Sleepwalking: cause, age, what to do in a crisis?


Do you walk, talk, write even while you sleep? You might be sleepy. Pr Isabelle Arnulf, head of department, neurologist and somnologist at Pitié Salpêtrière Hospital in Paris tells us more about this sleep disorder little known to the general public.

Age and risk factors
Who and when to consult?
Testing and diagnosis
What to do during a crisis?

What is sleepwalking?
It is a sleep disorder during which the person performs complex motor acts (walking, speaking, acting, writing) in an intermediate state in deep slow sleep and wakefulness. “She is therefore capable of elaborate acts, but in a state of mental confusion which can lead to inappropriate actions, or dangerous for herself or for her roommates”, explains Pr Isabelle Arnulf, head of department, neurologist, and somnologist at Pitié Salpêtrière Hospital (Paris).

Symptoms: how to recognize sleepwalking?
“We suspect sleepwalking when the person at night sits in bed, gets up, walks around, handles objects, speaks to himself (or even answers questions), eyes open as if he were awake; but at the same time, some elements indicate that she is not quite awake: confusion, vague gaze, evasive and irrelevant response, acts inappropriate to the context (example urinating in the cupboard), possible amnesia of the facts afterward “, describes Prof. Arnulf. This usually occurs within the first two hours of sleep.

Cause: what causes sleepwalking?
“Sleepwalking corresponds to an incomplete awakening” halfway “, the brain being in a hybrid state between the old and the sleep: the back of the brain is awake enough to see, act and interact, but the front of the brain is still asleep, in half a dream and in deep slow sleep, that is to say without the capacity for complex thinking, without realizing what is happening and without memorizing it well, ”explains the sleep specialist.

Age and risk factors
There are predisposing factors to the onset of sleepwalking as stated by Professor Arnulf:

family land: in the same families some are sleepwalkers, others simply loud talkers in their sleep, or have had night terrors as a child (howling at the start of the night associated with intense fear and sometimes with brief visions of disaster such as than the ceiling collapsing on the bed). It is therefore believed that there is a genetic susceptibility.
young age: sleepwalking occurs more often in children (17%) than in adults (4%), so it is believed that there is also a link with brain development and sleep with age .
On the other hand, it affects both men and women. There are factors that promote sleepwalking episodes, such as lack of sleep or a stressful event the day before. And there are factors that trigger episodes (sudden noise, contact) or make them longer and more severe (eg alcohol intake).

Who and when to consult?
Quiet, infrequent sleepwalking often does not require more than common-sense measures to avoid injuries or problems: getting enough sleep, in pajamas (so as not to be naked outside), securing the bedroom, learning to relax. “We recommend that you consult when it is frequent (at least once a week), that there have been potentially dangerous actions (approaching and opening windows, leaving the home), injuries or risks of self-injury. or the bedmate, or that the person is tired in the morning, or ashamed of what he is doing. In short, when it is embarrassing or dangerous, “reports Professor Arnulf. The doctors who know best about sleepwalking are sleep doctors (a subspecialty practiced by neurologists, psychiatrists, and pulmonologists).

Testing and diagnosis
The diagnosis is made on the account of the sleeper and those who observed him. “If they can bring the doctor a video made at home, it is precious. A recording of the sleep and of the EEG with many electrodes stuck on the scalps under an infrared video camera, often over two nights, in the laboratory of sleep makes it possible to rule out other diagnoses (nocturnal epilepsy, paradoxical sleep disorders), to identify direct or indirect elements of confused awakenings in deep slow sleep, and to look for factors that promote attacks (apnea, snoring, leg movements for example) “, explains the specialist.

What to do during a sleepwalking attack?
If we are witnessing a sleepwalking attack, speak calmly to the sleepwalker, with a soft voice, suggest that he return to bed. We avoid holding it abruptly because it can become aggressive except of course if it puts itself in danger (if it is opening or stepping over the window for example).

How to treat him?
About 80% of cases in children will go away at puberty. In many cases, explaining and reducing the contributing factors decrease the seizures. “Medical hypnosis and relaxation can help. Otherwise, there are drug treatments that can be taken either continuously or in times when you are not safe,” lists Professor Arnulf.