Children and Sleepwalking
As a mother and father lie soundly in their bed, they are startled awake by a loud noise from the hallway. It's not the cat, the dog or even a burglar. It is their own child.
Across the country, thousands of children sleepwalk each night -- most without their parents' knowledge. Sleepwalking is not necessarily a serious disorder but the behaviors that occur when a child is sleepwalking can be. Once parents know what sleepwalking is, what causes it, how they can protect their child from harm if and when they do sleepwalk and when to seek help for a child's sleepwalking activity, only then can parents and children alike settle in for a restful, stationary night's sleep.
About 18 percent of children in the United States are prone to sleepwalking, according to the National Academy for Childhood Sleep Disorders. Sleepwalking is more common in boys than girls. Sleepwalking in children is most common between the ages of 6 and 12 years and oftentimes does have a genetic tendency. In addition, medical reports from the National Academy for Childhood Sleep Disorders state that if a child continues to sleepwalk after the age of 9, the incidence of sleepwalking in adulthood increases by 75 percent compared to those children whose sleepwalking activity ceases before the age of 9. Just as each of the children who leave their beds to walk in the night differs from others, the reasons and causes for sleepwalking differ as well.
The proper medical term for sleepwalking is somnambulism. Taber's Cyclopedic Medical dictionary defines sleepwalking as "an affection that prompts the sleeping person to perform, unconsciously, acts that naturally belong to the waking state." A common picture that comes to mind when hearing the word "sleepwalking" is one from the movies: a person walking, eyes closed, arms outstretched in front of them. Although the movies offer this image, it is not a true depiction of the activities of sleepwalkers.
Dr. Stephen Sheldon, the director of the sleep medicine center at Children's Memorial Hospital in Chicago, says children who sleepwalk may look as if they are awake. One of the only clues to know a child is sleepwalking may be strange or unusual behaviors that occur during the episode.
"Sleepwalking will occur during this deep, deep sleep," says Sheldon. "Youngsters will get up out of bed, wander around the house, occasionally urinate in unusual places around the house and then either fall asleep in an unusual place in the house or walk right back to bed and go to sleep and not remember the episode at all."
Karen Casey of Ohio, whose son is now 16, said her son was about 5 or 6 when she discovered his sleepwalking.
"He would walk from room to room, usually just through bedrooms and the living area," she says. "He never went outside or anything. He'd just walk about, speaking nonsense and end up back in bed."
What Causes Sleepwalking?
Although medical research does not have a definitive answer as to what causes sleepwalking, there are many clues. These clues include maturation rates, outside or environmental stress or anxiety, Sheldon says. However, what may be the cause of one child's sleepwalking episode may not be the cause of another. As each child matures at different rates and handles stress and anxiety differently, the causes for a child's episodes of sleepwalking will need to be individually identified.
Sheldon says the most common cause of sleepwalking is maturation issues. As a child continues to grow and their body matures, some areas will develop faster then others, causing imbalances between various anatomical systems.
"Sleepwalking is most commonly thought to be due to a maturational issue where a part of the nervous system is maturing faster then another part," says Sheldon. "As a child grows and their systems begin to even out -- or reach the same level of maturity -- the sleepwalking episodes will decrease due to a more level balance in their own body."
There are other factors that may cause or worsen episodes in children who have been known or are prone to sleepwalking called stressors. These stressors include stress and anxiety, sleepiness or being excessively sleepy, fever, bladder distention, environmental noise and being awakened within the first few hours of sleep onset. The identification of a child's stressors can offer assistance into decreasing the number of sleepwalking episodes or even ceasing the activity all together.
"Sometimes the stressors are very easy to identify: a scary movie, a test at school, a bully in the schoolyard that's picking on somebody," says Sheldon. "Other times they are not so easy to identify and the parent may need to investigate the little things that normally wouldn't be thought of as stressors such as rules or chores or even a parent's involvement in an argument between siblings."
Brette Sember's 8-year-old daughter has been sleepwalking since the age of 4.
"She has gone downstairs from her room and she would walk around and then go back to bed," says Sember, of Basom, N.Y. "I think it is related to stress, but when she was younger I am not sure there was a trigger, just her growing and developing. You couldn't get her to really wake up so the best thing was just to get her to lie down and she would go back to sleep, never to remember a thing about it."
Coping with Sleepwalking
Very helpful tools used in identifying stressors related to sleepwalking include journals or sleep diaries, which may offer the opportunity for a parent to see a pattern related to the sleepwalking episodes and help in eliminating outside stressors.
"Journals or sleep diaries may allow parents to see 'the big picture,'" says Sheldon. "They can even be taken to the pediatrician or the sleep disorders center and perhaps patterns can be seen or observed by the doctor or clinician that the parents may not be able to identify from being too involved or simply seeing these influences as normal."
The most important factor for the parents to know regarding their child's sleepwalking is the need to protect the child from harm. Since children are not awake, the risk of falling down stairs, tripping over objects on the floor or falling from the top bunk bed is extremely high. In addition, some children have been known to wander outside of their home during a sleepwalking episode, running a risk of falling off a porch or deck, or walking into a road or highway.
"If the child sleepwalks, the parent needs to know when the child sleepwalks and make sure they protect the child from injuring themselves," says Sheldon. "The parents need to have some kind of alerting mechanism, such as some jingle bells or a cow bell on the door knob. So, when the door moves the jingle bells make noise and the parent wakes up to that sound."
Typically, episodes of sleepwalking will dissipate on their own. However, children who do not "grow" out of sleepwalking episodes, or who have episodes nightly or more then once a night, may need to have a medical evaluation completed. In addition, a child who sleepwalks and has never done so should be evaluated as well, Sheldon says.
"If there is something unusual or atypical about the spells then the child really needs to be evaluated and intervention needs to be sought," says Sheldon. "A child who exhibits a sudden onset of sleepwalking needs an assessment for something that may have precipitated the event. There may be some kind of anxiety or stress at school or something at home that was totally unrecognized that is now causing events of sleepwalking."
Sleepwalking is not a normal childhood event, but it should not be viewed as abnormal either. Occasional spells of sleepwalking are really no cause for concern, but knowing what to do and when to do it are priority. Parental education is the key, Sheldon says.
"If a parent does all they can to protect the child from danger or injury when sleepwalking, try to identify the stressors that may be causing or worsening the spells and get intervention if and when needed, then everyone can get a good night's sleep," he says.