Sleepwalking: causes, safety at home and when to seek help

The NHS says sleepwalking is when you get up and move around while you are asleep. The person appears to wake and sit up or get out of bed, usually has their eyes open but a blank-looking face, and cannot respond normally to what is around them. They may do routine things such as getting dressed or walking about the house, and less commonly more complex things such as eating, sexual activities or leaving the house.

Sleepwalking usually happens in the first part of the night and lasts a few minutes. The person may go back to bed on their own or wake up confused, and will not remember it afterwards. It happens when someone partly wakes from deep sleep so that they can move while the brain is not fully awake, according to the NHS.

It is not known exactly why it happens, but the NHS says it can be linked to not getting enough sleep, other conditions that affect sleep such as sleep apnoea or restless legs syndrome, being unwell with a high temperature, taking certain medicines such as sleeping pills, stress, and drinking alcohol. It is more common in children and in people with family members who also sleepwalk. The NHS says most children grow out of it without treatment by the time they are teenagers.

Sheffield Children's NHS Foundation Trust describes sleepwalking as a type of parasomnia, as are night terrors, which are common in childhood and are not usually a sign of an underlying problem or anxiety. It notes that for many children getting a little more sleep each night is enough to reduce the frequency of such events.

• Short or irregular sleep.

• Fever or illness.

• Sleep apnoea or restless legs syndrome.

• Certain medicines, including sleeping pills.

• Stress and alcohol.

• A family history.

The NHS advises keeping doors and windows closed, using stair gates to keep children safe, keeping floors clear so nobody trips, locking away sharp objects like knives and tools, and fitting door alarms if there is a risk of leaving the house. Do not let a child who sleepwalks sleep in the top of a bunk bed. Sheffield Children's adds that if you are concerned about a child falling out of bed, move the mattress to the floor or attach a bed guard, and use a bell or alarm on the door to alert you.

The NHS also suggests trying to get enough sleep by relaxing before bed, avoiding daytime naps and keeping regular bed and wake times; trying to manage stress; avoiding caffeine and alcohol in the evening; and keeping a sleep diary recording whether you sleepwalked, bedtime, sleep quality, caffeine, alcohol, tiredness and stress, which can help identify what makes it more likely.

The NHS says to gently guide the person back to bed. If you need to wake them, wake them gently, because if woken suddenly they will be confused and will not know what is happening, and they may be scared, angry or upset. Sheffield Children's advice for children is to try to guide them back to bed gently and not to wake them, because waking them is likely to make an episode last longer, and not to talk about the episode the next day, which can make a child worried.

The two sources differ slightly on waking, so the practical rule is to guide rather than shake or shout, and to wake gently only if there is a danger such as stairs or an open door.

The NHS says to see a GP if you or your child sleepwalk and it is disrupting sleep, you are worried about accidents or injuries, or you have other symptoms such as feeling very tired during the day or your breathing stopping and starting while you sleep. Sleepwalking does not usually need treatment. If it is linked to another condition or to taking certain medicines, treating the condition or changing the medicine should help, but you should not stop medicines without talking to a GP.

A GP might refer you to a sleep clinic for tests and treatment if sleepwalking puts you at risk of accidents, severely affects your sleep, or may be linked to a condition such as sleep apnoea. Treatment from a sleep clinic may include psychological therapies such as cognitive behavioural therapy or hypnotherapy, and medicines such as clonazepam or antidepressants if other things have not worked.

Start with the GP, who can review medicines, check for sleep apnoea and other triggers, and refer on if the risk is high. Children's services and health visitors can advise on safety, and sleep-related advice from the NHS and children's hospital trusts is widely available.

Private sleep physicians and psychologists can offer faster assessment, a sleep study and CBT, but for most children the approach is safety, sleep regularity and time. Adults who injure themselves or others during an episode should ask for a medical review.