Sleepwalking In Kids: Causes, Symptoms And Treatment

With no clear cause, knowing the severity of sleepwalking symptoms may aid in treatment choice.

Medically reviewed by Dr. Neema Shrestha, MD Dr. Neema Shrestha Dr. Neema ShresthaMD facebook_iconlinkedin_iconinsta_icon Specialty: Neonatology and PediatricsExperience: 5 years
Written by Dr Bisny T. Joseph
Last Updated on
Sleepwalking In Child: Causes, Signs, Complications, And Prevention

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Sleepwalking in kids, also known as somnambulism, is a kind of parasomnia, a sleep disorder that causes predicted or unexpected events to occur during sleep. In this situation, a child may get out of bed and stroll around while still asleep.

Sleepwalking is a common condition in children, but most outgrow it when they reach adolescence. In addition, while isolated sleepwalking does not suggest a serious disease, recurrent sleepwalking may indicate a serious underlying condition that may need therapy.

Read on to know the causes, risk factors, symptoms, and complications of sleepwalking and how it can be diagnosed and prevented in children.

Causes Of Sleepwalking In Children

The exact cause of sleepwalking is not known in many children. Some may have a family history of night terrors and sleepwalking behaviors. The following factors may trigger or worsen sleepwalking in some children (1).

  • Sleep deprivation or lack of adequate sleep
  • Sleep schedule disruptions
  • Anxiety
  • Physical and emotional stress
  • Fever and other illnesses
  • Certain sedative medications
  • Restless leg syndrome (RLS), which is the uncontrollable urge to move legs
  • Obstructive sleep apnea, that is, the cessation of breathing during sleep for short periods
  • Waking up abruptly from deep sleep due to the need to pee
  • Abruptly waking from sleep by a sudden noise or touch
  • Gastroesophageal reflux disease (GERD)

Trigger Factors For Sleepwalking

Sleepwalking can begin from when the child is able to walk. However, it often worsens between the ages of eight and 12 years. The risk factors for sleepwalking and night terrors can be the same in most cases. The following factors may increase the risk of sleepwalking in children (2).

  • Migraine headaches
  • Head injuries
  • Stroke
  • Hyperthyroidism (increased thyroid hormones)
  • Encephalitis (brain swelling)
  • Bloated stomach
  • Travel
  • Sleeping in unfamiliar places
  • Noise or light
  • Seizure disorders
  • Medications

Besides these, genetics may also be a major factor, as sleepwalking tends to run in families.

Signs Of Sleepwalking In Children

Usually, most children may have a sleepwalking episode lasting less than ten minutes, and they may go back to sleep or wake up. The following symptoms are seen in children who sleepwalk (2).

  • Sit up in the bed and open the eyes
  • Get off the bed and walk around the room
  • Have a glassy-eyed expression. Their eyes may be open while sleepwalking, but they may fail to recognize others around them.
  • Confused when they wake up while sleepwalking
  • Quickly fall asleep after the walk
  • Often have sleep terrors
  • Do not remember what happened or may have a patchy memory in the morning
  • Partially respond or say things that do not make sense when you talk to them while sleepwalking
  • Able to move well around familiar objects
  • May get up and open cupboards and eat or get dressed

The following signs are also seen in some rare cases.

  • Unusual behaviors such as peeing in the closet
  • Leave the house
  • Show violent behavior
  • Get injured

Not all children who sleepwalk may get out of bed and do certain things. Many may sit up in the bed and appear confused during sleepwalking episodes. If your child tends to walk around or leave their room during a sleepwalking episode, take measures to prevent it and ensure their safety.

What To Do If You Find Your Child Sleepwalking

Your priority should be to stay calm and keep your child safe. Do not hold or wake your child up if you find them sleepwalking or sitting on the bed. Instead, you may gently guide them back to bed and ensure their safety. If undisturbed, most children fall asleep again.

However, if your child experiences more than one episode of sleepwalking, you may gently wake them up after they come out of the first episode. This may help prevent another sleepwalking episode in the same sleep cycle.

Do not shout or startle the child unless they are in danger. Physically restraining them is also not recommended since this may impact their mental wellbeing. You may consult a pediatrician or a sleep expert to identify and resolve sleepwalking in your child (1).

Complications Of Sleepwalking

Sleepwalking may not cause significant problems in many children. However, some may have the following complications (3).

  • Sleep disruptions at night may lead to excessive daytime sleepiness and often result in behavioral problems and poor school performance.
  • Some can hit furniture’s or fall from the stairs, fall through open windows while sleep walking. Wandering outdoors or driving a car unintentionally while sleepwalking can also increase the risk of injuries.
  • Some may eat inappropriate things while sleep walking.
  • Some children may face social relationship problems due to embarrassment.
  • In some rare cases, some children may injure someone nearby

Sleepwalking in children can disturb other family members’ sleep and often result in family conflicts. Early diagnosis and appropriate care may help alleviate or prevent sleepwalking in many children.

How To Prevent Sleepwalking In Children?

The following measures may help prevent sleepwalking in some children to an extent (4).

  • Reduce stress: Adequate physical activity may help reduce stress. Trying out meditation and other relaxation games and techniques can also be beneficial.
  • Get enough sleep: Ensure your child gets enough sleep without any distractions during the night. Following a regular sleep time routine can help the child fall asleep. Usually, a three- to five-year-old child requires 10 to 13 hours of sleep, an older child requires nine to 12 hours of sleep, and a teen requires eight to ten hours of sleep every night (2).
  • Avoid stimulations: Visual or auditory stimulations before bedtime can cause trouble falling asleep in children. You may limit their screen time and other activities before sleeping. Emptying the bladder before bedtime may also help the child to avoid getting up and walking in their sleep for a pee.
  • Further, encourage your child to do their activities and school homework way before their bedtime.

When To See A Doctor?

You may consider a consultation with a doctor if you notice any of the following situations (5):

  • Frequent sleepwalking
  • Repeated injuries
  • Walks outdoors
  • Loud snoring or gasping for breath
  • Excess daytime sleepiness
  • Wets their bed or pajamas during an episode
  • Psychological factors

Never hesitate to consult a pediatrician or sleep specialist if you suspect a medical condition to be the cause of the sleepwalking in your child.

Diagnosis Of Sleepwalking

Sleep specialists may ask the parents to keep a sleep diary for at least two weeks to identify the cause of the problem. They may also ask a few questions to determine how the child’s life is being affected by sleepwalking.

A sleep study called polysomnography (PSG) is often done in many children with sleep disorders (2). This involves the recording of the brain waves, breathing, and heart rate while the child sleeps. PSG includes the following tests:

  • EEG (electroencephalogram) to record brain activity
  • ECG (electrocardiogram) to record heart rate and electrical activity
  • EMG (electromyography) to record muscle activity such as chin and limb movements
  • EOG (electrooculography) to record eye movements
  • Pulse oximetry to measures oxygen levels in the blood and diagnose obstructive sleep apnea (OSA)
  • Position sensors to observe abdominal and thoracic movements
  • Oronasal airflow measurement to identify apneas

Tests included in the PSG study can help show any unusual behaviors and sleepwalking during sleep. This study may also help identify the cause of sleep problems in most children. Doctors may order some tests to rule out the following problems while looking for the cause or worsening of sleepwalking symptoms in children.

  • Other sleep disorders
  • Medical conditions
  • Substance use
  • Medication use

PSG is usually ordered if the doctor suspects sleep apnea or other sleep-related breathing issues in children. In most cases, the sleep diary and health history findings can help diagnose sleepwalking.

Treatment For Sleepwalking In Children

There is no specific treatment for sleepwalking. Usually, doctors may not prescribe any medications to treat sleepwalking in children since most may outgrow it.

Medications such as benzodiazepines or some antidepressants are prescribed for some children in some rare cases.

Scheduled awakening is a treatment recommended for frequent sleepwalkers. You may have to record the time when your child falls asleep and sleepwalks for several days. Then, rouse your child from sleep 15 minutes before the expected sleepwalking episode for the next several days. There is no need to wake the child completely, and you may just interrupt their sleep at this time to interrupt their sleep cycle.

Doctors may recommend the following measures to prevent injuries in children who sleepwalk(2).

  • Keep the doors and windows locked during the night to prevent them from leaving home.
  • Use safety gates at the child’s bedroom doors or near the stairs.
  • Avoid bunk beds or elevated beds to reduce the risk of falls from the bed.
  • Keep breakable, sharp, and dangerous furniture or items away from the child’s bed or preferably away from their room.
  • Remove objects on floors that may cause them to trip or fall.

Frequently Asked Questions

1. Can ADHD cause sleepwalking?

Although sleepwalking is observed in children without ADHD, parasomnias, including night-time terrors and sleepwalking, may also be included in various sleep disorders that may affect children with ADHD (6).

2. At what stage of sleep does sleepwalking occur?

Sleepwalking usually occurs in a deep stage of sleep called non-REM sleep or N3 sleep, which could be a more prevalent stage in children than adults (7).

Sleepwalking in children is usually caused by sleep schedule disruptions, stress, illness, etc. Most children shun this habit as they reach adolescence. To avoid sleepwalking in children, doctors may treat underlying disorders such as sleep apnea. However, children with no underlying conditions and occasional sleepwalking may not require treatment. Establishing a good sleep schedule from a young age may also be beneficial. Never chastise, or control your child for sleepwalking since this may cause more harm. Instead, ensure your child’s safety and get medical advice from a specialist to identify and treat the problem.

Key Pointers

  • Sleepwalking may run in families, and conditions such as GERD, anxiety, restless leg syndrome (RLS) may aggravate the condition in children.
  • Sleepwalking worsens between the ages of eight and 12.
  • Sleep disruptions, increased risk of injuries, and eating inappropriate things are a few complications of sleepwalking in children.
  • Reduced stress and getting sufficient sleep will help prevent this disorder in children.

References

1. Sleepwalking; National Health Service
2. Sleepwalking; Sleep Education – American Academy of Sleep Medicine (AASM)
3. Sleepwalking in children; St. Clair Health
4.Sleepwalking in children and teenagers; Raising Children Network
5. Sleepwalking; The Royal Children’s Hospital Melbourne
6. Arthur S. Walters et al., Review of the Possible Relationship and Hypothetical Links Between Attention Deficit Hyperactivity Disorder (ADHD) and the Simple Sleep Related Movement Disorders, Parasomnias, Hypersomnias, and Circadian Rhythm Disorders; (2008); Journal of Clinical Sleep Medicine.
7. Sleep Walking; Penn Medicine
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Dr. Neema Shrestha
Dr. Neema ShresthaMD
Dr. Neema Shrestha is a pediatrician with a special interest in the field of neonatology. She has an overall experience of five years working in the field. Currently working in Kathmandu, Nepal, she completed her MBBS from Kasturba Medical College, Manipal in 2008, Diploma in Child Health from D.

Read full bio of Dr. Neema Shrestha
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