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Sleep walking disorder

Last edited: 4/13/2026

Overview

Sleepwalking disorder, also known as somnambulism, involves complex behaviors performed during sleep without full awareness, often including walking around and potentially engaging in activities that can be hazardous. 40

Diagnosis

  • Clinical Presentation: Episodes of complex behaviors occurring during sleep, often involving ambulation.
  • History and Symptoms: Detailed patient history focusing on sleep behaviors, family history of sleep disorders, and associated symptoms like confusion post-episode.
  • Sleep Diaries: Utilization of sleep diaries to track patterns and frequency of episodes.
  • Polysomnography (PSG): Recommended for definitive diagnosis, assessing brain waves, muscle activity, and eye movements during episodes. 60

    • Management

  • Environmental Safety Measures: Ensuring a safe sleep environment to prevent injury during episodes.
  • Behavioral Therapies: Cognitive-behavioral therapy for insomnia (CBT-I) may help reduce frequency and severity when comorbid insomnia is present.
  • Medications: Benzodiazepines or similar hypnotics may be used cautiously for severe cases, though evidence is limited and risks must be weighed against benefits. (Evidence: Expert opinion) 17

    • Special Populations

  • Pregnancy: Limited data; management focuses on minimizing risks and ensuring a safe environment. 55
  • Pediatrics: Common in children, often improving with age; parental education and safety measures are crucial. 40
  • Elderly: Increased risk due to comorbid conditions; management includes addressing underlying sleep disorders and environmental safety. 44

    • Key Recommendations

  • Conduct Polysomnography for Definitive Diagnosis: Essential for confirming sleepwalking disorder and ruling out other sleep disorders. (Evidence: Moderate) 60
  • Implement Environmental Safety Measures: To prevent injuries during sleepwalking episodes. (Evidence: Expert opinion)
  • Consider Behavioral Therapies for Comorbid Insomnia: CBT-I can be beneficial if insomnia coexists with sleepwalking. (Evidence: Moderate) 60

    • References

    1 Oliver JJ, Ediger DS, Phelps JF, Hoffman AL, Martin AW, Martin SA et al.. Factors impacting military emergency medicine residents' sleep and barriers to seeking help: A sequential exploratory mixed-methods study. The American journal of emergency medicine 2025. link 2 Song M, McHill AW, Dieckmann NF, Musil CM, Hayman LL. Association Between Adverse Childhood Experiences and Sleep Duration in US Children: Analysis of 2020-2021 National Survey of Children's Health. The Journal of cardiovascular nursing 2025. link 3 Erickson TS, Durr ML. Sleep & Wellness for the Otolaryngologist. Otolaryngologic clinics of North America 2025. link 4 Wilder J, Lauderdale D, Qato DM. Use of Medications With Somnolence Adverse Effects and Somnolence Symptoms Among Older Adults in the U.S. Journal of aging and health 2025. link 5 Dai Y, Liu J. Neighborhood predictors of short sleep duration and bedtime irregularity among children in the United States: results from the 2019-2020 National Survey of Children's Health. World journal of pediatrics : WJP 2024. link 6 Acosta CG, Ye Y, Wong KLY, Zhao Y, Lawrence J, Towell M et al.. Implementing AI-Driven Bed Sensors: Perspectives from Interdisciplinary Teams in Geriatric Care. Sensors (Basel, Switzerland) 2024. link 7 Santos-Orlandi AAD, Ottaviani AC, Alves EDS, Brito TRP, Inouye K. Sleep quality of vulnerable elderly people: associated factors. Revista brasileira de enfermagem 2024. link 8 Menezes-Júnior LAA, Sabião TDS, Moura SS, Batista AP, Menezes MC, Carraro JCC et al.. The role of interaction between vitamin D and VDR FokI gene polymorphism (rs2228570) in sleep quality of adults. Scientific reports 2024. link 9 Howell M, Avidan AY, Foldvary-Schaefer N, Malkani RG, During EH, Roland JP et al.. Management of REM sleep behavior disorder: an American Academy of Sleep Medicine clinical practice guideline. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine 2023. link 10 Babbar S, Williams KB, Cheng AL. Sleep among Obstetrics and Gynecology Trainees: Results from a Yoga-Based Wellness Initiative. American journal of perinatology 2023. link 11 Rouhani P, Lotfi K, Anjom-Shoae J, Hajhashemi Z, Mokhtari E, Heidari Z et al.. Association between patterns of nutrient intake and circulating vitamin D with sleep status among Iranian adults. Scientific reports 2023. link 12 de Menezes-Júnior LAA, Sabião TDS, de Moura SS, Batista AP, de Menezes MC, Carraro JCC et al.. Influence of sunlight on the association between 25-hydroxyvitamin D levels and sleep quality in Brazilian adults: A population-based study. Nutrition (Burbank, Los Angeles County, Calif.) 2023. link 13 Huang G, Lee TY, Banda KJ, Pien LC, Jen HJ, Chen R et al.. Prevalence of sleep disorders among first responders for medical emergencies: A meta-analysis. Journal of global health 2022. link 14 Hill VM, Rebar AL, Ferguson SA, Shriane AE, Vincent GE. Go to bed! A systematic review and meta-analysis of bedtime procrastination correlates and sleep outcomes. Sleep medicine reviews 2022. link 15 Hash JB, Alfano CA, Owens J, Littlewood K, Day A, Pandey A et al.. Call to action: Prioritizing sleep health among US children and youth residing in alternative care settings. Sleep health 2022. link 16 Minich DM, Henning M, Darley C, Fahoum M, Schuler CB, Frame J. Is Melatonin the "Next Vitamin D"?: A Review of Emerging Science, Clinical Uses, Safety, and Dietary Supplements. Nutrients 2022. link 17 Meng L, Huang J, He Q, Zhao Y, Zhao W, Tan J et al.. Hypnotics and infections: disproportionality analysis of the U.S. Food & Drug Administration adverse event reporting system database. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine 2022. link 18 Huang Y, Xu J, Zheng S, Xu S, Wang Y, Du J et al.. The risk factors for insomnia and sleep-disordered breathing in military communities: A meta-analysis. PloS one 2021. link 19 Schibler U. PARP-1 drives slumber: A reciprocal relationship between sleep homeostasis and DNA damage repair. Molecular cell 2021. link 20 Tsao HS, Gjelsvik A, Sojar S, Amanullah S. Sounding the Alarm on Sleep: A Negative Association Between Inadequate Sleep and Flourishing. The Journal of pediatrics 2021. link 21 Engel R, Chung MT, Johnson J, Stathakios J, Chang ET, Waxman J et al.. Fellow selection protocols in sleep surgery: a national survey of sleep surgery program directors. Sleep & breathing = Schlaf & Atmung 2021. link 22 Yu PK, Gadkaree SK, Li J, McCarty JC, Huyett P, Bergmark RW. Characteristics of the Dual Board-Certified Sleep Otolaryngology Workforce. The Laryngoscope 2021. link 23 Cammaroto G, Bianchi G, Zhang H, Veer V, Kotecha B, Jacobowitz O et al.. Sleep medicine in otolaryngology units: an international survey. Sleep & breathing = Schlaf & Atmung 2021. link 24 Beydoun MA, Ng AE, Fanelli-Kuczmarski MT, Hossain S, Beydoun HA, Evans MK et al.. Vitamin D status and its longitudinal association with changes in patterns of sleep among middle-aged urban adults. Journal of affective disorders 2021. link 25 Robertson BD, Collen JC. Sleep touches everything. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine 2020. link 26 Eckert DJ, Sweetman A. Impaired central control of sleep depth propensity as a common mechanism for excessive overnight wake time: implications for sleep apnea, insomnia and beyond. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine 2020. link 27 Sierro C, Leslie W, Putois B. Long-term effects of treatment for chronic nightmares: is imagery rehearsal therapy robust in the COVID-19 pandemic?. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine 2020. link 28 Belmon LS, Brasser FB, Busch V, van Stralen MM, Harmsen IA, Chinapaw MJM. Perceived Determinants of Children's Inadequate Sleep Health. A Concept Mapping Study among Professionals. International journal of environmental research and public health 2020. link 29 Padiyara TV, Bansal S, Jain D, Arora S, Gandhi K. Dexmedetomidine versus propofol at different sedation depths during drug-induced sleep endoscopy: A randomized trial. The Laryngoscope 2020. link 30 Lin MH, Huang YC, Chen WK, Wang JY. Sleepiness and injury risk in emergency medical service workers in Taiwan. PloS one 2020. link 31 Harbourt K, Nevo ON, Zhang R, Chan V, Croteau D. Association of eszopiclone, zaleplon, or zolpidem with complex sleep behaviors resulting in serious injuries, including death. Pharmacoepidemiology and drug safety 2020. link 32 Javaheri S, Gay PC. To Die, to Sleep - to Sleep, Perchance to Dream…Without Hypertension: Dreams of the Visionary Christian Guilleminault Revisited. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine 2019. link 33 Jacobowitz O, Woodson BT. A New Metric for Precision Medicine: PAP and Hypoglossal Neurostimulation. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine 2019. link 34 Durduran Y, Pekcan S, Çolpan B. Sleep habits and related factors in kindergarten children. Nigerian journal of clinical practice 2019. link 35 Moorman JD, Harrison K. Beyond Access and Exposure: Implications of Sneaky Media Use for Preschoolers' Sleep Behavior. Health communication 2019. link 36 Dunn LK, Kleiman AM, Forkin KT, Bechtel AJ, Collins SR, Potter JF et al.. Anesthesiology Resident Night Float Duty Alters Sleep Patterns: An Observational Study. Anesthesiology 2019. link 37 Ruda JM, Payne L, May A, Splaingard M, Lemle S, Jatana KR. Improving Communication Delay of Outpatient Sleep Study Results to Pediatric Otolaryngology Patients and Families. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery 2019. link 38 Carvalho KM, Figueiredo MDLF, Galindo Neto NM, Sá GGM. Construction and validation of a sleep hygiene booklet for the elderly. Revista brasileira de enfermagem 2019. link 39 Stenveld F, Bosman S, van Munster BC, Beishuizen SJ, Hempenius L, van der Velde N et al.. Melatonin, temazepam and placebo in hospitalised older patients with sleeping problems (MATCH): a study protocol of randomised controlled trial. BMJ open 2019. link 40 Arnulf I. Sleepwalking. Current biology : CB 2018. link 41 Kohyama J, Anzai Y, Ono M, Kishino A, Tamanuki K, Takada K et al.. Insufficient sleep syndrome: An unrecognized but important clinical entity. Pediatrics international : official journal of the Japan Pediatric Society 2018. link 42 Lehtinen MK. Say good night to your pain. Science translational medicine 2017. link 43 . Nocturnal sleep architecture is altered by sleep bruxism. British dental journal 2017. link 44 Dean GE, Weiss C, Morris JL, Chasens ER. Impaired Sleep: A Multifaceted Geriatric Syndrome. The Nursing clinics of North America 2017. link 45 Santander P, Sievers D, Moser N. Sleep-related breathing disorders and dentistry: What is the relationship?. Quintessence international (Berlin, Germany : 1985) 2016. link 46 Nguyen-Michel VH, Vecchierini MF. Exploration of sleep disorders in the elderly: which particularities?. Geriatrie et psychologie neuropsychiatrie du vieillissement 2016. link 47 Anderson KN. An update in sleep neurology: the latest bedtime stories. Journal of neurology 2015. link 48 . Yoga helps residents sleep easy. Nursing standard (Royal College of Nursing (Great Britain) : 1987) 2015. link 49 Richter E, Blasco V, Antonini F, Rey M, Reydellet L, Harti K et al.. Sleep disorders among French anaesthesiologists and intensivists working in public hospitals: a self-reported electronic survey. European journal of anaesthesiology 2015. link 50 Gleason K, McCall WV. Current Concepts in the Diagnosis and Treatment of Sleep Disorders in the Elderly. Current psychiatry reports 2015. link 51 Lande RG, Gragnani C. Relationships between polypharmacy and the sleep cycle among active-duty service members. The Journal of the American Osteopathic Association 2015. link 52 McCarty DE, Chesson AL, Jain SK, Marino AA. The link between vitamin D metabolism and sleep medicine. Sleep medicine reviews 2014. link 53 Uehli K, Miedinger D, Bingisser R, Dürr S, Holsboer-Trachsler E, Maier S et al.. Sleep problems and work injury types: a study of 180 patients in a Swiss emergency department. Swiss medical weekly 2013. link 54 Morris CJ, Aeschbach D, Scheer FA. Circadian system, sleep and endocrinology. Molecular and cellular endocrinology 2012. link 55 Hansen AM, Thomsen JF, Kaergaard A, Kolstad HA, Kaerlev L, Mors O et al.. Salivary cortisol and sleep problems among civil servants. Psychoneuroendocrinology 2012. link 56 Neikrug AB, Ancoli-Israel S. Sleep disturbances in nursing homes. The journal of nutrition, health & aging 2010. link 57 Shneerson JM. Sleep violence. British journal of hospital medicine (London, England : 2005) 2009. link 58 McBeth BD, McNamara RM, Ankel FK, Mason EJ, Ling LJ, Flottemesch TJ et al.. Modafinil and zolpidem use by emergency medicine residents. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine 2009. link 59 Schredl M. Snoring, breathing pauses, and nightmares. Perceptual and motor skills 2008. link 60 Hirshkowitz M, Sharafkhaneh A. Clinical and technologic approaches to sleep evaluation. Neurologic clinics 2005. link 61 Cole RJ. Nonpharmacologic techniques for promoting sleep. Clinics in sports medicine 2005. link 62 Lydic R, Baghdoyan HA. Sleep, anesthesiology, and the neurobiology of arousal state control. Anesthesiology 2005. link 63 Culebras A. Who should be tested in the sleep laboratory?. Reviews in neurological diseases 2004. link 64 Ciriello J, Rosas-Arellano MP, Solano-Flores LP, de Oliveira CV. Identification of neurons containing orexin-B (hypocretin-2) immunoreactivity in limbic structures. Brain research 2003. link04233-6) 65 Scher A, Amir T, Tirosh E. Object concept and sleep regulation. Perceptual and motor skills 2000. link 66 Jones TM, Swift AC. Snoring: recent developments. Hospital medicine (London, England : 1998) 2000. link 67 Osman EZ, Osborne J, Hill PD, Lee BW. Snoring assessment: do home studies and hospital studies give different results?. Clinical otolaryngology and allied sciences 1998. link 68 Mendelson WB. Experiences of a sleep disorders center: 1700 patients later. Cleveland Clinic journal of medicine 1997. link 69 Pichard L, Gillet G, Bonfils C, Domergue J, Thénot JP, Maurel P. Oxidative metabolism of zolpidem by human liver cytochrome P450S. Drug metabolism and disposition: the biological fate of chemicals 1995. link 70 Feinsilver SH, Hertz G. Sleep in the elderly patient. Clinics in chest medicine 1993. link 71 Hicks RA, Bautista J. Snoring and nightmares. Perceptual and motor skills 1993. link 72 Leung AK, Robson WL. The ABZzzzs of snoring. Postgraduate medicine 1992. link 73 Kurtz D. How much polysomnography is enough?. Lung 1990. link 74 Cohn MA. The development of a sleep disorders laboratory. Otolaryngologic clinics of North America 1990. link 75 Berlin RM. Sleepwalking disorder during pregnancy: a case report. Sleep 1988. link 76 West P, Kryger MH. Sleep and respiration: terminology and methodology. Clinics in chest medicine 1985. link 77 Wilson K, Mulrooney T, Gawtry RR. Snoring: an acoustic monitoring technique. The Laryngoscope 1985. link 78 Akerstedt T. Shifted sleep hours. Annals of clinical research 1985. link 79 Goode GB, Slyter HM. Daytime polysomnogram diagnosis of sleep disorders. Journal of neurology, neurosurgery, and psychiatry 1983. link 80 Cavagna GA, Franzetti P. Mechanics of competition walking. The Journal of physiology 1981. link 81 Crisp AH. Sleep, activity, nutrition and mood. The British journal of psychiatry : the journal of mental science 1980. link 82 Walker JM, Floyd TC, Fein G, Cavness C, Lualhati R, Feinburg I. Effects of exercise on sleep. Journal of applied physiology: respiratory, environmental and exercise physiology 1978. link

    Original source

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      Implementing AI-Driven Bed Sensors: Perspectives from Interdisciplinary Teams in Geriatric Care. — Acosta CG, Ye Y, Wong KLY, Zhao Y, Lawrence J, Towell M et al. Sensors (Basel, Switzerland) (2024)
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