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Sleepwalking

Sleepwalking Overview: – Signs and Symptoms: Partial arousal during NREM sleep, impaired judgment, impaired perception, dreamy content, and impaired motor behavior. – Associated Disorders: Linked […]

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Sleepwalking Overview:
– Signs and Symptoms: Partial arousal during NREM sleep, impaired judgment, impaired perception, dreamy content, and impaired motor behavior.
– Associated Disorders: Linked to bedtime routines, restless leg syndrome, night terrors, and psychological disorders like schizophrenia.
– Causes: Unknown cause, hypotheses include CNS delay, genetic factors, sleep deprivation, fever, and tiredness.
– Epidemiology: Lifetime prevalence 4.6–10.3%, more common in children (5%) than adults (1.5%).
– History: Investigated in the 19th century, theories included Odic force, attracted mystery and scientific interest.

Sleepwalking Consequences and Safety:
– Consequences: Sexomnia, sleep-related eating disorder, insomnia, injuries, fractures, and fatalities in rare cases.
– Safety Planning: Door alarms, ground floor bedrooms, restricted access to weapons, separate sleeping arrangements for violent sleepwalkers, crucial for preventing harm.

Sleepwalking Diagnosis and Treatment:
– Diagnosis: Polysomnography, self- or partner-report, common diagnostic systems (ICD-10, ICSD-3, DSM).
– Differential Diagnoses: Alcohol- or drug-induced blackouts, REM sleep behavior disorder, confusional arousals, night terrors.
– Treatment: Sleep hygiene improvement, medications (benzodiazepines, antidepressants), cognitive-behavioral therapy, safe sleep environment, referral to sleep specialist.

Sleepwalking in Culture and Literature:
– Culture: References in literature, opera, and drama, including works like “Dracula” and “Macbeth.”
– Opera: Examples like Vincenzo Bellini’s “La sonnambula” and artificial somnambulism.
– Drama: Depictions in plays like Shakespeare’s “Macbeth” and Walley Chamberlain Oulton’s “The Sleep-Walker.”
– Literature: References in works like Bram Stoker’s “Dracula” and legal cases involving sleepwalking as a defense.

Sleepwalking Legal Aspects and Research:
– Legal Cases: Examples like R. v. Parks, Pennsylvania v. Ricksgers, and Arizona v. Falater involving sleepwalking as a defense.
– Automatism Defense: Cases of individuals found not guilty by reason of insanity for crimes committed during sleepwalking episodes.
– Research: Studies on sleepwalking causes, assessment, treatment, and legal implications in various sources like Mayo Clinic and British Medical Journal.

Sleepwalking (Wikipedia)

Sleepwalking, also known as somnambulism or noctambulism, is a phenomenon of combined sleep and wakefulness. It is classified as a sleep disorder belonging to the parasomnia family. It occurs during slow wave stage of sleep, in a state of low consciousness, with performance of activities that are usually performed during a state of full consciousness. These activities can be as benign as talking, sitting up in bed, walking to a bathroom, consuming food, and cleaning, or as hazardous as cooking, driving a motor vehicle, violent gestures and grabbing at hallucinated objects.

Sleepwalking
Somnambulism
John Everett Millais, The Somnambulist, 1871
SpecialtyClinical psychology, Psychiatry, sleep medicine

Although sleepwalking cases generally consist of simple, repeated behaviors, there are occasionally reports of people performing complex behaviors while asleep, although their legitimacy is often disputed. Sleepwalkers often have little or no memory of the incident, as their consciousness has altered into a state in which memories are difficult to recall. Although their eyes are open, their expression is dim and glazed over. This may last from 30 seconds to 30 minutes.

Sleepwalking occurs during slow-wave sleep (N3) of non-rapid eye movement sleep (NREM sleep) cycles. It typically occurs within the first third of the night when slow-wave sleep is most prominent. Usually, it will occur once in a night, if at all.

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