Where Were You Last Night?

Sleepwalking. Sleep eating. Sleep driving. Even sleep emailing. Four to 5 percent of the world’s population may suffer from these activities, all of which fall under the category of parasomnias, or sleep disorders that are characterized by abnormal movements or behaviors that shouldn’t occur during sleep, but do.

Although there is not a clear answer about why such nocturnal activities occur, sleep experts believe they know at what point during sleep they take place.

According to Dr. Donald Greenblatt, director of the Strong Sleep Disorders Center at the University of Rochester Medical Center, New York, these activities mostly happen during the deeper stages of sleep, or stages three and four. “These stages occur within the first third of night. That is why sleepwalking tends to be more common in kids because we outgrow deep sleep as we get older,” he explains.

Greenblatt says anything that causes stress is suspect as a trigger. “Being sick, having a fever, being deprived of sleep, overworking, alcohol or emotional stress, and in women pregnancy or menstruation, can worsen parasomnia or bring it on,” he says.

Medication can cause it, too, even those that are meant to be sleep aids. Sleep experts say that as more of these drugs hit the market, reports of parasomnia grow. Greenblatt notes, however, few Ambien users report sleepwalking episodes.

Because sleep aid drugs are psychoactive, Greenblatt notes, they are meant to turn off certain parts of your brain. This can lead to engaging in activities during sleep that you will not remember the next day — and that could be dangerous.

Past reports of parasomnia activity include everything from overeating to committing murder. Sleepwalkers can carry out activities they know how to do, no matter how complex, Greenblatt says. For instance, an adult might start a car and drive it, or a child might log onto a computer and email someone.

Although Greenblatt says behavioral changes such as avoiding sleep deprivation and minimizing stress and anxiety are an option, HME providers may find his other recommendation to their benefit, and their patients’. “Above all, I recommend securing the environment for the patient and people around the patient. That means something to alarm patients if they get up to awaken them,” he says.

The process used to wake sleepwalkers has transformed from placing a coffee can filled with pebbles next to the bed to installing a motion detection alarm. An alarm with a sensor beam — a retail possibility for home care providers — sounds when someone moves through it.

“[Installing an alarm] is the most important thing to do to help people with sleepwalking. In my mind, alarms are the treatment of choice for people who continue to have sleepwalking episodes and are a potential danger to themselves or others,” Greenblatt says.

With the growing number of sleep disorders, Greenblatt says sleepwalking and other unusual sleep activities rank up there with others, such as sleep apnea, in terms of seriousness. “I don’t know if people realize how common sleepwalking is; it’s not discussed a lot,” he says.