What is sleepwalking?

Sleepwalking is a sleep disorder characterized by unconsciously getting out of bed and moving or engaging in various activities during sleep. It usually occurs during the deep sleep phase, i.e. the first half of sleep, and the person is unconscious of his or her surroundings during this process. During sleepwalking, behaviors such as walking, talking, doing simple tasks may be exhibited, but these behaviors are usually not purposeful. After waking up, the person does not remember what happened. It is more common in children and usually resolves spontaneously during adolescence. Stress, sleep deprivation, genetic predisposition and certain medications can trigger sleepwalking. Since this condition may pose safety risks, it should be handled carefully and a specialist should be consulted when necessary.

Sleepwalking is a sleep disorder that occurs when a person moves or engages in various activities unconsciously during sleep. This condition, medically called somnambulism, usually occurs during the third stage of NREM (Non-Rapid Eye Movement) sleep, which is the deep stage of sleep. During sleepwalking, a person may get out of bed, walk around the room, or even perform some seemingly complex activities, but these behaviors are often purposeless and not under the person's conscious control. A sleepwalking individual is unable to respond to the events around them and usually does not remember them when they wake up in the morning.
Sleepwalking is more common in children, but can also occur in adults. In children, it usually resolves spontaneously during adolescence with the completion of brain development. However, sleepwalking in adults is less common and can often be caused by factors such as stress, sleep deprivation, excessive alcohol consumption, psychiatric disorders, neurological diseases or side effects of certain medications.

What are the symptoms of sleepwalking?

Sleepwalking is a sleep disorder in which a person moves unconsciously during sleep and usually does not remember it after waking up. This can range from a simple act of getting out of bed to doing activities that seem complex but are not purposeful. During sleepwalking, the person does not respond to their surroundings, sometimes mumbling or speaking in an unintelligible way. Sleepwalkers often walk around with their eyes open, but their gaze is blank and expressionless. Sometimes the sleepwalker may repeat movements they make in everyday life, for example, sitting on a chair or opening a cupboard. In this process, the person is unconscious, has no awareness of what is going on around him/her, and is unable to show a reflex to protect himself/herself in case of danger. Sleepwalking is common, especially in childhood, and is usually harmless. However, when it occurs in adults or when it is accompanied by severe and dangerous behavior, it can become a problem that needs to be handled with care. Symptoms of sleepwalking are as follows;

Getting out of bed and walking around: Sleepwalkers may get out of bed and walk around the room or house, usually when they are in the deep stage of sleep. They are unconscious during this behavior and do not react to the environment.
Blank and expressionless gaze: Sleepwalkers' eyes are usually open, but their gaze is blank and expressionless. They do not focus on the objects around them.
Purposeless Movements: They may make some movements that seem to be part of everyday life, for example, turning on a faucet, carrying an object or opening doors. However, these movements do not have a purpose or logic.
Talking or Mumbling: During sleepwalking, a person may mumble or say words or sentences in an incomprehensible way. However, the speech is usually meaningless.
Unresponsiveness to the Environment: The sleepwalker does not react to sounds or touches around them. He/she may not react when his/her name is called or stimulated.
Difficulty in Awakening: It can be quite difficult to wake a sleepwalker. When awakened, the person is often surprised and confused.
No Morning Recall: Behaviors performed during sleepwalking are usually not remembered after waking up in the morning.
Risky and Dangerous Behaviors: In some cases, the sleepwalker may engage in risky behaviors such as going down the stairs, going outside, looking out the window or interacting with a dangerous object.
Disruption in Sleep Patterns:Individuals with sleepwalking often experience disruption in sleep patterns, frequent awakenings during the night, or problems transitioning to deep sleep.
Relationship with Other Sleep Disorders: Sleepwalking can often be associated with other sleep disorders such as sleep apnea or restless leg syndrome.
Things to Watch Out For:
When sleepwalking symptoms become recurrent and affect daily life and safety, a specialist should be consulted. Although it usually resolves spontaneously in children towards adolescence, if it persists in adults, it may be a symptom of another underlying health problem. Precautions that can be taken at home and correct treatment methods are of great importance to ensure the safety of sleepwalkers.

What Causes Sleepwalking?

Sleepwalking is a sleep disorder that occurs during NREM (Non-Rapid Eye Movement) sleep, the deep stage of sleep, and is characterized by unconscious movement. Although the exact cause of this condition is not fully understood, there are a number of biological, genetic and environmental factors that are thought to influence sleepwalking. Sleepwalking is often associated with disruptions in the sleep-wake cycle, irregularities in neural activity in the brain and an individual's stress levels. Here are the possible causes of sleepwalking:

1. Genetic Predisposition: Sleepwalking may have a genetic predisposition. Individuals with a family history of sleepwalking are more likely to develop this condition. For example, if a parent sleepwalks, the risk of a child developing the disorder increases. This risk is even higher if both parents have a history of sleepwalking. Genetic factors are thought to trigger sleepwalking by affecting sleep regulation mechanisms in the brain.
2. Sleep Phase Disorders: Sleepwalking usually occurs during the third stage of NREM sleep, deep sleep. During this stage, the brain can experience a transition between both rest and some unconscious automatic behaviors. Sleepwalking occurs when this transition does not occur smoothly. During deep sleep, some areas of the brain may remain active, while areas related to consciousness may remain dormant. This causes the individual to act unconsciously.
3. Stress and Psychological Factors: Stress, anxiety and traumatic experiences are among the important environmental factors that trigger sleepwalking. It has been observed that sleepwalking cases increase especially in individuals who experience intense emotional stress. Psychological pressures can cause the brain to not be able to fully switch to rest mode during sleep and lead to abnormal sleep behaviors such as sleepwalking.
4. Sleep Deprivation: Insufficient sleep can increase the risk of sleepwalking. Disrupted sleep patterns or not getting enough rest can lead to irregularities in brain waves, triggering sleepwalking episodes. Sleep deprivation can disrupt the brain's normal sleep cycle, particularly affecting the transition to deep sleep.
5. Childhood and Developmental Factors: Sleepwalking is more common in children than in adults. Because children's brains are still developing, the sleep-wake cycle may not be fully mature. Therefore, sleepwalking in children is usually a temporary condition and may disappear spontaneously during adolescence.
6. Neurological and Physiological Factors: Some neurological abnormalities in the brain can cause sleepwalking. For example, epilepsy, brain traumas or neurological diseases can affect sleep regulation mechanisms in the brain. Also, sleepwalking episodes are known to increase in children during febrile illnesses.
7. Drugs and Chemical Substances: Some medications, especially sedatives, antidepressants and antipsychotics, can trigger sleepwalking. These drugs can alter the chemical balance in the brain, increasing abnormal activity during the deep sleep phase. Individuals under the influence of alcohol and other drugs are also more likely to sleepwalk.
8. Sleep Apnea and Other Sleep Disorders: Other sleep disorders such as sleep apnea can be among the triggers of sleepwalking. Frequent awakenings during sleep apnea can lead to interrupted deep sleep and more frequent sleepwalking episodes.
9. Environmental Factors: Changes in the sleep environment, such as noise, light or temperature, can trigger sleepwalking. Also, changing beds or sleeping in a new environment can increase the risk of sleepwalking.

Sleepwalking is a complex sleep disorder that can be caused by a combination of genetic, biological and environmental factors. In most cases it is harmless and resolves over time, but dangerous behaviors or cases that persist into adulthood should be treated with caution. If sleepwalking is frequent and severe, it is important to be evaluated by a specialist and treated as needed. Identifying the underlying causes can help manage sleepwalking effectively.

Why does sleepwalking occur?

Sleepwalking is a sleep disorder characterized by unconscious movements during sleep, usually occurring during the deep phase of sleep. Although the causes of this condition, medically called "somnambulism", are not fully understood, it is thought that many genetic, biological and environmental factors come together to cause this condition. While sleepwalking is more common in children, persistent or severe cases in adults are often associated with more complex causes. Here are the main factors that can lead to sleepwalking:

1. Sleep Phase Disorders: Sleepwalking usually occurs during the NREM (Non-Rapid Eye Movement) stage, which occurs in the first half of sleep and is known as deep sleep. Normally, the brain and body are in a state of deep rest during this phase. However, during sleepwalking, some parts of the brain behave as if they are awake, while other parts related to consciousness remain in sleep mode. This causes the individual to move unconsciously. The irregularity in this transition process is one of the main mechanisms of sleepwalking.
2. Genetic Factors: Sleepwalking is thought to have a genetic component. Individuals with a family history of sleepwalking have a higher risk of developing this condition. Studies have shown that this condition is more common in first-degree relatives of individuals with sleepwalking. This suggests the presence of a genetic predisposition that may be associated with sleepwalking.
3. Stress and Anxiety: Stress and intense emotional states can trigger sleepwalking episodes. Sleep patterns of individuals under stress may be disrupted and this may increase the risk of sleepwalking. The fact that sleepwalking cases are more common in children, especially during stressful times such as exam periods, is an observation that supports this relationship.
4. Sleep Deprivation and Irregular Sleep: Insufficient sleep can increase the risk of sleepwalking by disrupting the natural flow of the sleep cycle. Sleep deprivation can make it harder for the brain to transition into deep sleep, which can trigger sleepwalking episodes. In addition, factors such as irregular sleeping hours or jet lag can also increase the risk of sleepwalking.
5. Childhood and Brain Development: Sleepwalking is usually more common in children and usually disappears spontaneously during adolescence. Since children's brains are still developing, the sleep-wake cycle may not yet be fully mature. This is considered to be one reason why cases of sleepwalking are more common in childhood.
6. Medical and Neurological Factors: Some medical conditions can increase the risk of sleepwalking. For example, sleep-related disorders such as epilepsy, sleep apnea and restless leg syndrome may be associated with sleepwalking. Also, sleepwalking may occur more frequently in children during febrile illnesses. Brain traumas or neurological diseases can also trigger this condition.
7. Drugs and Substances: Some medications, especially sedatives, antidepressants or antipsychotics, can trigger sleepwalking. These drugs can affect the sleep cycle by altering chemical balances in the brain. In addition, sleepwalking may be more common in individuals under the influence of substances such as alcohol and drugs.
8. Sleep Environment and Environmental Factors: Changes in the sleep environment can trigger sleepwalking episodes. For example, factors such as noise, bright light or changing beds can affect the individual's sleep patterns and increase the risk of sleepwalking. Sleeping in a new environment can also trigger this condition.
9. Hormonal Changes: Sleepwalking episodes may occur more frequently during periods of intense hormonal changes such as puberty, pregnancy or menstruation. Hormonal fluctuations can affect the overall functioning of the body, leading to changes in sleep patterns.
10. Emotional and Psychological Factors: Trauma, depression and other psychological disorders can be triggers for sleepwalking. Especially in individuals who have experienced a traumatic event in the past, the incidence of sleep disorders such as sleepwalking may increase.

Sleepwalking is a complex condition caused by a combination of genetic predisposition, disturbed sleep patterns, stress and environmental factors. In most cases, it is harmless and may resolve spontaneously in childhood. However, in cases of sleepwalking that are accompanied by dangerous behavior or persist into adulthood, it is important to investigate the underlying causes and seek appropriate treatment. Regular sleep habits, stress reduction methods and, if necessary, guidance from a sleep specialist can be effective in managing sleepwalking.

Is There a Sleepwalking Test?

While there is no direct test for sleepwalking, there are various methods and approaches used to diagnose and assess the condition. Sleepwalking is usually diagnosed based on information about the patient's history, symptoms and sleep patterns. In addition, various diagnostic tools and tests can be used to identify underlying causes and rule out other possible sleep disorders. Here is the process and methods that can be used to diagnose sleepwalking:

1. Patient History and Symptom Assessment: The first step in diagnosing sleepwalking is based on the information provided by the patient and family about the condition. The doctor learns how often and when sleepwalking episodes occur, what kind of behavior is observed during the episodes, any trauma or stress factors the person has experienced in the past. A family history is also important, as sleepwalking may have a genetic tendency. Detailed information is obtained about the impact of the condition on the patient's daily life and sleep patterns.
2. Sleep Diary: The patient may be asked to keep a sleep diary for several weeks. In this diary, the times of falling asleep and waking up, awakenings during the night, sleepwalking episodes and details of this condition are recorded. A sleep diary is useful to identify irregularities in sleep patterns and to understand the circumstances under which sleepwalking episodes occur.
3. Observation of the sleep environment: In some cases, the sleepwalker may be videotaped during sleep. This recording is used to determine what kind of behavior the person exhibits during sleepwalking episodes, how they react to their environment, and the duration of the episodes. This type of observation is particularly important to understand if there are any dangerous behaviors.
4. Polysomnography (Sleep Study): Polysomnography is one of the most comprehensive diagnostic tools used to diagnose sleepwalking. Performed overnight in a sleep laboratory, this test records brain waves (EEG), heart rate, breathing patterns, muscle activity and eye movements during sleep. This test is also used to determine if there are other sleep disorders, such as sleep apnea, restless leg syndrome or epilepsy, that may trigger sleepwalking. Polysomnography plays a critical role in distinguishing between sleepwalking and neurological disorders, especially in complex cases.
5. Multiple Sleep Latency Test (MSLT): This test is used to measure a person's daytime sleep patterns and alertness. Because sleepwalking usually occurs during the deep phase of NREM sleep, MSLT is not directly used to diagnose sleepwalking, but it can be helpful to understand other abnormalities in sleep patterns.
6. Neurological and Psychological Evaluation: In some cases, sleepwalking may be associated with a neurological or psychological disorder. Neurological tests can be performed to assess whether there is brain trauma, epilepsy or other neurological disorders. Psychological evaluation is useful to determine whether stress, anxiety, depression or traumatic experiences have an impact on sleepwalking.
7. Blood tests and other medical examinations: If sleepwalking is associated with a side effect of medication or an underlying metabolic disorder, the doctor may order blood tests or other medical examinations. In particular, conditions such as thyroid problems, hormonal imbalances or infections are investigated to see if they affect sleep patterns.
8. Exclusion of other sleep disorders: Sleepwalking can be confused with other sleep disorders (for example, sleep apnea or REM sleep behavior disorder). Therefore, doctors take care to exclude such disorders when making a diagnosis. In REM sleep behavior disorder, unconscious behaviors are seen, as in sleepwalking, but this disorder occurs during the REM phase and is often associated with dream content.
9. Family and Partner Interviews: Since the individual's behavior during sleepwalking is often not remembered by the individual, observations of the family or sleep partner are invaluable in the diagnostic process. Family members or the partner can share in detail the behaviors that the person exhibits during sleep.

Although there is no specific test for diagnosing sleepwalking, the condition can be accurately diagnosed through a thorough assessment process and appropriate diagnostic tools. Patient history, sleep diary, polysomnography and other medical tests are used in combination to understand the causes and characteristics of sleepwalking. If sleepwalking recurs frequently, leads to dangerous behavior or interferes with daily life, it is important to consult a sleep specialist. Accurate diagnosis is a critical step in managing this condition and improving the individual's quality of life.

Is there a treatment for sleepwalking?

Sleepwalking is a treatable condition; however, treatment varies depending on the underlying causes of sleepwalking, the age of the individual and the severity of the symptoms. In children, sleepwalking usually resolves spontaneously with growth and may not require treatment. However, in adults, it is important to have a professional treatment plan for sleepwalking that persists or is associated with dangerous behaviors. Different methods can be used to treat sleepwalking, from lifestyle changes to medication. Here is a detailed explanation of the treatment of sleepwalking:

1. Lifestyle Changes

The first step in the management of sleepwalking is to improve sleep hygiene and reduce trigger factors. This approach can be particularly effective in mild cases:
Regular Sleep Schedule: Going to sleep and waking up at the same time every day helps regulate the sleep-wake cycle.
Regulating the Sleep Environment: A quiet, dark and comfortable sleep environment should be provided. Factors that affect sleep quality such as noise or light should be minimized.
Stress Management: Stress is an important factor that triggers sleepwalking. Relaxation techniques such as yoga, meditation or deep breathing exercises can alleviate sleepwalking episodes by reducing stress.
Relaxation Before Sleep: Avoid heavy meals, caffeinated drinks and electronic devices before bedtime. These can negatively affect sleep quality and increase the risk of sleepwalking.

2. Safety Precautions

Where sleepwalking poses a safety risk, precautions at home are vital to prevent harm to the individual:
Bedroom Arrangements: Remove furniture with sharp corners and reduce the risk of falls. Locking Doors and Windows: Doors and windows should be locked to prevent a sleepwalker from leaving the house. Putting Barriers on Stairs: Safety barriers can be used to prevent falls on stairs.

3. Treatment of Underlying Causes
Sleepwalking can sometimes be caused by other health problems. In these cases, the underlying problem should be treated first:
Sleep Apnea: If sleepwalking is related to sleep apnea, treatments such as the use of a CPAP device or weight loss can be applied.
Psychological Problems: Conditions such as stress, anxiety or depression can trigger sleepwalking. Psychotherapy or medication may be recommended to manage such conditions.
Neurological Disorders: Treatment of neurological problems such as epilepsy can reduce sleepwalking symptoms.
4. Behavioral Treatments
Behavioral therapy methods can be very effective in the treatment of sleepwalking:
The Awakening Technique: Sleepwalking episodes usually occur at a certain time of sleep. In this method, the person is gently awakened before the sleepwalking behavior begins, disrupting the sleep cycle and preventing the episode.
Cognitive Behavioral Therapy (CBT): In cases of sleepwalking associated with stress or anxiety, CBT can help the person to cope with these situations.
5. Medication
In cases of severe or recurrent sleepwalking, medication may be considered. However, medication is usually used as a last resort and should be prescribed under the supervision of a specialist:
Benzodiazepines: Benzodiazepines such as lorazepam or clonazepam can be effective in reducing sleepwalking episodes. Antidepressants: SSRIs or other antidepressants can be used in cases of sleepwalking due to stress or anxiety.
Melatonin: In some cases, melatonin supplements may be recommended to help regulate sleep patterns.
6. Psychological and Family Support
Sleepwalking can have not only physical but also psychological and social effects. It is important to inform family members and the immediate environment about this condition so that the individual feels safe. Psychological support can help the person cope with the anxiety and stress they are experiencing.
7. Treatment of Sleepwalking in Children
Sleepwalking in children is often seen as part of the growth process and may disappear with puberty. Treatment is usually not needed in children, but it is important to take safety precautions and reduce triggers. In very frequent or dangerous cases, a pediatric sleep specialist should be consulted.
Treatment for sleepwalking is planned with an individualized approach depending on the individual's age, underlying causes and severity of symptoms. In mild cases, lifestyle changes and improved sleep hygiene may be sufficient, while severe cases may require medication and behavioral methods. If sleepwalking recurs frequently, causes dangerous behaviors or affects the quality of life of the individual, a specialist physician should be consulted and professional support should be sought. With the right treatment and support, sleepwalking can be largely controlled and the safety of the person can be ensured.