Sleepwalking, a real eye-opener
Wednesday, September 01, 2004
By Dennis Maurizi :::::::::::::::::::::::::::::::::illustration by Cindy Michalowski
First the bad news: About 15 percent of children-one in seven-will walk in their sleep. Now, the much better news: Almost all children will outgrow it, and there are things a parent can do to help.
So says Rosalind Cartwright, chair of the Department of Psychology at Rush University in Chicago and founding guru of its Sleep Disorder Service.
Cartwright says sleepwalking splits pretty evenly between boys and girls. Actually, it splits pretty evenly most ways: tall vs. short, black vs. white, rich vs. poor, lefty vs. righty.
There really isn't a typical profile of a sleepwalker. There are some typical facts, however, says Cartwright.
If it's going to appear, sleepwalking usually shows up between the ages of 4 and 6. It's most prevalent in kids 6 to 16. One-third will sleepwalk for about five years, a few for as many as 10. In many ways children sleepwalk because, well, they're children.
Why it happens A normal night's sleep consists of four stages and REM, or "dream" sleep. Stages three and four are deep-sleep stages, the time when sleepwalking almost exclusively occurs. It's also where children spend a lot of time each night.
The reason, according to Judith Owens, is because their bodies need to. Owens is director of the Pediatric Sleep Disorders Clinic at Hasbro Children's Hospital in Providence, R.I.
"That's the stage of sleep in which the nocturnal secretion of growth hormone largely occurs," she says.
So, kids need a lot of deep sleep to grow. And deep sleep is when sleepwalking usually happens. It's sort of a double-whammy. Make that a triple-whammy. The disorder also is much more common in people with a relatively immature nervous system.
You have to wonder, though, why Mother Nature didn't come up with a plan to guard against this sort of nighttime rambling. Well, as it happens, she did, according to Jerome Siegel, professor of psychiatry at UCLA and the Center for Sleep Research in the Sepulveda VA Medical Center.
According to Siegel, the human body has a built-in protective mechanism to prevent motor behavior, such as sleepwalking, during sleep. It's a way to keep us from hurting ourselves. Our muscles become so relaxed that we simply can't get up and get ourselves into trouble.
Sounds like a plan, all right. But sleepwalkers have trouble following it.
"Their brains are still very asleep," says Owens. "But they're acting like they're awake."
Genetics are partly to blame. The 15 percent chance a youngster normally has of becoming a sleepwalker doubles if one parent was a "walker," and doubles again if both were.
Still, sleepwalking usually needs an additional trigger. Ironically, that trigger often turns out to be lack of sleep.
That's because when an overly tired child finally falls asleep, the body is determined to make up for every scrap of deep sleep it's owed. And remember, "deep sleep" is when most sleepwalking happens.
Some solutions So what's the answer? Make sure kids get enough rest. One idea is to have them go to bed and get up at the same times every day.
"It's all a matter of being careful about sleep deprivation," says Cartwright. "About not letting kids overextend themselves."
Parents need to limit caffeine, too. Caffeine doesn't just come from coffee. Soda and chocolate can have it, as well. And too much caffeine can interfere with proper sleep, making a sleepwalking episode more likely.
But even if your child does sleepwalk, there's no need to panic.
There are dramatic stories, to be sure. Like the pajama-clad 7-year-old who decided to direct traffic, barefoot, on a snowy Chicago night.
But those are the exceptions. Normally, kids simply bumble their way around their room. Or fall asleep on the kitchen floor. Or mistake a waste basket for a toilet.
While serious injury is unlikely, it is possible. That's why Siegel urges parents to be proactive. High on his list is making sure a child's bedroom is safe.
If a youngster's bedroom is on the second floor, it might make sense to move it to the first. And consider some sort of alarm system. It could be as low-tech as hanging a bell from a knob or as high-tech as an electric eye across a doorway.
The single most important thing, however, is to not overreact. "Just be matter-of-fact about the situation. Give kids more of a sense that they have some control over things," Owens says.
And, let them know that sleepwalking "doesn't mean that there's anything wrong with their brains."
Calling for help Still, there are situations when it's advisable to get professional advice.
• If the frequency of the episodes seems to keep increasing.
• When there are noticeable sleep behavior changes, such as loud snoring or violent leg movements, which can disrupt a child's sleep.
• If the sleepwalking continues in a significant way well into adolescence.
• If a child's self-esteem is suffering.
So what does Cartwright recommend a parent do if they find their children wandering about?
"Mostly what I tell them is simply to guide them gently back to bed."
Dennis Maurizi is a freelance writer in Glenview. His work has appeared in the Chicago Tribune, Dallas Morning News and the Chicago Sun-Times.