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Sleep WalkingAka: Sleepwalking, Somnambulism, Sleep Talking, Somniloquy, Nocturnal Wandering

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  1. Epidemiology
    1. Incidence: 15% of normal children ages 4 to 15 years
    2. More common in boys than in girls
    3. Inherited
  2. Definitions
    1. Somnambulism: Sleep Walking
    2. Somniloquy: Sleep Talking
  3. Pathophysiology
    1. Occurs during first 3 hours of sleep
    2. Occurs during non-REM Sleep: Stages 3 and 4
  4. Signs
    1. Eyes are open but stare is blank
    2. Speech is mumbled, slurred and unintelligible
    3. Not well coordinated, but can do semi-purposeful acts
      1. Dressing
      2. Open and close doors
      3. Turn on and off lights
    4. Lasts for 30 seconds to 30 minutes
    5. Unable to awaken during episode
  5. Associated parasomnias
    1. Night Terrors
    2. Nocturnal Enuresis
    3. Nightmares
  6. Differential Diagnosis
    1. Partial complex Seizures occurring during sleep
    2. REM behavior disorder
    3. Night Terrors
    4. Malingering
    5. Dissociative phenomena
    6. Medication effect
  7. Management
    1. Reassure parents (See Course below)
    2. Avoid Fatigue (leads to sleepwalking)
      1. Provide regular sleep-wake schedule
      2. Ensure sufficient sleep
    3. During episode
      1. Lead child back to bed
      2. Minimize interventions with child
        1. Do not shake or slap child
        2. Do not shout at child
      3. Stop by bathroom if needed
      4. Once in bed, episode may end
    4. Protect from accidents
      1. Gates across stairs
      2. Special locks on outside doors and windows
      3. No bunk-bed sleeping
      4. Situate bedroom on first floor of home
    5. Consider Prompted Sleep Awakening technique
  8. Course
    1. Sleep walking spontaneously stops with adolescence
  9. Indications to call or return to clinic
    1. Signs of Seizure during episode
      1. Drooling
      2. Jerking or stiffening
    2. Persistent frequent or prolonged episodes
      1. Twice weekly despite prompted awakenings for 7 days
      2. Episodes last longer than 30 minutes
    3. Child does something dangerous during episode
    4. Episodes occur during second half of night
    5. Child with daytime fears
  10. References
    1. Masand (1995) Am Fam Physician 51(3):649
    2. Thiedke (2001) Am Fam Physician 63(2):277

Somnambulism (C0037672)

Definition (MSH)A parasomnia characterized by a partial arousal that occurs during stage IV of non-REM sleep. Affected individuals exhibit semipurposeful behaviors such as ambulation and are difficult to fully awaken. Children are primarily affected, with a peak age range of 4-6 years.
ConceptsDisease or Syndrome (T047)
ICD9307.46
MSHD013009
EnglishNocturnal Wandering, Sleep Walking, SLEEP WALKING DIS, Sleep walking disorder, Sleep Walking Disorders, Sleepwalking, Somnambulism, Somnanbulism, Walking in sleep
Spanishcaminar dormido, sonambulismo, trastorno de caminar dormido
Parent ConceptsParasomnias (C0030508), Sleep Arousal Disorders (C0752294), [X]Nonorganic sleep disorder, unspecified (C0154565), Sleep automatism (C0424284), Duplicate concept (C1274013)
SourcesAOD, COSTAR, CSP, CST, LCH, MSH, MTH, MTHICD9, NDFRT, QMR, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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