When is there cause for concern?
Believe it or not, sleepwalking and excessive nightmares are related—and both could potentially require a visit to the doctor. Learn more about these common sleep disorders, and when to seek treatment.
What is sleepwalking?
According to Sleep Specialist Liyue Xu, MD, sleepwalking and nightmare disorder fall under the umbrella category of “arousal disorders,” meaning partial arousal from deep sleep. “Deep sleep,” Dr. Xu defines, “is a prolonged and restorative sleep stage during which we are quiet and difficult to wake. Sleepwalking episodes start with a confused partial awakening.” During a sleepwalking episode, speaking to the individual affected will not cause them confusion or disorientation. They will likely seem coherent and reply. Often, the individual will return to bed on his own, and won’t remember the episode the next day.
Can sleepwalking be dangerous?
The biggest safety concerns with sleepwalking are risks of falling, bumping into objects and even leaving the house. Dr. Xu says that sleepwalkers are almost never violent, but family members should be careful intervening, as sleepwalkers may push, hit or kick if they are touched. For this reason, it is better to let the sleepwalker make their own way back to bed.
So what exactly causes sleepwalking?
Truthfully, sleep specialists haven’t narrowed down the exact cause of sleepwalking disorders. Although stress tends to make sleepwalking worse, psychological problems are not thought to be the cause. Dr. Xu says it’s likely that genetic factors and brain maturation play a role—sleepwalking tends to run in families, and most children grow out of it. Sleepwalking is fairly common, occurring in about 5% of children and 1.5% of adults.
Individuals living with sleepwalking disorders often notice that being overly tired, jet lagged or changing a sleep environment can make sleepwalking more likely. Ironically, there is evidence to suggest that common sleep aids like zolpidem can cause sleepwalking.
Is treatment necessary?
Dr. Xu says that most people don’t need to see a doctor concerning arousal disorders, and adds that there are no specific medical treatments. However, if a person is experiencing other problems, like daytime sleepiness, it’s a good idea to talk to a provider. The main course of treatment involves reducing stress, maintaining a regular sleep schedule and not skimping on sleep, in addition to safety measures.
When are nightmares more than just bad dreams?
According to Dr. Xu, “Nightmare disorder is when nightmares happen excessively, cause distress, disrupt sleep, cause problems with daytime functioning and/or lead to fear of going to sleep.”
Where do nightmares come from?
The exact cause of dreams and nightmares is not known, nor is their function. But Dr. Xu says that “abnormal nightmares are common in people suffering from post-traumatic stress disorder (PTSD), or after an accident. For children, nightmare disorder is most likely to occur in those exposed to severe psychosocial stressors at home or school.” A recent study also suggested that recurrent nightmares occurred more often in those who habitually slept less than eight hours per night. Insomnia and sleep deprivation can make nightmares worse, and so can certain medications, use of drugs, and withdrawal from alcohol.
When should I talk to my doctor?
Dr. Xu says that it is important to get evaluated by a provider if nightmares are causing problems. “Your sleep physician will carefully discuss your symptoms, and evaluate you for other sleep disorders if indicated. You may need an overnight sleep study in a lab.”
If nightmares are affecting your or your child’s quality of life, there is treatment. According to Dr. Xu, the recommendations will depend on the underlying cause of the nightmares, but include therapy, medications and sleep hygiene practices. With treatment and time, nightmare disorders can improve.
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Rosei Skipper, MD completed her Psychiatry residency and Child fellowship at the Mayo Clinic in Rochester, MN. She is currently pursuing further training in psychoanalytic therapy.
