Experts Weigh in on the Causes of Sleepwalking and Talking

by Jodi Helmer
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Experts Weigh in on the Causes of Sleepwalking and Talking

It sounds like the plot for a bad sitcom: You wake up in the midst of making a triple-decker sandwich in the kitchen, and you have no recollection of even getting out of bed.

For the 8.5 million Americans who sleepwalk, there is no studio audience or laugh track with this real-life sleep disorder. It’s no laughing matter.

Sleepwalking belongs to a category of sleep disorders called parasomnias, says Emerson Wickwire, PhD, director of the insomnia program at the University of Maryland Midtown Medical Center.

“The brain doesn’t work like a light switch that turns on or off,” Wickwire explains. “Instead, different parts of the brain can be more or less asleep. Most of the time when people sleepwalk or sleep talk, the brain is actually in deep stages of sleep. But the part of the brain that controls walking is wide awake.”

Sleepwalking happens during deep, non-REM sleep. It’s more common in children. Rates in children are as high as 17%, compared with 4% of adults, according to the American Academy of Sleep Medicine. “Most people outgrow it,” says Wickwire.

THE CAUSES OF SLEEPWALKING

The causes of sleepwalking range from sleep deprivation and medical conditions like head injuries, migraine headaches and obstructive sleep apnea to medications and stress. One Stanford University study found that those with depression, obsessive-compulsive disorder and alcohol addiction were significantly more likely to sleepwalk.

At first glance, sleepwalkers might seem awake, but there are telltale signs that they are still asleep, including a glazed, glassy-eyed expression and confusion.

Sleepwalkers may also do more than just walk around, says Natalie Dautovich, PhD, the environmental scholar for the National Sleep Foundation. “Complex behaviors like opening doors and going outside can occur, in addition to walking,” she says.

Most sleepwalkers will be difficult to wake up and, if directed back to bed, will quickly fall back asleep and wake with no recollection of the episode.

Not surprisingly, sleepwalkers are prone to injuries. (The London Telegraph reported that one woman broke eight bones, including her spine, when she fell down the stairs during a sleepwalking episode; she remained asleep despite the injuries.)

In terms of treatment, since, “persistent insufficient sleep and stress are all antecedents for sleepwalking,” Wickwire suggests getting 7–9 hours of sleep per night and managing stress.

Sleepwalking is not the only parasomnia sleep disorder: You could also be talking in your sleep. It might be a coherent one-sided “conversation” or a series of jumbled mutterings.

“Oftentimes, individuals will be unaware that they are talking in their sleep unless a bed partner alerts them to the behavior,” Dautovich says.

THE CAUSES OF SLEEP TALKING

Sleep talking can occur in both lighter and deeper stages of sleep and is not necessarily tied to dreaming. In the lighter stages of sleep, talking is easier to understand but becomes more unintelligible in deeper sleep stages, says Dautovich.

Consuming caffeine or alcohol before bed can increase the likelihood of sleep talking. Certain medications are also linked to middle-of-the-night ramblings. Like sleepwalking, stress is also associated with increases in sleep talking.

“These nocturnal behaviors are affected by behaviors during the day and by having poorer overall sleep,” says Dautovich. “Making sleep a priority can help to set you up for healthy sleep across the night.”

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