perform complex actions over a short period of time that they do not remember when they are awake.

In children, this dreamless walking is usually easy to explain. The connection of internal stimuli to the waking state has not yet developed the nervous system. For example, they have a full bladder and feel the stimulus to get up and relieve themselves while sleeping.

Researchers explain sleepwalking with an immature central nervous system. This is supported by the fact that the phenomenon is very common in children, goes back to puberty and disappears.

Genes and psyche

The likelihood of walking asleep is ten times that of a family with a case of somnambulism, and 60-80% of adults have relatives who also walk around in sleep. That speaks for a genetic influence. Similarly, very introverted people and / or people who suppress aggression are particularly often affected, which in turn suggests psychological factors.

Psychosocial causes of sleepwalking

Studies also show social triggers for sleepwalking. These include extreme diets, nutritional and sleep deprivation, and chaotic wake-sleep rhythms. Thus, after sleep deprivation, long periods of deep sleep ensue, which may be associated with an incomplete wake-up reflex. The result: those affected become active without being awakened.

Whoever gets up at the same time and goes to bed, has the experience that he usually goes into the waking state immediately before the alarm clock rings. However, if this rhythm is disturbed, because we once during the day, once a night sleep, and / or rarely come to an average of six to eight hours of continuous sleep, which promotes recovery.

Today, stress is considered a major trigger for somnambulism. Simply put, those who fall asleep are plagued by having to do certain things, such as getting up at night and walking around.

Nocturnal noise, brightness or an uncomfortable mattress can promote sleepwalking. (Image: andriano_cz / fotolia.com)

The environment

A sleep-harmful environment promotes night walking. Nocturnal noise, nocturnal lights or even an uncomfortable sleeping place disturb the course of the sleep phases, and can lead to irritations of the nervous system.

For example, nocturnal hammering of the neighbor can trigger a wake-up reaction. However, we only accept these as rudimentary, especially if they occur at an unfamiliar time. Somnambulism can be a consequence.

Mental causes of somnambulism

Mental illness can be the trigger, especially depression and anxiety disorders.

Night walking and other sleep disorders

It is not always an isolated phenomenon. Night anxiety and night terrors often overlap with sleepwalking. Bedwetting is above average among sufferers. This raises the question of whether bedwetting such as somnambulism indicates a mental health problem, or both are an indication of an insufficiently trained sleep and wake rhythm in the nervous system.

Sleepwalking in children: When will it be critical?

Somnambulism in children, which does not burden those affected and does not endanger them or others, is not an alarm signal, but a normal symptom of maturing the central nervous system. In such cases, parents should only pay attention to the safety of their children: sleepwalking children, for example, should not sleep on top of a bunk bed, the windows should be locked at night, access to stairs etc. should be blocked.

The walking children should not be awakened by the parents, but carefully led to the bed.

Night walking children should not sleep in a loft bed for safety. (Image: contrastwerkstatt / fotolia.com)

loss of control

Sleepwalkers are a popular figure in jokes. Those affected usually find their nocturnal behavior scary, especially because they have no control over it.

For many people, moving about at night is so uncomfortable that they conceal it and thus prevent help.

Therapy for somnambulism

Sleepwalking Adults, or the affected children suffer from their nighttime wanderings, help with various treatments.

The first and most important self-help is sufficient sleep hygiene. This includes a regular sleep and wake rhythm in the same environment. Be sure to darken the room and prevent sources of noise. This helps to avoid sleep disturbances as a result of a bad environment, and so also the deep sleep phases are shorter.

If mental disorders are the cause, psychotherapy is recommended. This is especially true for adults who suffer from an anxiety or personality disorder.

Relaxation techniques reduce stress and thereby reduce a possible trigger for somnambulistic behavior. These range from yoga over autogenic training to a forest walk before falling asleep.

Behavioral therapies are used to normalize the wake-up mode through associative learning. For example, the sleepwalker can be fully woken up when in "change mode". But beware: This is a treatment under the professional guidance of a therapist - not a self-test of relatives.

The abrupt awakening can confuse the affected persons, make them aware of the helplessness in the situation and thus trigger strong fears. If associative learning is successful, the brain stores an adjusted wax situation and somnambulism ends.

Medication treatments should be discussed with a specialist in sleep disorders.

Many things are made about sleepwalking - but for those affected, the topic is usually very serious and unpleasant. (Image: milkovasa / fotolia.com)

Attention: risk of confusion

Not everyone who gets up in a twilight state and walks around is a sleepwalker in the diagnostic sense. The following causes can also cause this behavior:

1) Alcohol and substance abuse: Here, the effects of the drug can cause those affected to get out of bed and do things. However, the substance-related twilight state does not correspond to the disturbance between sleep and recovery phase typical for somnambulism. However, alcohol and substance abuse can promote walking during sleep.

2) dementia. Even dementians sometimes get up at night and wander around without knowing what they are doing. You are not in a sleep mode then.

3) Strong stress. Those who suffer from severe stress are sometimes "beside themselves" and also perform actions that they can only vaguely remember. But these are also no sleep actions. However, as with substance abuse, stress is also a trigger for sleepwalking.

4) epilepsy. Epileptic seizures are accompanied by uncontrolled movements that often occur at night. It is not somnambulism.

5) drowsiness. Sleepwaves take unusually long to get from sleep to wakefulness. However, it is typical of this phenomenon that it occurs especially in the early morning, and those affected often behave aggressively. They are "not quite at work". For the external observer, affected persons also look like someone who wakes up but has not yet left sleep; a sleepwalker, however, is obviously sleeping.

6) dissociations. The "fugue" states are awake states in which those affected are "next to each other". Other dissociative states in which the patients commit acts that they hardly remember afterwards are not sleepwalking. (Dr. Utz Anhalt)
Specialist supervision: Barbara Schindewolf-Lensch (doctor)

swell
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