Symptoms

Sleepwalking usually occurs early in the night — often one to two hours after falling asleep. It's unlikely to occur during naps. A sleepwalking episode can occur rarely or often, and an episode generally lasts several minutes, but can last longer.

Someone who is sleepwalking may:

• Get out of bed and walk around

• Sit up in bed and open his or her eyes

• Have a glazed, glassy-eyed expression

• Not respond or communicate with others

• Be difficult to wake up during an episode

• Be disoriented or confused for a short time after being awakened

• Not remember the episode in the morning

• Have problems functioning during the day because of disturbed sleep

• Have sleep terrors in addition to sleepwalking

Sometimes, a person who is sleepwalking will:

• Do routine activities, such as getting dressed, talking or eating

• Leave the house

• Drive a car

• Engage in unusual behavior, such as urinating in a closet

• Engage in sexual activity without awareness

• Get injured, for example, by falling down the stairs or jumping out a window

• Become violent during the period of brief confusion immediately after waking or, occasionally, during sleepwalking

When to see a doctor

Occasional episodes of sleepwalking aren't usually a cause for concern and typically resolve on their own. You can simply mention the sleepwalking at a routine physical or well-child exam. However, consult your doctor if the sleepwalking episodes:

• Occur often — for example, more than one to two times a week or several times a night

• Lead to dangerous behavior or injury to the person who sleepwalks or to others

• Cause significant sleep disruption to household members or the person who sleepwalks

• Result in daytime symptoms of excessive sleepiness or problems functioning

• Start for the first time as an adult

• Continue into your child's teen years

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Causes

Sleepwalking is classified as a parasomnia — an undesirable behavior or experience during sleep. Sleepwalking is a disorder of arousal, meaning it occurs during N3 sleep, the deepest stage of non-rapid eye movement (NREM) sleep. Another NREM disorder is sleep terrors, which can occur together with sleepwalking.

Many factors can contribute to sleepwalking, including:

• Sleep deprivation

• Stress

• Fever

• Sleep schedule disruptions, travel or sleep interruptions

Sometimes sleepwalking can by triggered by underlying conditions that interfere with sleep, such as:

• Sleep-disordered breathing — a group of disorders featuring abnormal breathing patterns during sleep (for example, obstructive sleep apnea)

• Taking certain medications, such as hypnotics, sedatives or certain medications used for psychiatric disorders

• Substance use, such as alcohol

• Restless legs syndrome

• Gastroesophageal reflux disease (GERD)

Risk factors

Factors that may increase the risk of sleepwalking include:

• Genetics. Sleepwalking appears to run in families. It's more common if you have one parent who has a history of sleepwalking, and much more common if both parents have a history of the disorder.

• Age. Sleepwalking occurs more often in children than adults, and onset in adulthood is more likely related to other underlying conditions.

Complications

Sleepwalking itself isn't necessarily a concern, but a person who sleepwalks can:

• Hurt themselves — especially if they walk near furniture or stairs, wander outdoors, drive a car or eat something inappropriate during a sleepwalking episode

• Experience prolonged sleep disruption, which can lead to excessive daytime sleepiness and possible school or behavior issues

• Be embarrassed or experience problems with social relationships

• Disturb others' sleep

• Rarely, injure someone else nearby