Nightmares & Sleepwalking When is there cause for concern? By Rosei Skipper, MD
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elieve 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.
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.
What is sleepwalking? According to Sleep Specialist Liyue Xu, MD, sleep walking 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.
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, Dr. Liyue Xu 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.
Can sleepwalking be dangerous? The biggest safety concerns withs 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.
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.”
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. 14 | May/June 2021
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
