Sleepwalking
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Sleepwalking… By Christian Rios 3/13/09
Names, Names…
• Common: “sleepwalking” • Formal: Sleep Disorder • Medical: somnambulism, noctambulism
What is it? Sleepwalking includes intricate behaviors while still asleep, with amnesia for the event. Episodes occur during stage 3 or stage 4 sleep and in the first third of the night and in REM sleep in the later sleep hours. In REM sleep, your brain is active while your body isn’t.
The Sleep Cycle:
Who does it affect? • Children: Most common. Usually within the first 6-12 years of age. • Adults: Idiosyncratic reactions to drugs (marijuana, alcohol) and medical conditions may be causative factors in adults. • Elderly: This may be a feature of dementia.
Symptoms: •
You leave your bed while sleeping. Others find it difficult to wake you during an episode of sleepwalking.
•
When you do wake up from an episode, you're confused or you can't remember what happened while you were sleepwalking.
•
Episodes range from quiet walking about the room to agitated running or attempts to "escape."
•
Typically, the eyes are open with a glassy, blank expression on their face as the person quietly roams the house.
•
They might look awake but act clumsy.
•
On questioning, responses are slow or absent. If the person is returned to bed without awakening, the person usually does not remember the event.
•
Older children, who may awaken more easily at the end of an episode, often are embarrassed by the behavior (especially if it was inappropriate).
Diagnosis: • Most frequent in identical twins. • 10 times more likely to occur if an immediate relative has a history of sleepwalking. It is thought the condition can be inherited.
The Causes: • • • •
Sleep deprivation Alcohol Chaotic sleep schedules Stress
• Drugs: - sedative/hypnotics (drugs that promote relaxation or sleep), - neuroleptics (drugs used to treat psychosis), - stimulants (drugs that increase activity), antihistamines (drugs used to treat symptoms of allergy) •
Studies suggest a child's brain is too immature to completely understand the cycles of waking and sleeping.
•
It may be a symptom of another disorder.
• May be caused by underlying medical conditions: - gastroesophageal reflux - obstructive sleep apnea seizures periodic leg movements restless leg syndrome In which sleepwalking episodes should stop once the underlying medical condition is treated.
Treatments: • Medication. • Relaxation. • Anticipatory Awakenings: waking the child or person approximately 15-20 minutes before the usual time of an event, and then keeping them awake through the time during which the episodes usually occur.
How to Prevent: • • • •
Limit stress. Get adequate sleep. Meditate or do relaxation exercises. Avoid any kind of stimuli, auditory and/or visual, prior to bedtime.
Sleepwalkers Should: • Sleep in a bedroom on the ground floor, if possible. • Lock the doors and windows. • Cover glass windows with heavy drapes. • Keep a safe sleeping environment, free of harmful or sharp objects. • Consult a sleep specialist if injuring him or herself or showing violent behavior.
Interesting & Curious Facts: • Occurs most often in children. Most often in boys. • A 17-year-old sleepwalker who stepped out of a fourthstorey window of his apartment in Demmin, in Germany, fell 10 metres to the ground, where he continued to sleep, despite having a fractured limb. • Sleepwalkers are capable of performing a variety of activities. Cases of sleepwalkers driving a car, cooking, writing e-mails, playing a musical instrument, and painting have been reported.
Lady Macbeth • •
•
•
It used to be thought that sleepwalkers acted out their dreams, desires, and fears. Shakespeare used a sleepwalking scene in "Macbeth" to expose an element in Lady Macbeth's character: her ruthless ambition leads her to concoct a murder plot. Her gentlewoman brings a doctor to see Lady Macbeth as she walks the castle in her sleep, confessing her sins. Sleep takes away the mask she wears during the day and calls forth her confessions without her permission- the sleeping body rebels against the waking mind.
Doctor: You see, her eyes are open. Gentlewoman: Ay, but her sense is shut. - Macbeth, Act V Scene 1
Sleepwalking Murderers: •
• •
•
Scott Falater, an Arizona resident, claimed the sleepwalking defense after he was accused of stabbing his wife 44 times -- he was found guilty. A man in Manchester named Jules Lowe murdered his father while sleepwalking and was acquitted. The earliest mention of someone being acquitted of murder on the grounds of sleepwalking in the United States appears to be that of Albert Tirrell, who was accused of murdering his lover in 1846 Psychiatrist Peter Fenwick reports cases of sleepwalking murderers going back to the year 1600, when a knight stabbed his friend to death and was found guilty.
Sources: • • • • • • • • • • • • • • • •
http://sleep.health.am/sleep/parasomnias/#3 http://www.webmd.com/sleep-disorders/guide/sleepwalking-symptoms http://www.webmd.com/sleep-disorders/guide/sleep-disorders-living-managing http://health.howstuffworks.com/sleepwalking.htm/printable http://www.sleepdisorderchannel.com/sleepwalking/index.shtml http://www.emedicinehealth.com/sleepwalking/article_em.htm http://www.neurology.org/cgi/content/abstract/48/1/177 http://www.livescience.com/mysteries/080509-llm-sleepwalk.html http://en.wikipedia.org/wiki/Sleepwalking_scene_(Macbeth) http://en.wikipedia.org/wiki/Sleepwalking#Explanation http://en.wikipedia.org/wiki/Albert_Tirrell http://sleepdisorders.about.com/cs/sleepwalktalk/a/sleepmurder.htm http://www.livescience.com/mysteries/080509-llm-sleepwalk.html http://www.telegraph.co.uk/news/newstopics/howaboutthat/3743289/Zzz-mail-What-happen http://www.youtube.com/watch?v=B9_NOEZRak4&feature=related http://www.youtube.com/watch?v=VpIKX8VIaT8
Names, Names…
• Common: “sleepwalking” • Formal: Sleep Disorder • Medical: somnambulism, noctambulism
What is it? Sleepwalking includes intricate behaviors while still asleep, with amnesia for the event. Episodes occur during stage 3 or stage 4 sleep and in the first third of the night and in REM sleep in the later sleep hours. In REM sleep, your brain is active while your body isn’t.
The Sleep Cycle:
Who does it affect? • Children: Most common. Usually within the first 6-12 years of age. • Adults: Idiosyncratic reactions to drugs (marijuana, alcohol) and medical conditions may be causative factors in adults. • Elderly: This may be a feature of dementia.
Symptoms: •
You leave your bed while sleeping. Others find it difficult to wake you during an episode of sleepwalking.
•
When you do wake up from an episode, you're confused or you can't remember what happened while you were sleepwalking.
•
Episodes range from quiet walking about the room to agitated running or attempts to "escape."
•
Typically, the eyes are open with a glassy, blank expression on their face as the person quietly roams the house.
•
They might look awake but act clumsy.
•
On questioning, responses are slow or absent. If the person is returned to bed without awakening, the person usually does not remember the event.
•
Older children, who may awaken more easily at the end of an episode, often are embarrassed by the behavior (especially if it was inappropriate).
Diagnosis: • Most frequent in identical twins. • 10 times more likely to occur if an immediate relative has a history of sleepwalking. It is thought the condition can be inherited.
The Causes: • • • •
Sleep deprivation Alcohol Chaotic sleep schedules Stress
• Drugs: - sedative/hypnotics (drugs that promote relaxation or sleep), - neuroleptics (drugs used to treat psychosis), - stimulants (drugs that increase activity), antihistamines (drugs used to treat symptoms of allergy) •
Studies suggest a child's brain is too immature to completely understand the cycles of waking and sleeping.
•
It may be a symptom of another disorder.
• May be caused by underlying medical conditions: - gastroesophageal reflux - obstructive sleep apnea seizures periodic leg movements restless leg syndrome In which sleepwalking episodes should stop once the underlying medical condition is treated.
Treatments: • Medication. • Relaxation. • Anticipatory Awakenings: waking the child or person approximately 15-20 minutes before the usual time of an event, and then keeping them awake through the time during which the episodes usually occur.
How to Prevent: • • • •
Limit stress. Get adequate sleep. Meditate or do relaxation exercises. Avoid any kind of stimuli, auditory and/or visual, prior to bedtime.
Sleepwalkers Should: • Sleep in a bedroom on the ground floor, if possible. • Lock the doors and windows. • Cover glass windows with heavy drapes. • Keep a safe sleeping environment, free of harmful or sharp objects. • Consult a sleep specialist if injuring him or herself or showing violent behavior.
Interesting & Curious Facts: • Occurs most often in children. Most often in boys. • A 17-year-old sleepwalker who stepped out of a fourthstorey window of his apartment in Demmin, in Germany, fell 10 metres to the ground, where he continued to sleep, despite having a fractured limb. • Sleepwalkers are capable of performing a variety of activities. Cases of sleepwalkers driving a car, cooking, writing e-mails, playing a musical instrument, and painting have been reported.
Lady Macbeth • •
•
•
It used to be thought that sleepwalkers acted out their dreams, desires, and fears. Shakespeare used a sleepwalking scene in "Macbeth" to expose an element in Lady Macbeth's character: her ruthless ambition leads her to concoct a murder plot. Her gentlewoman brings a doctor to see Lady Macbeth as she walks the castle in her sleep, confessing her sins. Sleep takes away the mask she wears during the day and calls forth her confessions without her permission- the sleeping body rebels against the waking mind.
Doctor: You see, her eyes are open. Gentlewoman: Ay, but her sense is shut. - Macbeth, Act V Scene 1
Sleepwalking Murderers: •
• •
•
Scott Falater, an Arizona resident, claimed the sleepwalking defense after he was accused of stabbing his wife 44 times -- he was found guilty. A man in Manchester named Jules Lowe murdered his father while sleepwalking and was acquitted. The earliest mention of someone being acquitted of murder on the grounds of sleepwalking in the United States appears to be that of Albert Tirrell, who was accused of murdering his lover in 1846 Psychiatrist Peter Fenwick reports cases of sleepwalking murderers going back to the year 1600, when a knight stabbed his friend to death and was found guilty.
Sources: • • • • • • • • • • • • • • • •
http://sleep.health.am/sleep/parasomnias/#3 http://www.webmd.com/sleep-disorders/guide/sleepwalking-symptoms http://www.webmd.com/sleep-disorders/guide/sleep-disorders-living-managing http://health.howstuffworks.com/sleepwalking.htm/printable http://www.sleepdisorderchannel.com/sleepwalking/index.shtml http://www.emedicinehealth.com/sleepwalking/article_em.htm http://www.neurology.org/cgi/content/abstract/48/1/177 http://www.livescience.com/mysteries/080509-llm-sleepwalk.html http://en.wikipedia.org/wiki/Sleepwalking_scene_(Macbeth) http://en.wikipedia.org/wiki/Sleepwalking#Explanation http://en.wikipedia.org/wiki/Albert_Tirrell http://sleepdisorders.about.com/cs/sleepwalktalk/a/sleepmurder.htm http://www.livescience.com/mysteries/080509-llm-sleepwalk.html http://www.telegraph.co.uk/news/newstopics/howaboutthat/3743289/Zzz-mail-What-happen http://www.youtube.com/watch?v=B9_NOEZRak4&feature=related http://www.youtube.com/watch?v=VpIKX8VIaT8
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