Definition

• Sleepwalking is a partial wake-up in which children walk in their sleep
• They act confused and can’t be fully awakened, but are usually calm
• Occurs in 15% of normal children
• Peak age is 5 to 16 years

Health Information

Symptoms

• While sleepwalking, your child may:
• Appear to be looking for something, such as a toy or the parent.
• Perform repetitive tasks such as dressing and undressing, opening and closing doors, or turning lights on and off.
• Walk normally but not as well coordinated as when awake.
• Come into the parent’s bedroom and just stand there.
• Not make much noise, and you may not know they are up and sleepwalking.
• Not realize you are present, even though their eyes are wide open and staring.
• Cannot be awakened or consoled, no matter what you do.
• Episodes usually start 1 to 3 hours after falling asleep.
• Each episode lasts 5 to 20 minutes and ends of its own accord with the child falling back into deep sleep.
• In the morning, your child can’t remember what happened.
• Sleepwalking can also occur during naps.

Cause

• Sleepwalking is a type of deep sleep disorder (parasomnia).
• It occurs in children who are dreaming but locked in deep sleep.
• It runs in families who also have a history of sleepwalking.
• The main trigger for bad nights is going to bed late or very tired.
• They are not a psychological problem, but stress and fears can make them worse.

Care Advice

1. Try to Help Your Child Return to Normal Sleep:
   • With that goal in mind, you may be able to shorten the episode.
   • Make soothing comments such as, "You’re all right. You’re looking for your bed."
   • Speak calmly and in a quiet voice.
   • Such comments are usually better than silence and may help your child refocus on sleep.
   • Some children like to have their hand held during this time, but most will pull away.
2. Gently Guide Your Child Back to Bed:
   • If he’s a child with bedwetting, first steer your child into the bathroom. He may be looking for a place to urinate.
   • Then lead him to his bedroom and encourage getting in to the bed.
   • Softly say "You can sleep now. You can rest".
   • Don’t try to restrain your child. He will become upset.
3. Don’t Try to Wake Up Your Child:
   • There is no way to abruptly stop the episode.
   • Shaking or shouting at your child will just cause the child to become more agitated and will prolong the attack.
4. Protect Your Child from Injury:
   • Although accidents are rare, they do happen, especially if the child wanders outdoors.
   • Sleepwalkers can be hit by a car or become lost.
   • Put special locks on your outside doors (above your child’s reach).
   • Be sure they can’t go out through a window.
   • Put a gate on stairways.
   • Put an alarm system on their bedroom door so you will know if they are up and about.
   • Avoid having your child sleep in the top of a bunk bed.
   • Be extra careful when camping or on vacations.
5. Prepare Babysitters for Possible Sleepwalking:
   • Explain to people who care for your child what sleepwalking is and what to do if it happens.
   • Important for sleepovers. Reason: sleep talking is more common in a strange environment.
   • Understanding this will prevent others from over-reacting.
6. How to Prevent Some Sleepwalking:
   • Try to keep your child from becoming overtired or exhausted
   • Sleep deprivation is the most common trigger for frequent sleepwalking.
   • Try to avoid late bedtimes. If your child has bedtime resistance and tries to postpone bedtime, deal with that first.
   • If your child needs to be awakened in the morning, that means he needs an earlier bedtime. Move lights out time to 15 minutes earlier each night until your child can self-awaken in the morning.
7. Try Prompted Wake-ups to Treat Severe Sleepwalking:
   • If your child sleepwalks frequently and is over age 6, try this technique. It has cured some children.
   • Wake your child 1 hour after he falls asleep and before the time when sleepwalking normally occurs.
   • Remind your child at bedtime that when you do this, his job is "to wake up fast."
   • Keep your child out of bed and fully awake for 5 minutes.
   • Continue these "prompted wake-ups" for 7 nights in a row. Sleepwalking should occur less often.
8. What to Expect:
   • Children will usually stop sleepwalking during adolescence.
   • But if adults in your family sleepwalk, your child may do the same.

Call Your Doctor If

• Your child has frequent snoring
• Your child does something dangerous during an episode
• Episodes last longer than 30 minutes
• Episodes become more frequent
• Episodes occur during the second half of the night
• You have other questions or concerns

Author: Barton Schmitt MD, FAAP

Copyright 2000-2020 Schmitt Pediatric Guidelines LLC

Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it. The information contained in this handout should not be used as a substitute for the medical care and advice of your pediatrician. Listing of any resources does not imply an endorsement.

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