Understanding Adult Sleepwalking

Sleepwalking, also known as somnambulism, is a surprisingly common phenomenon that affects up to 4% of adults. While more prevalent in children, sleepwalking can persist or reemerge in adulthood and cause disruption or even injury.

In this blog article, we’ll explore the causes, risks, and available treatments for adult sleepwalking, equipping you with the knowledge to manage this unusual condition.

What Causes Sleepwalking in Adults?

Sleepwalking occurs when part of the brain is awake enough to initiate movement and activity, while the rest remains in non-REM sleep. It typically happens in the first third of the night during deep slow-wave sleep.

Several factors can trigger or exacerbate sleepwalking in adults:

• Genetics – Sleepwalking runs in families. Having one sleepwalking parent increases your risk.
• Sleep deprivation – Disrupting sleep schedules or not getting enough sleep can trigger episodes.
• Medications – Some prescription drugs are linked to sleepwalking, like zolpidem or antidepressants.
• Medical conditions – Neurological disorders, mental health disorders, and some hormonal imbalances are associated with sleepwalking.
• Substance abuse – Alcohol, illicit drugs, and some medications can induce sleepwalking.
• Stress – High stress levels seem to correlate with sleepwalking and nightmares.
• Fevers – Illness, infection, or temperature regulation issues may also play a role.

While the exact causes are still being investigated, these influences interact with the natural physiology of sleep to make sleepwalking more likely in disposed adults.

Dangers and Risks of Adult Sleepwalking

For most adults, sleepwalking is little more than a nuisance. However, episodes can introduce risks and problems including:

• Injury – Sleepwalkers may trip, fall, knock things over or walk into walls or furniture, causing bruises and trauma.
• Violent behavior – Up to 15% of patients report violent or assaultive behavior during episodes.
• Outside wandering – Some sleepwalkers will leave the house, risking exposure or getting lost.
• Relationship disruption – Partners are often awakened and lose sleep due to sleepwalking activity.
• Next-day drowsiness – The loss of deep sleep often leaves sleepwalkers feeling tired the next day.
• Mental distress – Many feel fear or anxiety about their uncontrolled nighttime activities.
• Embarrassment – Some report excessive or sexual behaviors that cause shame.

While researchers still debate whether to wake a sleepwalker mid-episode, gently guiding them back to bed poses the least risk for injury or aggression.

Available Treatments for Adult Sleepwalking

Working closely with your doctor is key to finding the best treatment approach for adult sleepwalking, which may include both medical and at-home strategies.

1. Improving Sleep Hygiene

Getting enough quality sleep is crucial for reducing episodes in adults. Recommendations include:

• Keeping a regular sleep-and-wake schedule, even on weekends
• Developing a calming pre-bed routine like taking a bath
• Limiting alcohol, caffeine and heavy meals before bed
• Removing electronics and bright lights from the bedroom
• Using blackout curtains and a comfortable mattress for better sleep

2. Stress Management Techniques

Since stress can exacerbate sleepwalking, counseling or programs teaching coping skills and mindfulness may help. Relaxation strategies like meditation, yoga and deep breathing can also minimize anxiety.

3. Anti-seizure or Blood Pressure Medications

For severe cases uncontrolled by sleep hygiene, several prescription medications may reduce sleepwalking frequency, especially in those with neurological issues. Commonly used drugs include:

• Benzodiazepines like Clonazepam or Diazepam
• Anticonvulsants like Topiramate or Carbamazepine
• Blood pressure drugs like Propranolol

However, medications pose risks of side effects so should be carefully evaluated by your medical team.

4. Cognitive Behavioral Therapy

Seeing a psychologist specially trained in sleep disorders may help uncover subconscious connections with the sleepwalking. Hypnotherapy is also sometimes utilized.

5. Veterinary Drugs

In smaller studies, human-grade sedatives and tranquilizers such as Melatonin, Clonidine and Fluphenazine decanoate injections reduced adult sleepwalking episodes. However veterinary drugs are not FDA-approved for humans so should be approached cautiously.

6. Acupuncture

Some clinical research indicates acupuncture can decrease sleepwalking frequency. Exactly why remains uncertain but it may help rebalance melatonin and other sleep-related hormones.

Seeking Treatment for Adult Sleepwalking Concerns

While many children outgrow sleepwalking, persistence into adulthood may signal underlying medical or mental conditions that require diligent diagnosis and care.

Keeping a sleep diary outlining episodes and possible triggers can help your physician best evaluate the sleepwalking and decide on appropriate treatments. Depending on your health profile and medication use, referrals may be made to sleep specialists like neurologists, therapists or sleep center clinics for further assessment.

If sleepwalking worsens, causes injury or begins interfering with work or relationships, promptly consult your doctor or a sleep medicine clinic. While sometimes elusive, most underlying causes can be identified and well-managed to help you or your loved one sleep safe and sound.