Most people think of sleepwalking as something that happens to children. And it is more common in kids than adults. But roughly one in 250 adults sleepwalks at least once a week, so it is far from rare.

If you have woken up in a different room with no memory of getting there, or if someone in your household does this, it helps to understand what is actually going on and what might be behind it.

What Is Sleepwalking

Sleepwalking, technically called somnambulism, happens during deep NREM sleep, specifically the slow-wave stage known as stage 3. This is the deepest part of sleep, when the brain is in a very different state from waking.

During a sleepwalking episode, the part of the brain controlling movement becomes partially active while the rest of the brain stays in a deep sleep state. The result is movement without consciousness. The person is not aware of what they are doing and will typically have no memory of it afterward.

Episodes usually happen in the first few hours of the night, when slow-wave sleep is most concentrated.

Why Children Sleepwalk More Than Adults

Children spend more time in slow-wave deep sleep than adults do, which is why sleepwalking is more common in kids. As the brain matures, sleep architecture changes, and sleepwalking episodes tend to become less frequent. Many children simply grow out of it by their teenage years.

Hormonal changes during puberty, pregnancy, and menstruation have also been linked to higher rates of sleepwalking, which suggests that hormones play some role in how the brain transitions between sleep states.

What Can Trigger Sleepwalking in Adults

In adults, sleepwalking is often triggered or made worse by specific factors rather than happening out of nowhere. The most common ones include:

• Sleep deprivation: when you are very short on sleep, your body compensates by increasing the intensity of slow-wave sleep, which can increase sleepwalking risk
• Stress and anxiety: both are consistently linked to more frequent sleepwalking episodes
• Fever or illness: these can disrupt normal sleep cycling
• Alcohol: suppresses REM sleep and can push more sleep into the slow-wave stage early in the night
• Family history: if a parent or sibling sleepwalks, your risk is significantly higher, with some research suggesting up to a tenfold increase if a first-degree relative is affected

Medications That May Cause Sleepwalking

This is something many people are not aware of: certain medications can trigger or worsen sleepwalking as a side effect.

The main categories linked to sleepwalking include:

• Sedative-hypnotics (sleeping pills): some sleep medications, particularly older ones in the benzodiazepine family and Z-drugs like zolpidem, have been associated with complex sleep behaviours including sleepwalking. The FDA has issued warnings about this for certain drugs.
• Antidepressants and anti-anxiety medications: some medications that affect serotonin levels have been linked to increased sleepwalking in certain people
• Antipsychotics: medications used to treat certain mental health conditions can affect brain activity in ways that may contribute to sleepwalking
• Beta-blockers: used for heart conditions and blood pressure, these can affect sleep architecture and have been associated with sleepwalking in some cases

It is important to note that not everyone who takes these medications will sleepwalk, and the risk varies by individual. If you started sleepwalking after beginning a new medication, it is worth mentioning to your doctor. Do not stop any prescribed medication without talking to them first.

What to Do During a Sleepwalking Episode

The old belief that you should never wake a sleepwalker is not quite accurate, but there is a kernel of truth in it. Waking someone abruptly from deep sleep can leave them confused and disoriented, and they may react in a startled or unpredictable way.

A better approach is to gently guide the person back to bed without waking them if you can. Speak softly, steer them calmly, and avoid sudden movements or noise. Most episodes end on their own within a few minutes.

If someone in your home sleepwalks regularly, it is worth taking some basic safety steps:

• Make sure stairs are gated or clearly blocked
• Lock external doors and windows, or fit them with an alarm
• Remove obstacles from common paths between the bedroom and bathroom
• Keep sharp or hazardous items out of easy reach

When to See a Doctor

Occasional sleepwalking that causes no harm and has a clear trigger (a very late night, a stressful week) may not need medical attention. But there are situations where it is worth getting assessed:

• Episodes are frequent, happening more than once or twice a month
• The person leaves the house or is at risk of injury
• Sleepwalking started after beginning a new medication
• There is significant daytime sleepiness or other sleep problems alongside it
• The episodes are getting worse rather than better over time

A doctor can assess whether an underlying sleep disorder is involved and whether any current medications might be contributing. In some cases, a sleep study may be recommended.

Also on this site: The 4 stages of sleep explained  |  Sleep problems in children: what is normal

External resource: Mayo Clinic: Sleepwalking — symptoms, causes, and when to seek care for sleepwalking

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