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Activities During Full or Partial Awakening

Arousal Sleep Disorders

Parasomnia arousal disorders cause partial wakefulness during deep sleep, or during stages three and four of the . Dreams are not associated with these stages, so people who sleep walk or suffer night terrors are not acting out their dreams.

Sleepwalking may be as simple as sitting up, or walking around the room or through the house.
Sleepwalking, or somnambulism, is perhaps the best-known arousal disorder. Sleepwalkers are usually children, although the disorder can occur in adults. Somnambulism may be caused by a number of factors, including stress, fatigue, sleep deprivation and medication.

Incidence rates vary: some people experience less than one nighttime event a month, while the most seriously affected may have nightly events. Children are more likely to be affected than adults, and boys are affected more often than girls.

Symptoms of Somnambulism

The most obvious symptom is sleepwalking: movement of the body during deep sleep. This movement may be as simple as suddenly sitting up, or walking around the room or through the house. In extreme cases, people have been known to cook, or even drive, while asleep. Sleepwalkers may also experience:

Difficulty awakening during somnambulism
No memory of the event
Open eyes and blank facial expressions
Talking, although rarely comprehensibly
Urinating in unusual places (usually in children)
Use of obscene language not used when awake.

Violence and Other Myths

A horde of popular superstition has amassed around somnambulism. It has long been held that you risk violence if you wake up sleepwalkers. This is simply not true, although another parasomnia, REM movement disorder, can lead to violence as the afflicted person acts out dreams. Somnambulists will often be confused or disoriented when awoken, however, so often its best not to wake them. Instead, gently talk to them and try to get them to return to bed without waking.

Another popular legend holds that somnambulists cannot fall or injure themselves while sleepwalking. This too, is not true. Falls and injuries are actually fairly common.

Treatment Options: Benzodiazepine and Prevention

Severe cases of somnambulism are treated with low doses of benzodiazepine, a medication more often used to treat epilepsy. Side effects of benzodiazepine can include drowsiness, concentration difficulties, and dizziness. Children may experience hyperactivity as a result of the drug. Depression is a risk with chronic treatment. Some people may find hypnosis effective.

Some precautions to protect sleepwalkers and minimize occurrences include:

Practicing good
Avoiding fluids before bedtime: full bladders can trigger somnambulism.
Keeping the room free of obstacles to prevent tripping.
If possible, locating the bedroom on the ground floor.
Securing doors and windows to prevent the sleepwalker from going     outside.
Checking all current medications with your doctor: many drugs can    aggravate somnambulism.

Telling Your Child

If your child suffers from sleepwalking, breaking the news to him/her requires tact and sensitivity. The child has no memory of getting up at night, and often children react with fear, confusion, increased stress, and even shame.

Other Arousal Disorders

Nocturnal Eating Syndrome
Nocturnal eating syndrome is often associated with somnambulism. People get up and eat, or even prepare meals, while asleep. Nocturnal eating syndrome is more common in women than in men, and tends to manifest between twenty and thirty years of age. The disorder is often triggered by stress, depression or medication.

Complications of nocturnal eating syndrome include weight gain, and the possibility of choking as the somnambulist eats. The risk of injuries is also high; people may cut themselves while preparing meals, or suffer burns while cooking.

Night Terrors
Night terrors are one of the most disturbing of parasomnias, resulting in a "fight or flight" reaction while asleep that can lead to injuries or violence. More information on this disorder is available on the
Night Terrors page.

Confusional Arousal
Confusional arousal is more common in children than adults. The affected person cries out and thrashes around. Attempts to comfort the person are unsuccessful. After a period of time (possibly as long as half and hour), the person calms, wakes up briefly, and then falls back asleep.
Arousal: Those that wake the sleeper; night terrors and sleepwalking.
Night Terrors
Sleep-Wake Transition: Those that cause partial arousal; sleep talking.
REM Sleep: Those that occur during REM; RBD and sleep paralysis.
Sleep Paralysis
Other Parasomnias: Bedwetting, teeth grinding and SIDS 
Teeth Grinding

Last modified 20 September 2006
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