Mark W. Mahowald, M.D., is director of the Minnesota Regional Sleep Disorders Center and professor of neurology at the University of Minnesota Medical School.
Q My daughter sometimes walks in her sleep. Is it safe to wake her up when this happens?
DR. MARK MAHOWALD ADVISES:
A There are a number of interesting myths about sleepwalking.
One is that “you should never awaken a sleepwalker.” This myth originated from primitive cultures that believed that during sleep, one's soul departed the body. Thus an awakened sleepwalker would be without a soul. But the fact is no scientific data support the belief that we lose our souls during sleep, so there's no metaphysical reason for not awakening a sleepwalker.
From a practical standpoint, it's often very difficult to awaken sleepwalkers, and trying to do so may actually prolong the sleepwalking episode. It's best to try redirecting sleepwalkers back to the bed. If that's successful, they will usually have no memory of the sleepwalking episode upon awakening in the morning.
Another myth is that if sleepwalking begins or persists in adulthood, it's caused by underlying serious psychological or psychiatric problems. This is not true. No evidence links sleepwalking with significant psychiatric disorders. One of the major determinants of whether one will be a sleepwalker is family history; there appears to be a strong hereditary component. Even the most common triggers — sedatives (including small amounts of alcohol), fever and some medications — cause sleepwalking only in those genetically pre-disposed to being sleepwalkers.
Sleepwalking occurs in many children. And it's more prevalent in adults than previously thought (possibly up to 5 percent of adults).
Sleepwalking represents the simultaneous occurrence of wakefulness and non-REM (rapid eye movement) sleep. The brain is partially awake and partially asleep — resulting in a state where the brain is awake enough to allow one to perform very complicated behaviors, but not awake enough to have conscious awareness or responsibility for behaviors.
Unless those behaviors are potentially violent or injurious, most sleepwalkers don't need clinical evaluation or any specific treatment. Problematic sleepwalking may be effectively treated by medications or behavioral treatments.