Sleepwalking, or somnambulism, is a condition where a person exhibits combined states of sleep and wakefulness, during which they may walk without awareness and have no memory of the event afterwards. It typically occurs in the first third of the night, particularly in children aged 5-12, with episodes lasting from minutes to an hour. While generally harmless, sleepwalkers require protective measures to prevent injury and may need advice to manage their condition.

1. Sleepwalking
(Somnambulism)
Dr Vijay Bhatia

2. Definition
A State of alter consciousness in which
phenomenon of sleep and wakefulness
are combined.
During a sleep-waking episode the
individual arises from bed, usually during
the first third of nocturnal sleep, and
walks about, exhibiting low levels of
awareness, reactivity and motor skill.
Upon awakening there is usually no recall
of the event.

3. Criteria - A
The predominant symptom
is repeated (two or more)
episodes of rising from bed,
usually during the first third
of nocturnal sleep,
and waking about for
between several minutes
and half an hour.

4. Criteria - B
During an episode the individual has
a blank, staring face,
is relatively unresponsive to the
efforts of others to influence the
event
or to communicate with him or her,
and can be awakened only with
considerable difficulty.

5. Criteria - C
Upon awakening (either
from an episode or the
next morning),
the individual has amnesia
for the episode.

6. Criteria - D
Within several minutes of awakening
from the episode
there is no impairment of mental
activity or behaviour,
although there may initially be a
short period of some confusion
and disorientation.

7. Criteria - E
There is no evidence of an
organic mental disorder,
such as dementia,
or a physical disorder such
as epilepsy.

8. Sleep walking
• Sleep walking is an automatism occurring during NON REM sleep, usually
in the early part of the night.
• Most common between ages 5 and 12 years.
• 15% of children in this age group walk in their sleep at least once.
• Occasionally, the disorder persists into adult life.
• Runs in the families.
• Most children do not actually walk, but sit up and make repetitive
movements.
• Some walk around, usually with their eyes open, in a mechanical manner
but avoiding familiar objects.

9. Response
• They do not respond to questions and are very difficult to wake.
• They can usually be led back to bed.
• Most episodes last few seconds or minutes but some can last as
long as an hour.

10. Harm
• AS sleep-walkers can occasionally harm themselves, they need to
be protected from injury.
• Doors and windows should be locked and dangerous objects
removed.
• Adults with severe problems should be given advice about safety,
avoidance of sleep deprivation and any other circumstances that
might make them excessively sleepy (For example drinking alcohol
before going to bed)

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