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By Roberto Vetrugno MD PhD

Sleepwalking is also known as or subsumes Nocturnal automatism and Somnambulism. -ed.

Sleepwalking consists of recurrent episodes in which the subject arises from sleep and shows complex ambulatory behavior, including leaving the bed and walking. Typically, sleepwalking emerges during the first third of the night. Most often seen in children, sleepwalking may occasionally also present during adulthood. In this clinical article, Dr. Roberto Vetrugno of the Department of Neurological Sciences at the University of Bologna, Italy, reviews the many factors that can induce and influence the frequency and severity of sleepwalking. These include febrile episodes, emotional stress, drugs, sleep deprivation, and sleep fragmentation as in sleep-disordered breathing, restless legs syndrome, and periodic limb movements during sleep. Of special interest to healthcare practitioners is also a section discussing ways to manage sleepwalking, including pharmacological treatment, identifying any triggering and predisposing factor, and limiting the risk of injury.

Key Points

  • Sleepwalking is a disorder of arousal consisting of complex behaviors during arousals from slow wave sleep, commonly culminating in walking with an altered state of consciousness and impaired judgment.
  • Lack of autonomic features differentiates sleepwalking from other disorders of arousal, ie, sleep terrors and confusional arousals.
  • Sleepwalking often runs in families and in association with other NREM arousal parasomnias, suggestive of a genetic role.
  • NREM sleep instability and increased arousal oscillations may play a role in triggering abnormal motor episodes.
  • The first line of treatment is to eliminate precipitating factors.