Sleepwalking & Insomnia: The Link?

From globalvillagespace.com 

On May 9, 2023, an article was published discussing the potential link between sleepwalking and insomnia. Sleepwalking, also known as somnambulism, is a parasomnia that affects approximately 4% of the United States population. However, many people may not even be aware that they sleepwalk. Sleepwalking occurs when an individual is briefly aroused from non-rapid eye movement sleep, which is a deeply restful stage that helps restore body tissue and repair important body functions. According to Kenneth Lee, MD, an assistant professor of neurology and sleep medicine and clinical medical director at the UChicago Medicine Sleep Centre, sleepwalking typically occurs when an individual is no longer fully asleep but also not fully awake. In addition, individuals who experience sleep apnoea or leg movements are at risk for episodes of sleepwalking.

Sleepwalking usually occurs during the first third of the night, and individuals who sleepwalk are unable to think, plan, or function properly. They are unaware of their surroundings and cannot remember any dreams they may have had while sleepwalking. Many doctors believe that a lack of sleep is a major cause of sleepwalking. If an individual has insomnia, it can be hard for their brain and body to pass between sleep stages. When they do get to sleep, they may not settle into deep enough sleep, and their brain can get “tricked” into thinking their body should be active.

Risk factors for sleepwalking include children, as they have more non-rapid eye movement sleep than adults. However, sleepwalking can sometimes continue into adulthood and is usually associated with certain medications such as benzodiazepines and antidepressants. Psychological trauma could also be a contributing factor to episodes of sleepwalking. Sleepwalking can run in families, especially if one or both parents have experienced it. Other potential risk factors include drinking alcohol, having gastroesophageal reflux disease (GERD), having a fever, being stressed, and having a seizure disorder.

According to Jordan Standlee, MD, a neurologist at the University of Michigan Health and a clinical assistant professor of neurology at the University of Michigan Medical School in Ann Arbor, our mental state has an impact on sleep quality. During periods of high situational stress, our brains have a more active fight-or-flight signal, and this often carries over into the sleep period, where our brains have a harder time achieving deep, relaxed, stable sleep. Many people who sleepwalk will report that it happens more often during periods when they are especially stressed or worried.

Signs of sleepwalking include walking during sleep, having your eyes open with a blank look on your face, talking but not making sense, acting confused or aggressive if someone wakes you up, appearing awake to others, sitting up or engaging in activities as though you were awake, and not remembering anything that happened when you wake up.

While insomnia on its own doesn’t directly cause sleepwalking, there are at least four major ways in which the two conditions interact. These ways are a disruptive sleep environment, periods of “situational stress,” sleep apnoea, and medication effects. Sleepwalking has strong genetic factors, meaning some people are inherently more at risk for this symptom. It tends to arise not from deep, stable sleep but rather from disrupted and twilight sleep. Sleepwalking also occurs more when someone is sleeping in a foreign environment, like in a hotel room, or in the setting of sleep deprivation. 

Distractions in your sleeping environment can make things worse. Noise or light in the room can cause both insomnia and sleepwalking, particularly having a television on in the bedroom throughout the night. It is hard for the brain to stay in deep, stable sleep while this kind of light or noise is present, and the result can be either recurrent full awakenings – insomnia – or partial awakenings, which predispose you to sleepwalking. Some of the common medications used to treat insomnia can themselves cause sleepwalking. Sedating medications such as zolpidem, eszopiclone, zaleplon, suvorexant, lemborexant, and daridorexant have all been described to cause complex sleep behaviours, meaning sleepwalking, as well as other sleep activities such as cooking and eating food, making phone calls, and driving while asleep.

If an individual experiences a sleepwalking episode, they should talk to their doctor. A sleep study needs to happen, and safety measures need to be taken. For example, if an individual lives in a two-story home, they want to put up a barrier to their stairs and lock their windows. Problems falling and staying asleep can also be discussed with a psychologist. The best course of treatment is cognitive-behavioural therapy for severe insomnia. This is a way to retrain your brain and body how to sleep again. Making sure that insomnia is addressed and sleep is consolidated will reduce the risk of sleepwalking. Good sleep hygiene should also be a nightly ritual. Individuals should not eat or exercise close to going to sleep and should stop drinking caffeine for six hours beforehand. Yoga, meditation, and deep breathing can also help. Focusing on being kind to your mind and body can help individuals rest a lot easier.

https://www.globalvillagespace.com/GVS-Health/sleepwalking-insomnia-the-link/