Symptoms and causes

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

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)

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