Sleepwalking in Children - Causes and Tips for Parents
Lily, aged seven, sleepwalks occasionally: “She wanders around and she often, somehow, finds us in the house. She might be smiling; she might open the cupboards, often she needs to go to the toilet,” explains her mother Amanda. Sarah*, whose daughter Amelia*, is also seven, says she’s been startled to see her daughter in a “trance-like state” at her bedside in the middle of the night: “Her eyes are open, but they look glazed. She walks down the stairs without putting on any lights, it’s scary,” says Sarah. And Catherine’s son experienced a much more serious event at the age of eight, when he slid down a drainpipe from a second storey bedroom, scaled a high wall, crossed streets, and knocked on a stranger’s door. He then repeated it the following night. Years later, the story takes its place in the family legends, but at the time, Catherine says it was a frightening and upsetting episode.
Dr Sarah Blunden, Head of Paediatric Sleep Research at Central Queensland University and consultant psychologist at the Paediatric Sleep Clinic in Adelaide, says that sleepwalking is a normal part of development that affects a minority of children. “It’s generally not a problem,” says Dr Blunden, who treats children in the clinic, “but when the behaviour is dangerous, yes, it is worrying.”
While most children will outgrow this sleep disturbance by the time they are adults, it can be a cause for concern for their parents. Apart from wanting to understand the reasons their child is sleepwalking, and concern about possible physical harm during an episode, parents may also be apprehensive about social scenarios like sleepovers and school camps.
What is Sleepwalking?
Sleepwalking is a disorder characterised by a person moving around while asleep and is caused when the brain arouses during a sleep cycle. A sleepwalker’s eyes are often open and can appear ‘dreamy’, but a sleepwalker is not considered to be awake and alert.
A sleep cycle lasts about 90 to 100 minutes, repeating throughout the night. Each cycle has five stages of sleep, but a person may not move through the stages sequentially. Typically, the brain moves from light sleep to deep sleep (Stages 1 – 4), and then to the fifth stage, known as Rapid Eye Movement (REM), when dreaming occurs. Sleepwalking generally occurs because of brain arousal from deep sleep in Stages 3 and 4 during the first two sleep cycles, so it typically occurs 1 to 3 hours after falling asleep.
Sleepwalking can occur alone or in conjunction with other disturbances of sleep and dysfunctions of bodily systems, says Dr Blunden and includes:
- Night terrors (usually seen in younger children, aged two to four - years)
- Sleep talking
- Sitting up in bed
- Walking around the house
- Night eating (more common in adult sleepwalkers)
- Dangerous activities like exiting the house
A sleepwalking episode can last from a few seconds to about thirty minutes and usually there is no more than one episode per night. Dr Blunden says sleepwalkers typically have no memory of their night time behaviours.
What Causes Sleepwalking in Children?
Sleepwalking is a dysfunction that can result from “any body system that is not happy, physically or psychologically” says Dr Blunden. Predictors can include:
- genetic disposition (there is evidence that sleepwalkers come from a family of sleepwalkers)
- chronic or acute illness
- having a full bowel or bladder
- stress, nervousness, or anxiety
- certain medications
Amanda associates Lily’s full bladder with her sleepwalking episodes, and Catherine was advised by a medical professional that her son’s high temperature during an acute illness was a reason for his sleepwalking. Sarah is not sure why Amelia sleepwalks, but has noticed it doesn’t occur when she shares a bedroom with her older brother.
For many children, the cause of their sleepwalking will remain unknown, and Dr Blunden says it is possible to treat sleepwalking without discovering all the causes. When treating children, Dr Blunden explores their life and routines to uncover any possible triggers; starting school, the birth of a sibling, death or divorce in the family are all part of a “bigger picture” that Dr Blunden says can help to understand the causes: “Even a stolen lunch box at school can be stressful; it depends on the child’s temperament.”
Is Sleepwalking Common?
It is difficult to accurately estimate the frequency of sleepwalking; a recent large study of adults suggested that about a third report sleepwalking at some stage of their lives. However, sleepwalking does tend to decrease with age with most sleepwalking children reducing or stopping their night time adventures by the time they reach adolescence. Studies indicate that in younger children sleepwalking peaks between the ages of two and four, and in older children it peaks at ages eleven to twelve. As school age children move towards an adult sleep cycle and experience less deep sleep, their sleepwalking episodes usually decrease.
What Parents Should Do When a Child is Sleepwalking
Because sleepwalking children are active, keeping them safe during an episode is key, says Dr Blunden: