Sleepwalking Treatment & Management
- Author: Syed M S Ahmed, MD; Chief Editor: Selim R Benbadis, MD more...
General management principles include the following:
- Reassurance is the mainstay of treatment; the clinician should emphasize that in most cases, sleepwalking behavior is benign nature and will eventually disappear
- An attempt should be made to identify and eliminate any environmental or predisposing factors that may be present; this may include ensuring adequate sleep, regulating the sleep cycle, and treating any underlying medical conditions (eg, gastroesophageal reflux, obstructive sleep apnea, periodic leg movements, or seizures)
- Auditory, tactile, and visual stimuli should be avoided early in the sleep cycle; these induce events in some patients with parasomnias
- Parents should be instructed to lock windows and doors, remove obstacles and sharp objects from the room, and add alarms (if necessary) to reduce the likelihood of injury during an episode
- Depending on the situation, comforting the child and gently redirecting him or her to bed may be appropriate; attempts to confront or awaken the patient during the events frequently lengthen the parasomnia episode and may be met with resistance or even violence
- Pharmacologic therapy typically is not indicated for sleepwalking
- Sleepwalking associated with sleep-disordered breathing may improve or resolve with surgical treatment of the respiratory disorder
For long-term management, relaxation techniques, mental imagery, and anticipatory awakenings are preferred. The first 2 techniques should be undertaken only with the help of an experienced behavioral therapist or hypnotist. Anticipatory awakenings consist of waking the child approximately 15-20 minutes before the usual time of an event and then keeping him or her awake through the time during which the episodes usually occur. Ongoing reassurance should be provided at regular health maintenance visits.
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