medication/substances: hypnotics, sedatives, alcohol
Underlying conditions that can cause sleepwalking:
narcolepsy (neurological disorder – inability to regulate sleep-wake cycles)
restless legs syndrome (uncontrollable urge to move the legs)
head injury, stroke
gastroesophageal reflux disease
sleeping in unfamiliar surroundings
sleep apnea (abnormal breathing pattern)
restless legs syndrome
a small bladder or bladder nerves that have not yet matured
stressful events (starting school, becoming a big brother/sister)
lack of sufficient levels of vasopressin (anti-diuretic hormone produced by the pituitary gland) – levels normally increase during sleep and reduce the amount of urine produced by the kidneys
urinary tract infections
psychiatric problems (Alzheimer’s disease, dementia)
a family history predisposition: if the parents had bedwetting problems, the child is likely to have them too
Symptoms and signs
getting out of bed and walking around
doing routine activities
not responding/communicating with people they come across
disorientation, confusion after being awakened
falling asleep quickly after
not having any memory of the episode
sleep terrors (night terrors)
during night terrors the person remains asleep
does not remember anything regarding the episode
in primary bedwetting, the child has not regularly stayed dry during sleep for six months
in secondary bedwetting, the child/adult experiences “accidental episodes” at least twice a week for at least three months after they have had dry periods (that have lasted six months)
in the case of urinary tract infections: day-time “accidents”, frequent urination, pink coloration of the urine, pain while urinating
Sleepwalking and Night terrors:
your doctor will perform a physical and psychological examination in order to rule out other conditions such as night-time seizures, panic attacks or other sleep disorders
you can undergo a sleep study: monitoring is done in a laboratory and sensors are attached to the patient (brain waves, heart rate, breathing, oxygen levels are monitored)
if there are underlying conditions, they should be treated to prevent sleepwalking and night terrors
anticipatory awakenings: awaken the person in case 15 minutes before he/she usually sleepwalks
improve sleep habits
medication: benzodiazepines or antidepressants
the matter should be treated with patience, as the event is recorded as being most embarrassing for the child
bedwetting is usually outgrown by children
a doctor will recommend urine tests to see if there are signs of infection or diabetes and also X-rays or imaging tests (to have a look at the bladder and kidneys) if he suspects a structural problem in the child’s urinary system
moisture alarms are available (devices that are connected to a moisture sensitive pad on the child’s pajamas or bedding) and help the child wake before he/she wets the bed
medication: desmopressin (increase the levels of anti-diuretic hormone), anticholinergics (reduce bladder contractions and increase bladder capacity)
limit liquid intake in the evening
avoid foods/drinks that contain caffeine
encourage double-voiding of the bladder before bedtime
alternative therapies: acupuncture, hypnosis
punishing or teasing the child on this matter is of no help, instead parents should encourage and celebrate the child’s effort regarding the matter
You should never wake up a sleepwalker.
A sleepwalker is perfectly aware of what he/she is doing.
Sleepwalking mainly occurs in adults.
Bedwetting is just a sign of laziness.
Bedwetting is a sign of antisocial tendencies.
Night terrors are just bad dreams.
Eating cheese can give you nightmares and night terrors.
Recurrent sleepwalking affects 5% of children and 7% of adults
Prevalence is high in children between the ages of 3 and 8 years old
About 8.4 million Americans sleepwalk each year
In the USA, 1-6% of children experience night terrors
Less than 1% of adults experience frequent night terrors
Bedwetting is twice as common in boys than in girls
Somnambulistic sex behavior (or sexsomnia) is a variation of sleepwalking and can imply all types of sexual activity from sexual vocalizations and masturbating to complex sexual acts.
Sleep-related eating disorder is another variation of sleepwalking that implies binge-eating.
Awakening a sleepwalker is not dangerous but most likely he/she will be confused or agitated after awakening.
Natural sleep aids are not always risk-free. For example, large doses of valerian root can cause dizziness and a sluggish state in the morning.
Bedwetting is more common in children with ADHD.
A small number of the children with primary enuresis don’t produce the additional vasopressin needed during the night.