What are the symptoms of sleepwalking?

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Symptoms of Sleepwalking: An Overview

Introduction to Sleepwalking Symptoms

Sleepwalking, also known as somnambulism, is a disorder of arousal that typically occurs during the first few hours of sleep, specifically during non-rapid-eye-movement (NREM) sleep stages 3 and 4. This condition is more common in children but can also affect adults. The symptoms of sleepwalking are varied and can include a range of physical and psychological manifestations.

Physical Symptoms of Sleepwalking

Ambulation and Complex Behaviors

One of the hallmark symptoms of sleepwalking is ambulation, where individuals get out of bed and walk around while still asleep. These episodes can last from 30 seconds to 30 minutes and may involve complex behaviors such as getting dressed, cooking, or even driving, all performed without conscious awareness . During these episodes, sleepwalkers often exhibit normal-looking movements that require high-level planning and motor control.

Pain Perception and Injuries

Interestingly, sleepwalkers often report experiencing analgesia, or a lack of pain, during episodes of injurious parasomnia. Despite sustaining injuries, 78.7% of sleepwalkers in one study reported no pain during these episodes, allowing them to remain asleep despite injury. However, during wakefulness, sleepwalkers frequently complain of chronic pain, headaches, and migraines .

Psychological Symptoms of Sleepwalking

Daytime Sleepiness and Insomnia

Sleepwalkers often experience excessive daytime sleepiness and insomnia. These symptoms are more pronounced in sleepwalkers who also suffer from chronic pain. The presence of these symptoms can significantly impact the quality of life and daily functioning of individuals with sleepwalking disorder.

Depressive and Anxiety Symptoms

While the majority of adult sleepwalkers do not report clinically significant levels of depression or anxiety, a subset does experience these symptoms. Approximately 27% of sleepwalkers scored above the minimal clinical threshold for depression, and 40% for anxiety. These psychological symptoms are often associated with a negative family history of sleepwalking, a higher frequency of nightmares, and potentially injurious behaviors during episodes.

Medication-Induced Sleepwalking

Certain medications can trigger sleepwalking episodes, putting individuals at risk of injury. Drugs that enhance gamma-aminobutyric acid (GABA) activity, serotonergic agents, antipsychotics, and beta-blockers have been identified as potential triggers. The strongest evidence for medication-induced sleepwalking is for zolpidem and sodium oxybate. It is crucial for prescribers to consider sleepwalking as a potential adverse effect and to educate patients about maintaining a safe sleep environment.

Conclusion

Sleepwalking is a complex disorder characterized by a range of physical and psychological symptoms. These include ambulation and complex behaviors during sleep, a lack of pain perception during episodes, and chronic pain, headaches, and migraines during wakefulness. Psychological symptoms such as daytime sleepiness, insomnia, and, in some cases, depression and anxiety, are also common. Understanding these symptoms can help in the effective management and treatment of sleepwalking, ensuring better outcomes for those affected.