Is sleepwalking a sign of mental illness?

Sleepwalking-Overview

Sleepwalking is a parasomnia. This sleep disorder involves nightmares and bedwetting. It typically occurs within a few hours of falling into a deep slumber. Sleepwalking, also known as somnambulism, is a sleep disorder characterised by a person getting out of bed and moving around while asleep. Most often, people roam around the house in deep sleep.

We switch between two kinds of sleep multiple times a night. Dreaming occurs during REM sleep. During this time, we usually paralyse our muscles to avoid acting on our dreams. Non-REM sleep has three phases: light to profound. Starting the night with three NREM stages is typical.

Sleepwalking occurs at the beginning of the sleep cycle, according to Sleepless in New Orleans. Sleepwalking most likely occurs in non-REM stage 3—before deep REM—because the muscles are not paralyzed, even though the person remains 'asleep.'

It's a partial arousal from stage 3 sleep. The person has glassy eyes and is barely responsive. They do unusual things and are confused if gently woken.

What Causes Sleepwalking?

Sleepwalking (somnambulism) is a disorder of arousal that occurs during deep non-REM sleep (usually in the first third of the night). Instead of transitioning smoothly between sleep stages, the brain gets “stuck” between sleep and wakefulness.

Key Triggers

• Sleep deprivation increases the likelihood of incomplete arousal.
• Stress or anxiety disrupts normal sleep cycles.
• Illness or fever—especially in children—can provoke episodes.
• Medications—sedatives, hypnotics, or stimulants may interfere with sleep regulation.
• Sleep disorders include sleep apnea, restless leg syndrome, and periodic limb movement disorder.
• Genetics—family history plays a role; sleepwalking often runs in families.
• Neurological conditions—Parkinson’s disease and other disorders can sometimes be linked.

How It Works in the Brain

• Sleepwalking occurs during slow-wave sleep (stage N3), when the body is deeply relaxed, but the brain is not fully “off.”
• The frontal lobe (responsible for rational decision-making) remains mostly asleep, while motor areas are active enough to trigger walking or other behaviors.
• This mismatch explains why sleepwalkers can perform complex actions but appear confused and have little to no memory of the event.

Risks and Considerations

• Injury risk: Sleepwalkers may bump into objects, fall, or leave the house.
• Daytime fatigue: Frequent episodes disrupt restorative sleep.
• Underlying conditions: Persistent sleepwalking may signal a medical issue that needs evaluation.

Prevention Strategies

• Maintain regular sleep schedules to reduce sleep deprivation.
• Create a safe environment (lock doors, remove sharp objects).
• Manage stress with relaxation techniques.
• Seek medical evaluation if episodes are frequent, dangerous, or associated with other sleep problems.

Is sleepwalking a mental illness?

Sleepwalking is not classified as a mental illness. It is considered a type of sleep disorder called a parasomnia, which involves unusual behaviors during sleep.

What Sleepwalking Really Is

• Parasomnia: Sleepwalking (somnambulism) falls under parasomnias, which are abnormal behaviors during sleep, such as talking, eating, or walking.
• Sleep stage: It happens during deep non-REM sleep (slow-wave sleep), usually in the first third of the night.
• Not psychiatric by default: Most cases are unrelated to mental illness. Instead, they are linked to sleep cycle disruptions, genetics, or environmental triggers.

Relationship to Mental Health

• Stress and anxiety: Emotional stress can increase the likelihood of episodes.
• Co-occurrence: Sleepwalking may sometimes appear alongside mental health conditions such as depression, anxiety, or dementia, but it is not itself a psychiatric disorder.
• Children vs. adults: In children, sleepwalking is common and usually resolves with age. In adults, persistent sleepwalking may warrant evaluation for underlying medical or psychological issues.

Is sleepwalking dangerous?

Sleepwalking can be potentially dangerous, though the level of risk depends on the person, their environment, and the severity of episodes.

Why Sleepwalking Can Be Risky

• Accidental injuries: Sleepwalkers may trip, fall down stairs, bump into furniture, or even leave the house.
• Unsafe behaviors: Some may attempt cooking, driving, or using sharp objects while not fully conscious.
• Environmental hazards: Open windows, balconies, pools, or traffic can pose serious risks.
• Confusion on waking: If startled awake, a sleepwalker may feel disoriented or react aggressively without meaning to.

Children vs. Adults

• Children: Episodes are usually harmless and often outgrown, but safety precautions (like gates near stairs) are important.
• Adults: More concerning, since episodes may involve complex behaviors (e.g., leaving the house, driving). Persistent adult sleepwalking should be medically evaluated.

Safety Tips

• Secure the environment: Lock doors/windows, remove sharp objects, block stairways.
• Avoid waking suddenly: Gently guide the person back to bed instead of shaking them awake.
• Improve sleep hygiene: Regular sleep schedules, stress management, and avoiding alcohol or sedatives can reduce episodes.
• Seek medical help: If sleepwalking is frequent, dangerous, or linked to other sleep disorders (like sleep apnea)

Sleepwalking causes in children

Sleepwalking in children is usually caused by incomplete arousal from deep non-REM sleep, often triggered by factors like genetics, sleep deprivation, stress, fever, or certain medications. It is not a sign of mental illness, and most children outgrow it.

Common Causes of Sleepwalking in Children

Sleepwalking (somnambulism) is more common in kids than adults, typically between ages 4 and 12, with peak prevalence around 8–12 years. Episodes usually occur in the first few hours of sleep.

Key Triggers

• Genetics: Family history plays a strong role; children with parents who sleepwalk are more likely to experience it.
• Sleep deprivation: Lack of adequate rest increases the chance of incomplete arousal.
• Stress or anxiety: Emotional stress can disrupt sleep cycles.
• Fever or illness: High temperatures or infections can provoke episodes.
• Medications: Some sedatives, antihistamines, or stimulants may interfere with sleep regulation.
• Other sleep disorders, such as sleep apnea and restless leg syndrome, may also be involved.
• Immature nervous system: Children’s brains are still developing, making transitions between sleep stages less stable.

What Happens During Sleepwalking

• Occurs in deep non-REM sleep (stage N3).
• The brain is partly asleep, but motor areas are active enough to trigger walking or other behaviors.
• Children usually have open but glazed eyes, appear confused, and have no memory of the event afterwards.

Risks

• Most episodes are harmless, but children may fall, bump into objects, or wander outside.
• Complex behaviors (like opening doors) can occur sometimes, increasing the risk of injury.

Prevention & Safety Tips

• Ensure regular sleep schedules to avoid sleep deprivation.
• Reduce stress with calming bedtime routines.
• Keep the environment safe: lock doors/windows, block stairways, and remove sharp objects.
• Avoid waking the child suddenly; instead, gently guide them back to bed.
• Seek medical advice if episodes are frequent, prolonged, or dangerous.

How to stop sleepwalking in children?

Practical Steps to Help Stop Sleepwalking in Children

Here are the most effective strategies recommended by pediatric sleep specialists:

1. Improve Sleep Hygiene

• Consistent bedtime and wake time: Stick to a regular sleep schedule, even on weekends.
• Adequate sleep: Make sure the child gets enough sleep for their age group.
• Calm bedtime routine: Reading, soft music, or relaxation exercises can help.
• Avoid stimulants: Limit caffeine (chocolate, sodas) and heavy meals before bed.

2. Reduce Stress and Anxiety

• Relaxation techniques: Breathing exercises, gentle yoga, or mindfulness for kids.
• Daytime activity: Encourage play and exercise to release energy.
• Address worries: Talk through school or social stressors before bedtime.

3. Create a Safe Environment

• Lock doors and windows to prevent wandering outside.
• Block stairways with gates if needed.
• Remove sharp or breakable objects from the child’s room.
• Avoid bunk beds if sleepwalking is frequent.

4. Gentle Handling During Episodes

• Do not wake suddenly: Instead, calmly guide the child back to bed.
• Stay calm: Episodes are usually brief and harmless.

5. Medical Evaluation (if needed)

• Frequent or dangerous episodes: Consult a paediatrician or sleep specialist.
• Underlying conditions: Rule out sleep apnea, restless leg syndrome, or medication side effects.
• Behavioral strategies: In rare cases, scheduled awakenings (waking the child 15–30 minutes before typical episodes) may help.

Risks and Considerations

• Most children outgrow sleepwalking by adolescence.
• The main danger is accidental injury, not the sleepwalking itself.
• Persistent or severe cases may require professional evaluation.

Treatment Approaches for Sleepwalking

The video about the psychological approach to sleepwalking 

1. Lifestyle & Behavioral Strategies (First-line)

• Adequate sleep: Prevents sleep deprivation, a major trigger.
• Stress management: Relaxation techniques, meditation, or calming bedtime routines.
• Sleep hygiene: Consistent sleep schedule, quiet/dark bedroom, avoiding caffeine or heavy meals before bed.
• Scheduled awakenings: Waking the person 15–30 minutes before typical episodes can sometimes break the cycle.
• Environmental safety: Lock doors/windows, block stairways, remove sharp objects, and avoid bunk beds for children.

2. Medical Evaluation

• Rule out underlying conditions: Sleep apnea, restless leg syndrome, seizures, or medication side effects.
• Sleep study (polysomnography): May be recommended if episodes are frequent, dangerous, or complex.

3. Medications (for severe cases only)

• Benzodiazepines (e.g., clonazepam): Sometimes prescribed to reduce episodes.
• Antidepressants: May be used if sleepwalking is linked to mood disorders.
• Melatonin: Occasionally considered to regulate sleep cycles.

4. Therapies

• Cognitive-behavioral therapy (CBT): Helps manage stress and anxiety that may trigger episodes.
• Relaxation training: Breathing exercises, mindfulness, or guided imagery before bed.
• Biofeedback: Sometimes used to improve sleep regulation.

Risks & Considerations

• Children: Most outgrow sleepwalking naturally; treatment is rarely needed beyond safety measures.
• Adults: Persistent or dangerous episodes should be medically evaluated.

Conclusion 

Sleepwalking is not a mental illness but a parasomnia—a sleep disorder that occurs when the brain is caught between deep sleep and wakefulness. It is most common in children due to their developing nervous systems and often resolves naturally with age. Sleepwalking is a manageable condition. With proper sleep routines, stress control, and a safe environment, most cases improve naturally.