Sleepwalking: Symptoms and Insights from a Psychiatric Perspective

Is it sleepwalking?

Hello, Dr.
Su.
Let me first explain my "original" condition.
I have always had difficulty falling asleep, often taking more than half an hour to do so (unless I slept less than four hours the previous night or engaged in intense physical activity, which would make me so tired that I could fall asleep immediately).
I have also experienced mild sleepwalking symptoms since childhood, such as sitting up in bed and mumbling to myself at night; sometimes it's a clear phrase, and other times it's vague.
As a child, I would get up, go downstairs, and open doors, but as I grew older, I mostly just sat up and talked.
Recently, since moving in with my boyfriend, who goes to bed later than I do, he has observed my sleep patterns.
He mentioned that after I fall asleep (he pokes me to check if I'm unresponsive), if he asks me to do something, I will comply (but still appear to be in a sleep state).
For example, when he says "hug," I will turn and lean against his shoulder; when he says "pull up the blanket," I will adjust the blanket.
One time, I sat up halfway through my sleep with my eyes open, and when he asked why I got up, I said I wanted to cook (but I didn’t actually get out of bed), and then I just lay back down.
Of course, when I woke up, I remembered nothing and had no dreams.
I recall that sleepwalking typically does not involve responding to questions from those around, as I would not answer my parents when they asked why I was getting up to go downstairs when I was a child.
Is this also a form of sleepwalking? Thank you for reading!

Miss Lin, 20~29 year old female. Ask Date: 2015/10/21

Dr. Su Zongwei reply Psychiatry

Yes.

Reply Date: 2015/10/21

More Info

Sleepwalking, or somnambulism, is a fascinating and complex phenomenon that falls under the broader category of sleep disorders. It typically occurs during non-REM (Rapid Eye Movement) sleep, particularly in the deeper stages of sleep. Your description of your experiences aligns with common symptoms of sleepwalking, and it is important to understand the nuances of this condition from a psychiatric and medical perspective.

Symptoms of Sleepwalking
1. Involuntary Actions: Sleepwalking often involves performing complex behaviors while in a state of sleep. This can range from simple actions like sitting up in bed to more complicated behaviors such as walking around the house, opening doors, or even cooking, as you described. The key characteristic is that the individual is not fully awake and typically has no memory of these actions upon waking.

2. Partial Awareness: In some cases, individuals may exhibit a degree of responsiveness to external stimuli, which can lead to confusion. For instance, if your boyfriend prompts you to perform certain actions while you are sleepwalking, your brain may respond to those commands, but you remain in a sleep state. This phenomenon can be perplexing, as it blurs the lines between sleep and wakefulness.

3. Lack of Memory: A hallmark of sleepwalking is the absence of memory regarding the episode. You mentioned waking up with no recollection of your actions, which is typical for sleepwalkers. This lack of awareness can lead to safety concerns, especially if the individual engages in potentially dangerous activities.

Understanding the Causes
Sleepwalking can be triggered by various factors, including:
- Sleep Deprivation: Chronic difficulty in falling asleep, as you described, can lead to sleep deprivation, which is a known risk factor for sleepwalking. When the body is overly fatigued, it may enter deeper sleep stages more readily, increasing the likelihood of sleepwalking episodes.

- Stress and Anxiety: Emotional stressors, such as changes in living situations or relationship dynamics, can exacerbate sleep disturbances. Your recent transition to living with your boyfriend may have introduced new stressors that could influence your sleep patterns.

- Genetic Predisposition: There is evidence suggesting that sleepwalking can run in families. If you have a family history of sleep disorders, this could increase your likelihood of experiencing similar issues.

Recommendations for Management
1. Sleep Hygiene: Establishing a consistent sleep routine can significantly improve your sleep quality. Aim to go to bed and wake up at the same time each day, create a calming bedtime environment, and limit exposure to screens before sleep.

2. Stress Management: Engaging in relaxation techniques such as mindfulness, meditation, or yoga can help alleviate stress and anxiety, potentially reducing the frequency of sleepwalking episodes.

3. Consult a Sleep Specialist: Given the complexity of your symptoms and their impact on your daily life, it may be beneficial to consult a sleep specialist. They can conduct a sleep study (polysomnography) to monitor your sleep patterns and provide a more accurate diagnosis.

4. Safety Precautions: Since sleepwalking can pose safety risks, consider implementing measures to ensure your safety during episodes. This might include securing windows and doors, removing sharp objects from your sleeping area, and informing your boyfriend about your condition so he can assist if necessary.

Conclusion
Your experiences suggest that you may indeed be experiencing a form of sleepwalking, characterized by involuntary actions and a lack of memory. It is essential to address both the sleepwalking and the underlying sleep difficulties you face. By improving your sleep hygiene, managing stress, and seeking professional guidance, you can work towards better sleep quality and reduce the occurrence of sleepwalking episodes. Remember, you are not alone in this, and there are effective strategies and treatments available to help you navigate these challenges.

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