We keep patients overnight for observation and we use various instruments to help us make a diagnosis such as an electroencephalograph, or EEG. We also use video polygraphic equipment in order to show that the patient does indeed wake up and gets up out of bed,” says Markku Partinen, MD, PhD of Vitalmed Sleep Disorders Clinic and Research Centre in Helsinki. Around 25 per cent of children are sleepwalkers. Riitta, 63, recounts the time when her son Samuli used to walk in his sleep as a 10-year-old.
“Samuli slept in his own room and I once awoke to the sound of him trying to open the door to the balcony. He seemed to mutter something about going to school while he fiddled with the door handle,” Riitta recalls. “His eyes were open, but he didn’t make eye contact. It looked as though he were in some sort of trance. I took him by the hand and said that it wasn’t time to go to school just yet,” she continues.
Similar episodes occurred throughout Samuli’s childhood. “At some stage mum heard that strenuous physical activity within a couple of hours of going to bed increases the likelihood of being active in your sleep, so I wasn’t allowed to play football in the evenings,” Samuli recalls.
Somnambulism attacks
Indeed, a somnablumatic attack is all the more difficult to recount if you have virtually no recollection of what happened during the night. Samuli is now 28 and still sleepwalks. Fairly recently, while on a cruise from Turku to Stockholm with his friends, he experienced another such episode.
“We spent most of the evening in the bar, but I definitely didn’t drink that much before eventually retiring to the lower bunk of my cabin bed,” Samuli explains. “I woke up when the cleaner shook me and told me that we’d already docked at the harbour. I wondered to myself how on earth I’d managed to wake up in the top bunk. I jumped out of bed to discover that my friends were not in the cabin. I thought they must have already left. I couldn’t find my clothes nor any of my other stuff,” Samuli continues. Gradually he figured out that he had managed to sleepwalk his way not only to another part of the ship, but also a completely different cabin to the one he had rented with his friends.
“It felt pretty scary. I have no idea how I managed to make such a long trip and find an empty cabin with an open door in the middle of the night,” says Samuli of his experience on the cruise ship that night.
“Actually, it is quite typical to experience absence of knowledge or even a total blackout of events following somnambulism,” comments Partinen, adding: “Behaviour is strange, and objects in the outside world are confused. For instance, they can jump out of a window, thinking it’s a door, or get hit by a car because they just don’t realise that it is, in fact, a moving object. The risk of injuries is great to anyone sleepwalking.”
What you can do to help
Practical assistance you can offer to someone or someone close to you can be lifesaving. “I would advise locking the windows. In the event of RBD type (REM behaviour disorder), a sleep walking attack with signs of epileptic activity in the brain, fighting and aggressive behaviour may occur, although very rare. In such an event I would advise putting an extra lock on the door of the room where the person sleeps so they can’t get out,” warns Partinen.
Drastic measures are sometimes required as much for the safety of the sleepwalker as for what they may or may not do to someone in the outside world. Indeed, what causes sleepwalking is something of a mystery, albeit a treatable one. “It is partly genetic, partly stress related. Typically, sleepwalking occurs in children between the ages of three and eight and up to 10-year-olds. If there is no medical history of heredity sleepwalking then we must exclude brain disorders,” states Partinen.
Samuli’s mother also recalls how she, while staying with family friends as a 12-year-old, went for a walk in the middle of the night. “I awoke squeezed next to another kid on the lower part of a bunk bed. I immediately tiptoed back to my own bed. I was terribly ashamed, and I didn’t dare tell anybody about it,” she tells.
Treatments are available, although anyone suffering from sleep disorders is advised to consult a specialist first before seeking help. “We may give some medication, for example chlomesatine. If there is epileptic activity then they must seek treatment urgently as it may be a brain disorder. Other sleeping disorders can be treated using sodium valerate,” Partinen prescribes, adding: “Otherwise, avoid heavy exercise in the evening. People should know that sleepwalking is unusual but not untreatable.”
