The question

I used to sleepwalk frequently as a child and now my sleepy ambulatory ways have returned. I even slept-walked out of my house once in the middle of the night. I'm worried for my safety. Why is this happening to me as an adult and what can I do to stop it?

The answer

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Your concern for safety is a real one as sleepwalking in adults does carry some risk of endangering others or yourself. Some episodes can include leaving the home or driving; in rare situations, they can lead to violent behaviours.

Clinically, the definition of sleepwalking involves getting out of bed and walking while in a state of sleep. Sleepwalkers may have a glassy-eyed appearance and may perform routine functions such as cleaning or eating. For those living alone, they may not realize they sleepwalk but may notice that objects have mysteriously been moved in their house when they wake in the morning.

Sleepwalking is fairly common in children, and usually peaks between the ages of 4 and 12. It tends to go away in teenage years, but in rare cases it can persist into adulthood. Because sleepwalking is less common in adults, it can be confused with or co-exist with other sleep disorders such as sleep apnea or restless leg syndrome.

In a normal sleep cycle, the brain progresses through periods of wakefulness and sleep. If this process is interrupted, over time it can lead to sleep deprivation, which can potentially trigger episodes of sleepwalking in those who are predisposed.

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In sleepwalkers, it's the slow wave sleep cycle, which is in the first third of the night, that is regularly interrupted. When this happens, it can result in sleepwalking episodes.

Interruption of our sleep cycles can occur for a number of reasons including:

Certain medical conditions may also cause frequent waking, such as chronic pain or some prostate conditions, which can make you rise in the night to urinate. Diabetes can also interfere with restorative sleep. In addition to conditions, some medications can interrupt sleep patterns as well, such as those used to treat anxiety, depression or Parkinson's disease

In rare cases, if someone is having frequent episodes of sleepwalking in one night and has daytime fatigue, it would be important to ensure that the sleepwalking episodes are not actually seizures.

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My suggestion would be to visit your family doctor to further review what may be causing these episodes. Your doctor will evaluate you, assess to see if any other medical conditions may be affecting your sleep and do a medication review to see if a prescription may be triggering the episodes.

Your doctor will likely refer you for a sleep study to better understand what is happening while you sleep and to rule out other sleep disorders.

If your physician is able to identify a treatable cause, the sleepwalking episodes will likely stop.

While waiting for your evaluation, consider the following to assure a proper sleep cycle to minimize sleep disturbance:

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If you do sleepwalk, the concern for safety is a real one. Consider the following precautions to stay safe:

Send family doctor Sheila Wijayasinghe your questions at doctor@globeandmail.com. She will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail web site. Your name will not be published if your question is chosen.

The content provided in The Globe and Mail's Ask a Health Expert centre is for information purposes only and is neither intended to be relied upon nor to be a substitute for professional medical advice, diagnosis or treatment.