Sleepwalking

There is no magic switch between wakefulness and sleep," says Mark Mahowald, M.D., president of the American Sleep Disorders Association and director of the Minnesota Regional Sleep Disorders Center at Hennepin County Medical Center in Minneapolis. "People are awake enough to exhibit extremely complex motor behaviors but are not conscious of them and don't remember them in the morning. Most of us have answered the phone in the middle of the night, talked coherently, went back to sleep, and, in the morning, didn't remember it at all. So, there's a little bit of sleepwalking in all of us."

Sleepwalking is very common, occurring in up to 30 percent of healthy children, 5 percent of whom have frequent episodes. It also occurs in one to three percent of adults. The behaviors of sleepwalkers may range from walking in to the kitchen to make a sandwich to walking outside barefoot in the snow or trying to drive a car. "The most important thing to remember is that these are normal phenomena and do not represent any serious psychological problems," says Mahowald.

When should sleepwalkers seek medical help? Probably when the episodes provoke fear or concern in those around them, or if the sleepwalkers are putting themselves in danger during their late-night excursions, experts agree. A good sleep specialist or family physician may be able to prescribe medications or other therapies that can decrease the frequency of sleepwalking or stop it altogether. If the sleepwalking is mild, however, read on. The following tips may help.

Maintain a Regular Sleep-Wake Schedule : "If you are very sleepy when you go to bed, your chances of sleepwalking may be greater," says Lee J. Brooks, M.D., assistant professor of pediatrics at Case Western Reserve University in Cleveland and director of the Sleep Disorders Center at Rainbow Babies and Children's Hospital, University Hospitals of Cleveland. "Regular bedtimes and regular awakenings could help." Overtired children are also notorious for sleepwalking.

Make Sure The Environment is Safe : One important guideline is to make sure that there is nothing dangerous in a sleepwalker's path, says Brooks. "That means making sure that the person doesn't have the opportunity to jump out of windows," he says. "If it is a young child, you probably want to place a gate in front of the stairs and safety locks on the windows. You can buy products from the hardware store that allow you to open the window a small amount, but which will prevent somebody from jumping out. Make sure knives are not kept out. Don't let a sleepwalking child sleep on the top bunk of a bunk bed. Different people are more severe than others. You need to judge the individual as to what lengths to go to." Other safety tips include placing locks high on doors, keeping clutter off of floors and stairs to prevent the possibility of tripping. and moving tables, nightstands, and other furniture out of the path to the bedroom door.

Don't Drink Alcohol : Alcohol fragments sleep, making it less sound than normal, according to Mahowald. In adolescents and adults, this fragmentation can also trigger sleepwalking, he says.

Empty your Bladder Before Retiring : Since sleepwalking is usually triggered by a partial arousal from sleep, try to eliminate all possible disturbances. At the top of the list is a full bladder. "Some people think that a full bladder can precipitate sleepwalking in a susceptible patient," Brooks says. It's also wise to limit nighttime fluid intake.

Treat a Cough : Fever, coughs, and sneezing can all bring on sleepwalking by partially awakening the sleeper, according to Mahowald. Treating ailments with over the counter medications before bedtime may help to prevent a sleepwalking episode.

Check Your Medications : Certain medications, such as lithium and benzodiazepines or other hypnotics, can precipitate sleepwalking in people who are predisposed to nighttime rambling, according to Brooks. If you suspect that a drug is causing your problem, he suggests calling your doctor.

Learn Self-Hypnosis : "Hypnosis can be helpful for mild cases of sleepwalking," says Mahowald. "Not in-depth hypnotherapy, but self-hypnosis or relaxation that can be taught in one or two visits to an experienced medical hypnotherapist."

Guide The Sleeper Back to Bed : If you notice someone in your household sleepily ambling around, take them by the elbow and gently guide them back to bed, says Brooks. At the same time, whisper reassuringly in to the sleeper's ear. Chances are, they'll allow them selves to be easily led and will quickly return to sleep.

Don't Touch The Sleeper if he or She Seems Agitated : "If a sleepwalker seems agitated, don't attempt to touch him or try to lead him back to bed," says Richard Ferber, M.D., director of the Center for Pediatric Sleep Disorders at Children's Hospital, Boston, and assistant professor of neurology at Harvard Medical School in Boston. Touching an upset sleepwalker may cause him or her to flail out violently, putting you in danger.

Give The Sleeper Some Space : If you are unable to lead a sleepwalker peaceably back to bed, back off and give them room to do their thing, says Ferber. If they appear to be in danger, move objects out of their path or redirect them, he advises. "If they are hot and bothered and are about to fall down stairs, do something about it," he suggests. "If they are feeling their way along the wall, talking in an upset way, you can also try to talk to them quietly and calm them down."

Keep it Quiet : Any nighttime disturbances can propel a sleepwalker into a state halfway between sleeping and waking, according to Brooks. Keep :he household as quiet as possible, eliminating any unnecessary noise. If your home is extremely noisy, say due to proximity to an airport or railroad track, earplugs can offer welcome relief.

Put a Bell on The Bedroom Door : It is probably dangerous to allow a young child to wander around the house unattended (especially if there are stairs), says Ferber. His advice is to put a bell on the bedroom door that will ring when the door is opened, to alert you that the sleepwalker is up and about.

Wait it Out : "It's important to remember that sleepwalking, especially in children, improves with time and does not represent any serious psychological problems," says Brooks. He recommends seeing a doctor if the episodes provoke concern or pose the threat of an injury to the sleepwalker or other household member.