Is My Brother Still a Sleepwalker at 20? Sleepwalking Symptoms

Is this symptom indicative of somnambulism?

Hello: I have a younger brother who is twenty years old this year.
He suffered from somnambulism in childhood, but he still exhibits similar symptoms now.
Based on my observations, he mostly gets up and talks to people shortly after falling asleep, using confused language, but he responds to others' questions and does not remember his actions upon waking.
I have previously researched some information about somnambulism, which states that it occurs during deep sleep and that individuals typically do not hear others' questions, mostly affecting children.
Therefore, I would like to know: 1.
Is he a patient with somnambulism? 2.
Is the continuation of somnambulism into adulthood a problem with bodily functions? 3.
Which medical specialty should he consult? Thank you! I greatly appreciate it!

Nina, 20~29 year old female. Ask Date: 2001/02/07

Dr. Tang Xinbei reply Psychiatry

Dear Nina,
I apologize for the delay in responding due to issues with transmitting some symbols, which resulted in several failed attempts.
Your brother's situation seems somewhat unique.
According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) by the American Psychiatric Association, "somnambulism" (sleepwalking) typically occurs during the first third of the sleep cycle.
During an episode, there is a reduction in both awareness and responsiveness, with the individual appearing to stare blankly ahead and showing no reaction to external verbal communication (they may utter some words, but not engage in conversation).
The behaviors exhibited are generally simple and repetitive actions (such as getting up, sitting down, or eating).

There are, of course, rare cases where individuals may get up and converse with others, but their speech may be vague or confused, and they might respond to questions or follow instructions to return to bed.
This bears some similarities to your brother's condition, but there are also differences.
Generally, sleepwalking first occurs in childhood and tends to resolve by adolescence (rarely beyond the age of fifteen).
If sleepwalking appears in adulthood, it is important to assess for potential neurological issues or the possibility of substance abuse.
I recommend that you accompany your brother to a neurologist or psychiatrist for further evaluation and testing (such as a sleep EEG).
Wishing you peace and joy.

Reply Date: 2001/02/07

More Info

Sleepwalking, or somnambulism, is a type of parasomnia that typically occurs during deep sleep, particularly in the non-REM (rapid eye movement) stages. It is characterized by a person walking or performing other complex behaviors while in a state of sleep, often with little or no awareness of their actions. While it is more common in children, sleepwalking can persist into adolescence and adulthood, as seen in your brother's case.

1. Is He a Sleepwalker?
Based on your description, it seems likely that your brother is experiencing sleepwalking episodes. The fact that he engages in conversations, albeit with confused speech, and does not remember these interactions upon waking aligns with typical sleepwalking behavior. Sleepwalkers often appear awake and can perform tasks, but they are not fully conscious and usually have no memory of the event afterward.

2. Is Continuing Sleepwalking in Adulthood a Health Issue?
While sleepwalking is often associated with childhood, it can continue into adulthood for some individuals. In adults, persistent sleepwalking may be linked to various factors, including:
- Genetics: A family history of sleepwalking or other sleep disorders can increase the likelihood of experiencing similar issues.

- Sleep Deprivation: Lack of adequate sleep can trigger sleepwalking episodes.

- Stress and Anxiety: High levels of stress or anxiety can disrupt sleep patterns and contribute to parasomnias.

- Substance Use: Alcohol and certain medications can affect sleep architecture and may lead to sleepwalking.

- Underlying Sleep Disorders: Conditions such as sleep apnea or restless leg syndrome can also contribute to sleepwalking.

If your brother's sleepwalking episodes are frequent or pose a risk of injury, it is advisable to seek medical evaluation.

3. Which Specialist Should He See?
For a comprehensive evaluation, your brother should consider consulting a sleep specialist. This could be a physician trained in sleep medicine, who can conduct a thorough assessment, including:
- Sleep History: A detailed account of his sleep patterns, behaviors during sleep, and any associated symptoms.

- Polysomnography: A sleep study that records brain waves, oxygen levels, heart rate, and breathing during sleep to identify any abnormalities.

- Assessment of Lifestyle Factors: Evaluating stress levels, sleep hygiene, and any medications or substances that may affect sleep.

Additional Considerations
In addition to seeking professional help, there are several strategies that may help manage sleepwalking:
- Improving Sleep Hygiene: Encourage a regular sleep schedule, a comfortable sleep environment, and relaxation techniques before bedtime.

- Reducing Stress: Engaging in stress-reducing activities, such as mindfulness, yoga, or exercise, may help improve overall sleep quality.

- Safety Measures: If sleepwalking episodes are frequent, consider implementing safety measures at home, such as securing windows and doors and removing sharp objects from the vicinity.

In conclusion, while sleepwalking can persist into adulthood, it is essential to evaluate the underlying causes and potential risks associated with the behavior. Consulting a sleep specialist will provide your brother with the best chance of understanding and managing his condition effectively.

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