Follow-Up:
I hope this will be helpful to you. The Sleep Disorders of Sleepwalking and Sleep Talking Jennifer Mueller Psychology 473 February 4, 1997 Sleep is one of the great mysteries of life. Often it is difficult for individuals to understand what is happening during what we label as normal sleep, thus when we do something unusual while we are asleep, it can be even more confusing. Sleepwalking (somnambulism), and sleep talking (somniloquy), are two rather mysterious phenomenon people can experience while they sleep. Both of these sleep disturbances are partial arousal disorders, and therefore share some similarities. However, it is also apparent that there are some differences between these two disorders, including the severity of each. Also, although typically it is quite harmless to experience an episode of sleepwalking and/or sleep talking, it can be confusing and embarrassing and even at times dangerous, in the case of sleepwalking. Therefore, it is apparent that to come to a better understanding of the similarities shared by these two disorders, as well as their differences, a closer examination of them is necessary. Furthermore, exploring these sleep disorders in greater detail is of value, especially to those individuals that either experience sleepwalking and/or sleep talking episodes, or for those individuals that live with someone who does, in order come to a better understanding of the causes of the disorders, as well as the possible treatments. (Hales, 1981) Sleepwalking and sleep talking have been part of my life, as well as the lives of other family members. Though neither of my parents have ever sleepwalked, at least two of my uncles, one from each side of the family, have had episodes of sleep walking as children and/or in adolescence. One of my favorite stories about sleep walking, from my Mother’s side of the family, is about my uncle when he was an adolescent. Apparently, one evening my uncle, who had gone to bed earlier than some of the other family members, walked down the stairs from his bedroom, that was on the second story of the house, to the door that lead to the outside on the main floor. It was the middle of winter, and he was barefooted, but he opened the door and went outside just like that. A minute later he came back inside, wide awake, angry and accusing everybody of throwing him outside into the snow. He could not remember going outside, on his own, at all. My other uncle, on my Father’s side of the family, was known for wanting to go do his chores during his sleepwalking episodes. Luckily, he slept in the same room as my father, so my father usually stopped him before he got outside. I too have had experiences with sleepwalking. For instance, one night when I was about eight or nine, I made my way from an upstairs bedroom to the downstairs living-room, with a book in my hand. When my mother asked me what I was doing, I told her that I was going to read. It was quite late in the evening, so my mother told me that it was late, and told me to go back to bed, which I did. The next morning, I saw my book laying on the coffee table (where I left it during my sleepwalking episode), and I asked my mother how it got there. So she told me what I had done, but I could not remember having done it. Sleep talking is also common on both sides of my family. Though my mother does not talk in her sleep, one of her brothers does (the one that use to walk in his sleep), and my father is also known for the lively conversations he has in his sleep. For instance, during Christmas holidays this year, my mother, father and I played quite a bit of Scrabble. However, it never failed that whenever my father lost, that night he would dream about playing Scrabble and while he was dreaming about this, he would be talking in his sleep as though he was arguing with someone about cheating. I too, am known to talk in my sleep, though I did more so when I was younger, and from what I understand, I would only say a word or two or perhaps a sentence. These examples of sleepwalking and sleep talking are quite typical, and they are considered to be disorders of partial arousal. They are called this because when a sleepwalking or sleep talking episode occurs, it usually happens when the individual experiences a partial awakening as they sleep. In the case of sleepwalking, it usually occurs about one to four hours after falling asleep, when the individual experiences a partial waking at the end of the first or second sleep cycle, as they are coming out of stage IV non-REM sleep. This arousal or waking is only partial, in that although their body is able to move, the person’s brain is not fully "awake" but it is no longer in deep sleep either. In fact, when the brain waves of a sleepwalker are monitored, one finds a mixture of brain wave patterns, including those found in deep sleep, those seen during transitions towards waking, as well as some patterns seen during drowsy and waking states. Because the brain is in this state, it is possible for the person to exhibit waking and sleeping behaviors. For instance, the individual may exhibit such waking behaviors as having open eyes, sitting up in bed, walking around while avoiding obstacles, and performing simple tasks like picking up objects, getting dressed, or turning on a light. However, the individual is evidently also partly asleep, because they often seem confused and unable to perform more complex actions (though there is some debate about this). Also, another indication that the individual is not fully awake, is that it seems that during the sleepwalking episode the individual is not forming memories, which is associated with a the state of wakefulness, because the individual does not have any memory of the sleepwalking episode, when awaken (such as in the case of my uncle), or the next morning (such as what happened in my case). Generally, these sleepwalking episodes last from one to forty minutes (averaging usually five to twenty minutes), ending usually with the individual going back to bed on her own. (Ferber, 1985) Sleepwalking is common phenomenon among children, with most children having at least one sleep walking episode in their lives, while about fifteen percent of children have reoccurring episodes (Caldwell, 1995). Sleepwalking can occur at any age, starting as soon as a child learns to crawl (Caldwell, 1995). However, it occurs most often between the ages of four and twelve, with most sleepwalking occurring around age ten (Caldwell, 1995). Until about age five or six, sleepwalking is seen to be part of the normal maturational process, with it being partially due to a child’s very deep stage IV sleep, rather than being caused by physical or emotional problems (Ferber, 1985). Often the child during these episodes, will simply sit up in bed or perhaps walk around as though they are looking for something (Ferber, 1985). In this state, they have little awareness of what is happening around them, though they may look at people and/or answer simple questions (Ferber, 1985). Also, they may go back to bed if the parent tells them too, or allow you to lead them back to bed (Ferber, 1985). When children continue sleepwalking into middle childhood or adolescence, they may continue to have these same kind of calm episodes, as seen in younger children, however there is also the possibility that they may start having sleepwalking episodes, where they act in more of an agitated manner. When these agitated episodes occur, a child is less likely to respond to your questions, and typically the parent will have more difficulty in leading the child back to bed. However, eventually the child will calm down, and perhaps even briefly awaken (usually within five to twenty minutes), so that they can be lead back to bed. In older children, it appears that sleepwalking is due less to developmental factors, but rather due to perhaps emotional factors, especially if the child is sleepwalking frequently. This does not necessarily mean that the child has a sever emotional problem, but rather it is likely due to the child trying to work out her feelings, which she may feel unable to express while awake, or it may be due to the child feeling stress. (Ferber, 1985) It is also important to realize that there could be hormones, other biological factors or medical problems, causing sleepwalking episodes in children (Ferber, 1985). For instance, it has been discovered that there is a genetic link with sleepwalking, in that children who have family members that sleepwalk, are also more likely to sleepwalk (Hales, 1981). Furthermore, it has also been found that males are more likely than females to sleepwalk (Hales, 1981). As well, the sleepwalking could possibly be due to a medical problem, though this is usually quite rare (Ferber, 1985). For instance, pain from heartburn or middle ear disease, may account for some sleepwalking episodes (Ferber, 1985). Also, if a child is fatigued, the child’s depth of sleep is likely to be greater. Therefore, because sleepwalking has been linked to the depth of stage IV sleep, fatigue could encourage the incidence of sleepwalking episodes (Ferber, 1985). Even though sleepwalkers usually do not injure themselves during calm episodes of sleepwalking, injuries can happen, and the more agitated the child’s episodes are the more likely the child is to injure themselves. Even during calm episodes of sleep walking, the fact that their coordination is somewhat impaired, because they are not fully awake, may mean that parents will have to take some precautions, such as removing obstacles that may trip the child, moving a child’s bedroom to the main floor of the house, so the child will not have to go down any stairs. Also, if the child tries to leave the house while sleepwalking, the parent may want to place a lock higher up on the door, out of the child’s reach, or attaching a bell to the child’s bedroom door, so that the parent will know if their child is leaving their bedroom. (Ferber, 1985) Because sleepwalking is not usually seen to be the result of a serious problem in children, usually only precautions (such as what has been previously listed), need to be taken rather than a treatment program (Ferber, 1985). However, if it appears that the child’s sleepwalking is being caused by indigestion, one may have to consider making some changes to the child’s diet, or if it appears that it is being caused by fatigue, the parent should make sure the child has a regular sleep-wake cycle and limit late nights (Ferber, 1985). Also, if it appears that the child’s sleepwalking is being caused by emotional problems, if the child has several major episodes per week, or if the child’s sleepwalking is dangerous, psychotherapy may be helpful (Ferber, 1985). Also, if the sleepwalking is quite sever, then medication such as tranquilizers or anti-depressants may be useful (Hales, 1981). Mild sedatives such as Chamomile (Van Straten, 1990), or even hypnosis may help as well to decrease the incidences of sleepwalking (Hales, 1981). Most children usually stop sleepwalking before they reach adulthood (Caldwell, 1995). Therefore, sleepwalking as an adult is much more rare, with only about one in two hundred adults that sleepwalk (Caldwell, 1995). Like sleepwalking children, the sleepwalking episodes adults have, are the result of a partial arousal when they are coming out of stage IV non-REM sleep (Caldwell, 1995). Also, adults show basically the same behaviors as children, such as turning on lights or picking up objects (Caldwell, 1995). However, one difference between children and adult sleepwalkers, is that typically the sleepwalking of adults is much more aggressive and adventurous, which can lead to more injuries (Caldwell, 1995). As well, unlike children, the causes of adult sleepwalking are often much more serious (Hales, 1981). With adults, sleepwalking can be brought on by such things as a fever, sleep deprivation, stress, emotional tension, epilepsy or even a personality disorder (Hales, 1981). Furthermore, it may also be brought on by using various substances, such as heavy alcohol intake (which increases deep sleep), ingesting too much caffeine or other stimulants, long-term use of sleeping pills or anti-depressants, as well as mixture of alcohol and other drugs (Van Straten, 1990). The precautions that parents may have to take with sleepwalking children are also valid with adults. Also, if it appears that the adults’s sleepwalking could be caused by indigestion or other problems that may be linked to diet, then one may have to consider making some changes to one’s diet (Van Straten, 1990). As well, like children, if it appears that the sleepwalking could be caused by fatigue, one should try to keep a regular sleep-wake cycle and limit late nights (Caldwell, 1995). Furthermore, if the sleepwalking is the result of the misuse of a drug or a combination of drugs, the elimination of these may also decrease the incidence of sleepwalking (Van Straten, 1990). However, if it seems that the sleepwalking may be due to a more serious problem, the individual should seek medical help such as psychological counseling, and if the sleepwalking is particularly serious, such as if the sleepwalker is a danger to themselves, then medication such as tranquilizers or anti-depressants may also be useful (Hales, 1981). Also, relaxation techniques, biofeedback training, hypnosis, and mild sedatives such as Chamomile, may help to decrease the incidences of sleepwalking for the adult sleepwalker (Hauri, P. & Linde, S., 1990). Sleep talking is also a common sleep disorder, but unlike sleepwalking it occurs quite often in both children and adults, though more so in children (Caldwell, 1995). Also, the causes of the sleep talking are similar for both children and adults, which is also somewhat different from sleepwalking (Caldwell, 1995). Both children and adults display similar sleep talking behavior, as well. Sleep talking can occur at any stage of sleep, but like sleepwalking it is most likely to occur when the individual is coming out of stage IV sleep, as they are rising to a lighter and more aroused state of sleep (Caldwell, 1995). Often sleep talking during this stage of sleep, is associated with the sleeper moving, such as rolling over, however it is sometimes associated with actual sleepwalking (Caldwell, 1995). Also, when the individual sleep talks during this stage, the speech of the individual is usually quite unclear, in that their speech is usually mumbled, or their speech is not organized, in that it consists only of a word or two, or when it is a sentence or two, the sentences are usually disjointed (Caldwell, 1995). Also, if a person is asked a question while they are in this state, they will often answer it in a word or two (Hales, 1981). However, even though an individual can be somewhat conversational during this stage of sleep, their speech has little emotion (Hales, 1981). Another, time that an individual may sleep talk is during REM sleep, though this is much less common (about twenty percent of sleep talking episodes) (Caldwell, 1995). Though most muscles are paralyzed during REM sleep, sometimes the muscles of speech are not paralyzed, and this is when sleep talking occurs (Caldwell, 1995). Often sleep talking during this stage of sleep, reflects what the individual is dreaming about (Caldwell, 1995). However, the speech in REM sleep, unlike that of deep sleep, is clear and understandable (Perl, 1993) and often there is emotion with the individual even laughing or crying (Hales, 1981). Furthermore, like sleepwalkers, sleep talkers rarely remember talking in their sleep (Perl, 1993). There is some indication that sleep talking, like sleepwalking, runs in families (Van Straten, 1990). However, unlike sleepwalking, it appears that sleep talking in children or adults is not due to any psychological or physical disturbance (Hales, 1981). Furthermore, the words or phrases uttered by a sleep talker does not reveal any hidden truths or secrets about the individual, but rather it most likely reflects what the individual may have done that day (Caldwell, 1995). Therefore, because sleep talking does not seem to be due to a psychological or physical disturbance, nor does it seem to reveal anything of significance about the individual sleep talking, typically sleep taking is not seen as a sleep problem that needs treatment (Hales, 1981). However, if the individual is experiencing some anxiety over their sleep talking, or if they are for other reasons experiencing feelings of stress in their lives (the incidence of sleep talking seem to increase in times of stress for the individual, much like in the case of sleepwalking), psychological counseling may useful in relieving some of their stress (Van Straten, 1990). Furthermore, because most sleep talking seems to be related to the depth of the individual’s stage IV sleep, much like sleepwalking, a regular sleep-wake cycle and avoiding sleep deprivation, may also help to reduce the amount of sleep talking incidences (Caldwell, 1995). Also, like in the case of sleep walking, too much alcohol, caffeine and other stimulants, or a mixture of these seem to increase the occurrence of sleep talking, therefore reducing or eliminating your intake of these substances may also help to reduce an individual’s sleep talking (Van Straten, 1990). Thus, it appears that the sleepwalking episodes of my uncles and myself are quite typical. This is so, in that all three episodes occurred during the individual’s childhood or adolescence (Freber, 1985). Also, it seems that all of us experienced rather calm episodes, though it seems that my one uncle who walked outside, had a more active episode than perhaps my other uncle or myself (Ferber, 1985). In my case as well, there is further support to indicate that I was having a calm episode, in that I was easily convinced by my mother to go back to bed (Ferber, 1985). Furthermore, neither of my uncles nor myself have had episodes of sleepwalking in our adulthood, which suggests that our sleepwalking episodes did not indicate any major medical or psychological problems (Hales, 1981). Also, it would seem that when I spoke a few words to my mother during my sleepwalking episode, that I was exhibiting non-REM sleep talking, which is also a quite common thing to do when having a sleepwalking episode (Caldwell, 1995). In the case of my father, his sleep talking would seem to be somewhat more unusual, in that sleep talking is rarer in adults, and because he has emotion in his voice (arguing), which seems to indicate that he is sleep talking during REM sleep, is also rarer (Hales, 1981). Lastly, because of my uncles were sleepwalkers and because my father is a sleep talker, it seems that there may be a genetic link to my sleepwalking and sleep talking episodes (Van Straten, 1990). When one examines these two sleep disorders of sleepwalking and sleep talking, it becomes apparent that they share some similarities. For instance, both disorders seem to run in families (Van Straten, 1990). Also, it is apparent that both sleepwalking episodes and most sleep talking episodes, seem to be the result of a partial wakening, which occurs when an individual is coming out of stage IV sleep (Hales, 1981). Furthermore, both can be due to similar causes, such as the misuse of drugs, and some of the treatments, such as the elimination of these substances, for each are also similar (Van Straten, 1990). However, when one explores the differences between these disorders, it becomes apparent that sleepwalking is a much more serious disorder, because of the possibility of injury for the individual, as well as because it can be due to serious physical or psychological problems, while there seems to be no evidence to indicate that sleep talking is due to such problems (Hales, 1981). Therefore, it is evident that it is important for one to become more familiar with the sleep disorders of sleepwalking and sleep talking, especially if you have experienced these disorders, or live with someone does, in order to gain a better understanding as to the causes of and the possible treatments for each of these disorders. References Caldwell, J.P. (1995). Sleep. Toronto: Key Porter Books. Ferber, R. (1985). Solve Your Child’s Sleep Problems. New York: Simon & Schuster, Inc. Hales, D. (1981). The Complete Book of Sleep. Ontario: Addison-Wesley Publishing Company. Hauri, P. & Linde, S. (1990). No More Sleepless Nights. Toronto: John Wiley & Sons, Inc. Perl, J. (1993). Sleep Right in Five Nights. New York: William Morrow and Company, Inc. Van Straten, M. (1990). The Good Sleep Guide. London: Kyle Cathie Limited.