Violent behaviour occurs in many sleepwalkers
11 March 2013, 16:31
Adults don't always outgrow sleepwalking, and among those who don't, 58% may become violent and sometimes injure either themselves or their sleeping partner, a new study shows.
Not only that, these sleepwalkers suffer a host of health problems during their waking hours, the researchers noted.
"Daytime sleepiness is a frequent problem in adults affected with sleepwalking," said study author Dr Yves Dauvilliers, director of the sleep lab at Gui-de-Chauliac Hospital in Montpelier, France.
That's among the more obvious problems, he said. They also may experience depression, anxiety and lower quality of life.
Injuries, both to sleepwalkers and their bed partners, happen 17% of the time, Dauvilliers said. "Some patients have jumped out of windows," he said. "Some have walked on the house roof. And others fell down the stairs, with legs broken."
How the research was done
For the research, Dauvilliers evaluated 100 adult sleepwalkers who came to the hospital sleep disorders clinic. The median age was 30. They were all evaluated on video one night in the sleep lab. The patients answered questions about any problems with sleep, fatigue, anxiety, depression and overall quality of life.
The patients also divulged details on possible known triggers for sleepwalking, such as stress, strong emotions, drinking alcohol or engaging in intense physical activity in the evening.
The researchers also interviewed 100 healthy people who did not sleepwalk and compared the results.
Of the sleepwalkers, nearly 23% did so nightly and 43.5% did it weekly. The median age for starting the habit was nine years. More than half reported a family history of sleepwalking.
Compared to those who didn't sleepwalk, the sleepwalkers were more likely to have daytime sleepiness, fatigue, insomnia, symptoms of anxiety and depression, and to feel their quality of life was lower.
In 17% of patients who became violent while asleep, medical care was needed for at least one episode of such behaviour. The researchers defined violent behaviour as "physically aggressive or potentially dangerous behaviours for patients and co-sleepers." They noted that for six patients (five males), a bed partner needed medical care after being attacked.
The findings are not a surprise to Dr Maurice Ohayon, a professor of psychiatry and behavioural sciences at Stanford University, who has published his own studies on sleepwalking. In his research, he has found that about 4% of the adult population sleepwalks.
Ways to reduce sleep walking
The sleepwalkers studied by Dauvilliers, he said, are more severe cases than he found in his look at the general population. The study patients had been referred to a sleep clinic. Even so, he said he found some of the same issues with the sleepwalkers he studied. They often had a family history of the problem, and they reported depression and the need for sleeping pills due to insomnia.
How to reduce sleepwalking? People need to avoid the triggers, Dauvilliers said. Severe cases may require medication such as benzodiazepines, which are drugs that have sedating effects, he explained.
Ohayon agreed that both medication and paying attention to habits can help. "For example, reducing stress, keeping a regular sleep-wake schedule and getting enough sleep" all help, he said.
Increasing the safety of the environment can also help reduce injury, Ohayon suggested. "A bell on the door is a good idea," Ohayon said, "but it must be loud enough to awaken the sleepwalker."
He also advises sleepwalkers to sleep on the ground floor if possible, to install extra locks on doors and windows, and to install motion detector alarms.
Dauvilliers reports receiving honoraria and travel expenses from UCB Pharma, Cephalon, Novartis and Bioprojet. He has been on advisory boards for UCB and Bioprojet. Co-authors have been advisors for pharmaceutical companies.
To learn more about sleepwalking, visit the National Sleep Foundation.