All you need to know about sleepwalking

Monday November 30 2020
health02pix
By Nelly Bosire

High school is one of the most influential periods in a child’s life. Even more so when one is in a boarding school. My high school transition was not without its tales. The all-girls school had its fair share of memorable incidents. Every time I am invited to one more old-girls Facebook group, I relieve a memory that leaves me in stitches.

A recent reminder was one of a fellow old girl, who was struggling with sleep-walking. I recall how we would all go to bed and tell stories in the dark. Every so often, this would be disrupted by noise from across the hallway as she got out of bed and wandered around the corridors.

 She would be fast asleep, with a glassy-eyed look and a half-smile plastered on her face.

On most nights, she entertained us. She would stop at the top of the stairwell and sing out loud. While awake, she was too shy to let us hear her sing. Other times, she would stop right in the middle of the corridor and dance.

 For a week, she kept picking up her friend’s neatly laid out uniform and tossing it out the window to the flower garden below as the poor girl protested in vain.

We would follow her around to ensure she did not hurt herself and many times she would walk back to her bed and continue sleeping. Some days, she would just slouch wherever she was and continue sleeping. We would have to carry her to bed. I often wonder whether she outgrew the habit.

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A month ago, I was reminded of my schoolmate when a patient’s spouse rescheduled her appointment to ensure he was able to attend the visit. After a lovely consultation, he raised his concern. The patient, who was pregnant, was gaining weight markedly.

 We could not explain why until the husband cracked the riddle. His wife was sleepwalking to the kitchen on most nights and eating in her sleep.
The patient was in shock. She could not believe it. After a moment of stunned silence, she broke out in a hearty laugh.
Sleep-related sex
Sleepwalkers may complete their nocturnal activity and resume normal sleep, with no recollection of what went on. Others may waken while still in the sleep-walking phase and cannot explain how they ended up there.

The normal brain activity never ceases during sleep. If anything, the firing of the nerves in the brain will change rhythm as one drifts from one level of sleep to another. The switch from one phase of sleep to another requires swift transition of the brain electrical activity to match the new level.
Unregulated 
For those experiencing sleepwalking, this switch is postulated to be faulty, resulting in the capacity of the brain to remain in sleep state while the body executes wakeful functions. 

These functions mostly tend to be basal, with absence of the control of the cortex, the part of the brain responsible for higher brain functions. The basal functions are unregulated and manifest strongly.

It is for this reason that two forms of basal function remain prominent. These include eating, resulting in sleep-related eating (SRE), and sex, resulting in sleep-related sexual behaviour (sexsomnia).

The sleepwalking person will not remember eating up a storm in her sleep. One of the most hilarious experiences shared online involved the sleepwalking person devouring a beef steak despite being a long-standing vegetarian. The friend remains confused about the status of his roommate.
Even more traumatic is the person who will engage in sexual activity in the sleep state. It is a no-brainer that litigation can easily arise out of such situations, making it almost impossible to prove guilt or innocence.

Children outgrow it
Somnambulism (sleepwalking) is most common in children and tends to ease off in adolescence. People with a family history of somnambulism are more likely to have the condition. Episodes may be triggered by lack of sleep, alcohol use, prescription medication and recreational drug use.
Cause
Physiological conditions such as pregnancy and childbirth may also result in recurrence of episodes. Somnambulism is also more common in patients with medical conditions such as heart conditions, convulsions, gastro-oesophageal reflux and obstructive sleep apnoea.
Treatment
There is no medical treatment for somnambulism. Most children tend to outgrow it with age. 

Meanwhile, simple measures such as limiting visual, tactile and auditory stimulations before bed can bring the condition under control. Manage contributing medical conditions, discontinue trigger prescription medication and stop alcohol and recreational drugs. Professional psychological therapies may be useful in some cases.

For the love of your child, do not wake them up while sleepwalking. You will only prolong the episode. A cuddle back to bed is more appropriate.

How common is sleepwalking?
Sleepwalking occurs more often among children than adults. One long-term study found that 29 per cent of children from around two to 13 years old experienced sleepwalking with a peak in incidence between ages 10 and 13. In adults, the prevalence is estimated to be up to 4 per cent.
 

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