FAMILY MEDICINE® COLUMN

By John C. Wolf, D.O.Associate Professor of Family Medicine Ohio University College of Osteopathic Medicine

SLEEPWALKING STRESSFUL NOT ONLY FOR CHILD BUT ALSO FOR PARENT

Question: My 13-year-old son has recently started sleepwalking. He mainly does this when we are spending the night away from home. He has his eyes open and looks like he is awake, but he isn't. He wanted to drive the car the last time this happened. What causes sleepwalking, and what can I do to stop it?

Answer: Sleepwalking, a condition we doctors also call somnambulism, is a common disorder that affects up to 10 percent of children. Though this condition happens most frequently in those between 4 and 13, it can start as soon as the child can walk. In rare instances it can begin in adulthood.

As you might assume, sleepwalking is a disorder of sleeping. In it the individual is awake enough to sit up in bed or to even get up and move about as your son has, but not awake enough to behave normally. Many describe the eyes as being open but with a vacant stare. In addition, the person's movements are typically clumsy, and any attempt to talk -- either in response to questions or spontaneously -- usually makes little sense.

I also assume that you had great difficulty in waking your son during these episodes -- that is typical of the condition, too. A single event of sleepwalking is usually over in 15 to 20 minutes, and come morning, the person rarely has any recollection of the night's wanderings.

So what is a worried mother to do? A sleepwalking individual rarely is capable of performing complex tasks such as driving a car, but they can wander into the street and be hit by one. Obviously, you need to protect your son during these times. Most sleepwalking episodes take place within the first two hours after going to bed, so you will need to be more attentive during these hours. The next time your son sleepwalks, you should talk to him in a quiet and soothing voice but not try to reason with him. He is asleep, remember. Direct him away from dangerous things and ultimately get him back to bed.

Sleepwalking is more common when the individual is low on sleep. Perhaps this is why it happens to your son when you are away from home. The different activities may make it difficult for him to stay on a regular sleep schedule.

Some individuals continue to experience sleepwalking very regularly even though they are getting enough sleep. If this is the case with your son, you might try the following treatment that sometimes works in these situations. Note the time when he usually starts to sleepwalk. Wake him about 15 minutes before that time. Tell him beforehand that you will be doing this and that he will need to stay up long enough to actually wake up -- perhaps five to ten minutes. Doing this for several nights in a row can often break the nightly sleepwalking pattern.

Many individuals who sleepwalk in childhood stop doing so by their middle teen years. Perhaps your son will do this. Some unfortunate few will continue to sleepwalk throughout adulthood, however. Most of these individuals have a family history of this disorder.

The role of sleep in health and illness is an area of medicine that is not clearly understood today. We don't know why people sleepwalk, and we don't have any miracle treatments that eliminate the associated risks and worries for loved ones. Fortunately, there are additional treatments besides getting adequate sleep and getting up before an episode of somnambulation. I'd suggest that you and your son talk to a sleep expert about his condition.

"Family Medicine" is a weekly column.

To submit questions, write to: John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.

Past columns are available online at http://www.FamilyMedicineNews.org.