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Friday, August 20, 2010

What is Sleepwalking and its Causes ?

[Extracted from the website of health-cares.net]

Sleepwalking is one mainfestation of the fact that in sleep, certain parts of the brain may not "shut down" properly and sporadically cause outward signs of brain activity. Other examples of this sort of activity are sleeptalking and night terrors. They are techinically disorders of incomplete arousal. Activities such as eating, dressing or even driving cars have also been recorded as taking place while the subjects are technically asleep. There are even very rare instances of sleepwalkers, unknowingly, committing murder while in this trance-like condition. Most cases of sleepwalking, however, usually consist of walking, without the conscious knowledge of the subject.


Sleepwalking is a disorder characterized by complicated actions that result in walking during sleep. Sleepwalkers engage in their activities with their eyes open so they can navigate their surroundings, not with their eyes closed and their arms outstretched as parodied in cartoons and Hollywood productions. The victims eyes may have a glazed or empty appearance and if questioned, the subject will be slow to answer or unresponsive.

Sleepwalking behavior can range from simply getting out of bed and walking around the room to driving a car. Sleepwalking usually occurs during the slow-wave stages of non–rapid eye movement (NREM) sleep (stages of sleep in which eye movement does not take place. Persons affected with this disorder usually have their eyes wide open in a stare.


Causes of Sleepwalking

The normal sleep cycle involves distinct stages from light drowsiness to deep sleep. Rapid eye movement (REM) sleep is a different type of sleep, in which the eyes move rapidly and vivid dreaming is most common. During a night, there will be several cycles of non-REM and REM sleep. Sleep walking (somnambulism) most often occurs during deep non-REM sleep (stage 3 or stage 4 sleep) early in the night. It can occur during REM sleep near morning.

In children, the cause is usually unknown but may be related to fatigue, prior sleep loss, or anxiety. In adults, sleep walking is usually associated with a disorder of the mind but may also be seen with reactions to drugs and alcohol, and medical conditions such as partial complex seizures. In the elderly, sleep walking may be a symptom of an organic brain syndrome or REM behavior disorders. The sleep walking activity may include simply sitting up and appearing awake while actually asleep, getting up and walking around, or complex activities such as moving furniture, going to the bathroom, dressing and undressing, and similar activities.

Some people even drive a car while actually asleep. The episode can be very brief (a few seconds or minutes) or can last for 30 minutes or longer. Experts believe that sleepwalking probably results from immaturity in the brain's regulation of sleep/wake cycles. Most children outgrow the symptoms as their nervous systems develop. Sleepwalking that begins later in life or persists into adulthood may have psychological causes such as extreme stress or, rarely, medical causes such as epilepsy.

One common misconception is that a sleep walker should not be awakened. It is not dangerous to awaken a sleep walker, although it is common for the person to be confused or disoriented for a short time on awakening. Another misconception is that a person cannot be injured when sleep walking. Actually, injuries caused by such things as tripping and loss of balance are common for sleep walkers. Sleep walking occurs at any age, but it occurs most often in children aged 6 to 12. It may occur in younger children, in adults, or in the elderly, and it appears to run in families.


Symptoms of Sleepwalking

One of the key signs is walking or moving about during sleep. Sleepwalkers engage in their activities with their eyes open so they can navigate their surroundings, not with their eyes closed and their arms outstretched as parodied in cartoons and Hollywood productions. The victims eyes may have a glazed or empty appearance and if questioned, the subject will be slow to answer or unresponsive. Difficulty in arousing the patient during a sleepwalking episode with amnesia following waking. Sleepwalking typically occures in the first third of a sleep episode.

Sleeptalking may also take place during a sleepwalking episode. Although, sleeptalking during sleepwalking will most likely result in incomprehensible muttering. The range of sleepwalking actions can range from a simple act of sitting up in bed, to getting up running around and screaming. Sleepwalking episodes usually occur one to two hours after going to sleep and last from one to 30 minutes. A sleepwalker has open eyes and a blank expression, and is usually difficult, if not impossible, to awaken. The next morning, he or she won't remember the episode.


How is Sleepwalking diagnosed ?

Usually, no further examination and testing is necessary. A person's history usually provides enough information for a doctor to diagnose sleepwalking, especially in children. More difficult cases may require a consultation with a sleep specialist and an overnight sleep test called polysomnography. If sleep walking is frequent or persistent, examination to rule out other disorders (such as partial complex seizures) may be appropriate. It may also be appropriate to undergo a psychologic evaluation to determine causes such as excessive anxiety or stress, or medical evaluation to rule out other causes.

What's the treatment for Sleepwalking ?

Usually no specific treatment for sleep walking is needed. If sleepwalking is caused by underlying medical conditions, for example, gastroesophageal reflux, obstructive sleep apnea[Image], periodic leg movements (restless leg syndrome), or seizures, the underlying medical condition should be treated. Safety measures may be necessary to prevent injury. This may include modifying the environment by moving objects such as electrical cords or furniture to reduce tripping and falling. Stairways may need to be blocked off with a gate. In some cases, short-acting tranquilizers have been helpful in reducing the incidence of sleep walking.




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