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Sleepwalking Treatment & Management

  • Author: Syed M S Ahmed, MD; Chief Editor: Selim R Benbadis, MD  more...
 
Updated: Nov 23, 2015
 

Approach Considerations

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.

 
Contributor Information and Disclosures
Author

Syed M S Ahmed, MD Neurologist and Sleep Specialist, Capital Neurology and Sleep Medicine; Staff Attending in Neurology and Sleep Medicine, Montgomery General Hospital; Staff Attending in Neurology and Sleep Medicine, Suburban Hospital

Syed M S Ahmed, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Sleep Medicine, Maryland State Medical Society

Disclosure: Nothing to disclose.

Coauthor(s)

David Bienenfeld, MD Professor, Departments of Psychiatry and Geriatric Medicine, Wright State University, Boonshoft School of Medicine

David Bienenfeld, MD is a member of the following medical societies: American Medical Association, American Psychiatric Association, Association for Academic Psychiatry

Disclosure: Nothing to disclose.

Ariz Anklesaria, DO Resident Physician, Department of Psychiatry, Wright State University, Boonshoft School of Medicine

Ariz Anklesaria, DO is a member of the following medical societies: American Medical Association, American Psychiatric Association

Disclosure: Nothing to disclose.

Chief Editor

Selim R Benbadis, MD Professor, Director of Comprehensive Epilepsy Program, Departments of Neurology and Neurosurgery, Tampa General Hospital, University of South Florida Morsani College of Medicine

Selim R Benbadis, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Sleep Medicine, American Clinical Neurophysiology Society, American Epilepsy Society, American Medical Association

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Cyberonics; Eisai; Lundbeck; Sunovion; UCB; Upsher-Smith<br/>Serve(d) as a speaker or a member of a speakers bureau for: Cyberonics (Livanova); Eisai; Lundbeck; Sunovion; UCB<br/>Received research grant from: Cyberonics (Livanova); GW, Lundbeck; Sunovion; UCB; Upsher-Smith.

Acknowledgements

Iqbal Ahmed, MBBS, FRCPsych (UK) Faculty, Department of Psychiatry, Tripler Army Medical Center; Clinical Professor of Psychiatry, Uniformed Services University of Health Sciences: Clinical Professor of Psychiatry, Clinical Professor of Geriatric Medicine, University of Hawaii, John A Burns School of Medicine

Iqbal Ahmed, MBBS, FRCPsych (UK) is a member of the following medical societies: Academy of Psychosomatic Medicine, American Association for Geriatric Psychiatry, American Neuropsychiatric Association, American Psychiatric Association, American Society of Clinical Psychopharmacology, and Royal College of Psychiatrists

Disclosure: Nothing to disclose.

Ariz Anklesaria, DO Resident Physician, Department of Psychiatry, Wright State University, Boonshoft School of Medicine

Ariz Anklesaria, DO is a member of the following medical societies: American Medical Association and American Psychiatric Association

Disclosure: Nothing to disclose.

David Bienenfeld, MD Professor of Psychiatry, Vice-Chair and Director of Residency Training, Department of Psychiatry, Wright State University, Boonshoft School of Medicine

David Bienenfeld, MD is a member of the following medical societies: American Medical Association, American Psychiatric Association, and Association for Academic Psychiatry

Disclosure: Lippincott Williams Wilkins Royalty Author

Ali M Bozorg, MD Assistant Professor, Comprehensive Epilepsy Program, Department of Neurology, University of South Florida College of Medicine

Ali M Bozorg, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Sleep Medicine, and American Epilepsy Society

Disclosure: Cyberonics Honoraria Speaking and teaching; UCB, Inc. Honoraria Speaking and teaching

Christopher P Karcher, MD, MPH Fellow, Department of Pulmonary, Critical Care, and Sleep Medicine, University of South Florida College of Medicine

Christopher P Karcher, MD, MPH is a member of the following medical societies: American Academy of Neurology, American Academy of Sleep Medicine, American Association of Neuromuscular and Electrodiagnostic Medicine, and American Pain Society

Disclosure: Nothing to disclose.

Kenneth J Mack, MD, PhD Senior Associate Consultant, Department of Child and Adolescent Neurology, Mayo Clinic

Kenneth J Mack, MD, PhD is a member of the following medical societies: American Academy of Neurology, Child Neurology Society, Phi Beta Kappa, and Society for Neuroscience

Disclosure: Nothing to disclose.

Mohammed A Memon, MD Chairman and Attending Geriatric Psychiatrist, Department of Psychiatry, Spartanburg Regional Medical Center

Mohammed A Memon, MD is a member of the following medical societies: American Association for Geriatric Psychiatry, American Medical Association, and American Psychiatric Association

Disclosure: Nothing to disclose.

Anthony M Murro, MD Professor, Laboratory Director, Department of Neurology, Medical College of Georgia

Anthony M Murro, MD is a member of the following medical societies: American Academy of Neurology and American Epilepsy Society

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

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