It should be noted that somnambulism is a condition in which a person can perform complex and purposeful actions during sleep; however, after awakening, he or she, as a rule, does not remember committing any actions or movements. This condition can occur in both adult patients and children. Nevertheless, somnambulism is most frequently met in children, which may be due to their psychological and physiological characteristics of development.
Researchers emphasize that this condition can be accidental and there is no reason to believe that serious diseases in the human body cause it. However, despite this statement, it is necessary to understand the nature and characteristics of this condition due to the fact that a patient can perform complex actions requiring the use of physical strength; therefore, it is essential to take measures to protect the individual from accidental injuries. The purpose of this paper is to review the possible causes for somnambulism, discuss its symptoms, and analyze the plan of care.
General Description and Possible Causes
Many people believe that somnambulism is inherited; nonetheless, this has not been fully confirmed by evidence-based medicine. However, this condition occurs rather often, and approximately 2-4% of people experience somnambulism, and it is also necessary to take into account the number of undocumented cases. Somnambulism occurs during a partial awakening from deep delta sleep (Popat and Winslade 204).
In this period, the patient’s brain is in a state of partial sleep and partial wakefulness. The eyes of an individual can be opened, and the person sees the surrounding objects. In addition, the patient can produce some speech utterances and answer simple questions; involuntary urination is also possible. It is crucial that the patient cannot remember the episodes of sleepwalking.
It is important that the causes of somnambulism can be different since a variety of external and internal factors can cause both single and repetitive cases of this condition. In particular, chronic lack of sleep or fatigue, stress, and anxiety can cause episodes of somnambulism. In addition, some medications and therapies can produce a similar state (Ropper et al. 223). For instance, it has been documented that patients taking antihistamines or sedatives experienced this condition during the course of treatment. Also, patients suffering from migraine or convulsive disorders, as well as obstructive sleep disorders, can develop systematic somnambulism. Moreover, the use of drugs and banned substances can provoke episodes of this condition.
Experts in the field classify somnambulism with parasomnia, which is a violation of behavior during sleep. As mentioned above, this condition occurs during the NREM phase of sleep (Kryger et al. 634). The most common symptoms of somnambulism are the cases when at night, patients sit or stand with their eyes open, and the pupils of eyes can be narrowed.
Patients can walk around the room, perform routine activities (such as getting dressed, cleaning their teeth, washing the dishes), and they can commit actions that require strength, concentration, or strong balance (Thornton 180). Moreover, if during this period an individual sees a nightmare, he or she can start screaming and behaving aggressively. The most important sign of somnambulism is that the individual cannot be awakened in the usual way. In addition, the episodes can be repeated during one night or several nights in a row, which requires increased attention from the side of healthcare specialists.
Plan of Care
It is significant to emphasize that somnambulism does not always require special treatment. To be more precise, if a person has rare episodes of sleepwalking, which do not become systematic and are not accompanied by dangerous behavior, it is necessary to mention these cases during a medical examination without subsequent therapy (Ropper et al. 223). To prevent or minimize the causes of somnambulism, it is essential to maintain healthy sleep and nutrition regimes, walk in the fresh air, avoid stresses, and use a wet towel to wake the person during the episode of sleepwalking.
If somnambulism has a recurring character and leads to trauma, it is necessary to consult a specialist who will determine diagnostic measures to identify the causes of the disease. For example, neuropsychological tests can be performed to check the patient’s cognitive abilities, as well as electroencephalography to check the functioning of the brain (Hay et al. 107). A patient may be advised to receive psychotherapy or hypnosis to get rid of neurosis. Apart from that, one of the effective methods for treating somnambulism is drug therapy; however, it is used only in cases when episodes are caused by epilepsy or other serious impairments in the brain. Drug therapy is prescribed from three to six months and ceases as the normal work of the brain is restored.
Thus, it can be concluded that both adults and minors can experience somnambulism. In this condition, a person commits unconscious actions when sleeping. In childhood, these manifestations are normal while in adult patients they can be caused by disorders in the activity of the brain or central nervous system. Depending on the causes of somnambulism, treatment can be prescribed to help the individual normalize the functioning of the organism and restore the sleep regime.
Hay, William et al. Current Diagnosis and Treatment Pediatrics. 22nd ed., McGraw Hill Professional, 2014.
Kryger, Meir, et al. Principles and Practice of Sleep Medicine. 6th ed., Elsevier Health Sciences, 2015.
Popat, Shreeya, and William Winslade. “While You Were Sleepwalking: Science and Neurobiology of Sleep Disorders & The Enigma of Legal Responsibility of Violence During Parasomnia.” Neuroethics, vol. 8, no. 2, 2015, pp. 203-214.
Ropper, Allan, et al. Adams and Victor’s Principles of Neurology. 10th ed., McGraw Hill Professional, 2014.
Thornton, Elizabeth. Hypnotism, Hysteria and Epilepsy: An Historical Synthesis. Butterworth-Heinemann, 2016.