The sleepwalking can then take an agitated form, again sometimes worsened by attempts to intervene and with an even greater risk of injury from crashing through windows or glass doors, for example. In later childhood, adolescence or adult life, the wandering may extend further within the house or outside. from falling downstairs) is a substantial risk. Urinating in inappropriate places is not uncommon.Īccidental injury in sleepwalking (e.g. Quite complicated routes may be followed if well known to the child, or other complex habitual behaviour may occur. Some children are found asleep in various parts of the house. The child may appear downstairs or may be found standing on the landing or elsewhere in the house, looking vague with eyes open but with a glassy stare. At a later age he may calmly walk around his room or into other parts of the house such as to the toilet, towards a light or to his parents' bedroom. ![]() The young child may crawl or walk about in his cot. Episodes, which seldom last more than 10 minutes, tend to be less dramatic than confusional arousals. The condition usually ceases spontaneously by adolescence. Sleepwalking is said to occur in up to 17% of children, mainly between 4 and 8 years of age. Causes of such deep sleep include medication effects, recovery from sleep deprivation and other sleep disorders characterized by excessive sleepiness or abnormal circadian sleep-wake patterns. Each episode usually lasts 5-15 minutes (though it can be much longer) before the child calms down spontaneously and returns to restful sleep.Ĭonfusional arousals in adults (`sleep drunkenness') can occur on waking from particularly deep sleep. Such efforts may actually prolong the arousal and, if the child is woken to some extent, he is likely to be confused and frightened. In this and the other types of arousal, parents are often very alarmed and, wanting to console, may make vigorous attempts to waken the child, without success or only with great difficulty. Although appearing alert, the child typically does not respond when spoken to, and more forceful attempts to intervene may meet with resistance and increased agitation. An episode may begin with movements and moaning and then progress to agitated and confused behaviour with crying, calling out or thrashing about. This type of arousal disorder occurs mainly in infants and toddlers, perhaps most of whom have such episodes to some degree. In predisposed individuals, the arousal may be precipitated by such factors as a febrile illness, central nervous system depressant medication sometimes combined with alcohol, sleep loss or disruption in which SWS is increased (as in some other sleep disorders such as obstructive sleep apnoea) or psychological stress. Often there is a strong family history of an arousal disorder. However, repeated episodes sometimes occur throughout the night. Usually, only one episode occurs on the night in question, within two hours or so of going to sleep when SWS is most prevalent. ![]() The patient remains asleep during the episode itself, although waking sometimes at the end of it. Various behaviours can occur, from simply sitting up in bed and mumbling to rushing about in a highly agitated state. ![]() Arousal in this context does not mean that the patient wakes up fully in fact, the arousal is partial, usually from deep non-rapid-eye-movement (NREM) sleep (otherwise known as slow wave sleep or SWS) to a lighter stage of NREM sleep or REM sleep. The so-called arousal disorders are common in children but are by no means rare in adults.
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