Sleep Walking/ Somnambulism

Definition

Sleepwalking is a series of complex behavior carried out during sleep like walking. Symptoms of sleepwalking disorder range from simply sitting up in bed and looking around, to walking around in house, leaving the house and even driving long distances.

Sleepwalking appears to run in families.

There are five stages of sleep- Rapid eye movement sleep (REM sleep) is a normal stage of sleep which is characterized by the rapid and random movement of the eyes. REM sleep in adult humans occupies 20–25% of total sleep, about 90–120 minutes of a night’s sleep , REM sleep normally occurs close to morning.

Stages 1, 2, 3, 4, and REM (rapid eye movement) sleep, these stages make up a sleep cycle. One complete sleep cycle lasts about 90 to 100 minutes.

An average person experiences 4-5 complete sleep cycles per night. Sleepwalking characteristically occurs during the first or second sleep cycle during stages 3 and 4.

Sleepwalking is sometimes associated with –Restless leg syndrome, Migraines and Head injuries

Age / Sex groups affected by Sleep Walking/ Somnambulism

Common in middle childhood, with a peak incidence in children aged 11-12 years.
Equal incidence in males and females.

Races affected by Sleep Walking/ Somnambulism

No racial differences are known

Causes of Sleep Walking/ Somnambulism

• Fatigue, lack of sleep, anxiety
• Alcohol, sedatives, or other medication
• Mental disorders
• Genetic -Sleepwalking occurs more frequently in monozygotic twins and is 10 times more likely if a first-degree relative has a history of sleepwalking.
• Environmental: Sleep deprivation, fever, stress, magnesium deficiency, and chemical or drug intoxication , sedative ,antidepressants
• Fever
Migraine
Gastroesophageal reflux( GERD )
• Nocturnal asthma
• Nocturnal seizures
• Obstructive sleep apnea
• Psychiatric disorders –panic attacks, obsessive compulsive disorder, major depression
Hyperthyroidism
• Pregnancy and menstruation tend to increase the sleepwalking

Sleep Walking/ Somnambulism Signs and Symptoms

During sleepwalk people may get up and walk around, or do complex activities such as moving furniture, going to the bathroom, and dressing or undressing.

The episode of sleepwalking can be very brief (a few seconds or minutes) or it can last for 30 minutes or longer, but most episodes last for less than 10 minutes.
• Acting confused or disoriented when they wake up
• Blank look
• Opening eyes during sleep
• Not remembering the sleep walking episode on waking
• Sitting up and appearing awake during sleep
• Taking in sleep and saying things that do not make sense
• Walking during sleep
• Taking in sleep and saying things that do not make sense

Investigations of Sleep Walking/ Somnambulism

Sleep study, also known as a polysomnogram- spending the night in lab, Sensors that send electrical signals will be placed on various parts of your body, and a chip will be attached to finger. Now video camera records the –Heart beat, eye movements, brain waves and muscle tension

Differential diagnosis of Sleep Walking/ Somnambulism

• Febrile seizures
• Benign positional vertigo
• Cluster headache
• Epilepsy in children

Treatment of Sleep Walking/ Somnambulism

• There is no specific treatment for sleepwalking. Just improving sleep hygiene will be helpful. Treatment for sleepwalking in adults may include hypnosis.
• In some cases short-acting tranquilizers are helpful in reducing sleepwalking episodes.

Complications of Sleep Walking/ Somnambulism

• The main complication is getting injured while sleepwalking.
• Social and behavior issues

Homeopathic treatment for Sleep Walking/ Somnambulism

Aconite –
• A state of fear, anxiety, physical and mental restlessness.
• Sinking of strength
• Nightmares and anxious dreams
• Sleeplessness

Agaricus –
• Restless sleep, vivid dreams
• On falling asleep, wakes up often
• Paroxysms of yawning

Anacardium –
• Sleeplessness
• Anxious dreams
• Impaired memory , absent minded
• Lack of confidence

Natrum muriaticum –
• Sleepless from grief
• Jerking during sleep
• Great weakness and weariness

Opium –
• Great drowsiness
• Loss of breath during sleep
• Bed feels hot , unable to lie

Stramonium –
• Sleepy but cannot sleep
• Cannot bear darkness, wants light and company
• Rapid change from joy to sadness

Diet / management of Sleep Walking/ Somnambulism

• Avoiding alcohol
• Avoiding stress, anxiety
• Adequate sleep
• Meditation and relaxation exercises
• Reading books
• Regular relaxation
• Warm bath before bed
• Making safe environment

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