Sleepwalking (somnambulism) is when a person behaves as if awake while in a deep sleep. They might walk, talk, or perform routine activities all while sound asleep. Sleepwalking can happen due to stress, sleep deprivation, certain health conditions, and medications.

Most people don’t remember sleepwalking, and there is not always someone there to see it. It can easily go unrecognized and unreported.

1. Certain Medications

Common triggers for sleepwalking are substances such as alcohol and some medicines. These include prescription insomnia medications such as Ambien (zolpidem), Lunesta (eszopiclone), and Sonata (zaleplon).

Other medications that may cause sleepwalking are:

• Benzodiazepines and Z-hypnotics (non-benzodiazepines)
• Antidepressants
• Lithium
• Atypical antipsychotics such as quetiapine, lurasidone, olanzapine, and aripiprazole

2. Stress

Research suggests that stressful events during the day are one of the primary triggers in adults who sleepwalk. Living with a lot of stress also increases the risk of developing insomnia.

3. Sleep Deprivation

Lack of sleep, irregular sleep, and fatigue can trigger an episode of sleepwalking. Studies indicate that sleep deprivation increases the number and complexity of sleepwalking events when you do fall asleep.

4. Migraine

Migraine and sleep abnormalities, such as sleepwalking, teeth-grinding, and nightmares, often go hand in hand. There’s a higher rate of sleepwalking in people who have migraine with aura. Researchers haven’t discovered the exact mechanisms, but the link may be related to shared anatomical pathways.

5. Fever

Illness or fever, especially in children, can trigger sleepwalking. Fever can also reduce overall REM sleep time and promote bizarre dreams or nightmares.

6. Breathing Disorders

The prevalence of sleepwalking is higher in people with obstructive sleep apnea, a condition in which you repeatedly stop breathing during the night. This may have to do with interrupted sleep and oxygen supply to the brain, but the exact link is unclear. In some cases, getting treatment for sleep apnea results in fewer sleepwalking events.

Research suggests that people with severe sleep apnea are twice as likely to experience sleepwalking than those with mild sleep apnea.

7. Gastroesophageal Reflux Disease (GERD)

Studies show that GERD is associated with sleep disturbances such as shorter sleep duration and poor sleep quality.

There appears to be a bi-directional relationship between GERD symptoms and sleep disturbances. But sleep disturbances seem to be a stronger risk factor for GERD symptoms than the other way around.

8. Parkinson’s Disease

Some research suggests that about 10% of people with Parkinson’s disease experience sleepwalking. This may be because Parkinson’s disease-related neurodegeneration interferes with arousal regulation during sleep.

9. Restless Leg Syndrome

Restless leg syndrome is a movement and sleep disorder. It can severely disrupt sleep because it causes an irresistible urge to move your legs, particularly at night. This can lead to frequent awakenings and sleep deprivation, which can trigger sleepwalking.

When Does Sleepwalking Happen?

People go through different stages of sleep. Like other parasomnias (sleep behavioral disorders), sleepwalking happens when you only partially awake from non-rapid eye movement (NREM) sleep. That’s usually within 1 to 2 hours of falling asleep. Most episodes last 5 to 10 minutes, but some can last 30 minutes or more.

Research suggests that sleepwalking involves changes in brain processes that affect the space between sleep and wakefulness. When you sleepwalk, the brain’s frontal areas are asleep, but there’s still wake-related activity in motor areas.

While you might be able to get around, sensory perceptions aren’t working. You’re unaware of sights, smells, sounds, or pain.

How Do You Know If Someone Is Sleepwalking?

Here are some of the common signs of sleepwalking:

• Eyes are open, but the person looks blank and doesn’t recognize you
• Talking to you or responding with nonsensical answers
• Unusual behavior, like urinating in strange places, preparing food in the middle of the night, or leaving the house in pajamas
• Strange or aggressive reaction when you try to wake them

Sleepwalkers generally have no memory of what happened.

A Word From Verywell

When startled, sleepwalkers act out in a fight-or-flight response. They may lash out or fall, which could injure them or the person waking them. Encourage or lead a sleepwalker back to bed and let them get on with their night’s rest.

Is Sleepwalking Dangerous?

Poor sleep quality can make it difficult to function during the day. It can also disturb others’ sleep.

Sleepwalkers can often navigate around familiar territory, but they do have impaired perception and judgment, which puts them at risk of injury due to trips and falls. A person who is sleepwalking may not recognize the potential hazards of sharp objects. Sleepwalkers may put themselves in life-threatening situations through activities like cooking, climbing out windows, or even driving.

There are cases of violence toward others during a sleepwalking episode, but it’s not common.

How Is Sleepwalking Diagnosed and Treated?

Sleepwalking is typically diagnosed based on medical history and discussion of symptoms. Eyewitness accounts or video of the event can be helpful. A physical examination can inform the next steps if your healthcare provider suspects an underlying sleep disorder or other condition. In some cases, sleep studies, which measure how well you sleep and how your body reacts to sleep problems, can help diagnose sleep disorders.

It’s important to create a safe environment for sleepwalkers, clearing the area of any hazards. Roughly waking a sleepwalker by yelling or shaking them can cause confusion or anger. But you can try to gently guide them back to bed or wake them if necessary.

If you’re at risk of violence, remove potential weapons from the sleepwalker’s room and sleep in a separate, locked room. Sleepwalkers who appear to be at risk for violent behavior should avoid alcohol and drug use, as well as sleep deprivation.

Children often outgrow sleepwalking. Even in adults, it can resolve on its own. Most people don’t need treatment specific to sleepwalking. Sometimes, short-acting tranquilizers can help, but some of these same medicines can also cause sleepwalking.

When sleepwalking is related to an underlying disorder or medication, treating that condition or switching medications may help. Working on sleep hygiene to improve sleep overall is also a good idea.

When to Contact a Healthcare Provider

See a healthcare provider if:

• Sleepwalking happens regularly
• It involves dangerous behaviors
• You’re experiencing excessive daytime sleepiness
• You’re having trouble dealing with stress
• You have other bothersome symptoms

Summary

Sleepwalking is when a person looks and acts awake when sound asleep. This can happen when you’re sleep-deprived, sick, or stressed out. It can also be a symptom of a condition such as sleep apnea, restless leg syndrome, or Parkinson’s disease.

Sleepwalking doesn’t usually require treatment on its own. However, persistent sleepwalking can lead to daytime fatigue and prevent others from getting a good night’s sleep. See a healthcare provider if sleepwalking involves dangerous activities, happens frequently, or accompanies other symptoms. Diagnosing and treating an underlying condition may help resolve sleepwalking.