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Sleep Walking

Aka: Sleep Walking, Sleepwalking, Somnambulism, Sleep Talking, Somniloquy, Nocturnal Wandering
  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):649-54
    2. Thiedke (2001) Am Fam Physician 63(2):277-84

Somnambulism (C0037672)

Definition (NCI) A sleep disorder characterized by repeated episodes of rising from bed and walking about; while sleepwalking, the individual has a blank stare and can be awakened only with great difficulty. On awakening, the individual has amnesia for the episode.
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.
Concepts Disease or Syndrome (T047)
MSH D013009
ICD10 F51.3
SnomedCT 80495009, 192457006, 154927001, 268775007
DSM4 307.46
English Sleepwalking disorder, Sleep Walking, Somnanbulism, Somnambulism, Sleepwalking, LUNATISM, SLEEP WALKING, SOMNAMBULISM, Sleepwalking Disorder, Sleepwalking [somnambulism], SLEEP WALKING DIS, Lunatism, Somnambulation, sleep walking, sleepwalking (symptom), sleepwalking disorder (diagnosis), sleepwalking, sleepwalking disorder, Sleepwalking (disorder), Sleep Walking Disorder, Sleep Walking Disorders, Nocturnal Wandering, Wandering, Nocturnal, Somnambulism [Disease/Finding], sleep walking disorder, sleepwalk, sleep walk, sleepwalked, somnanbulism, Disorder;sleepwalking, sleeping walking, somnambulation, Sleep walking, Sleep walking disorder, Sleep walking disorder (disorder), somnambulism, Walking in sleep
French SOMNAMBULISME, Lunatisme, HUMEUR CHANGEANTE, Somnambulisme
Portuguese SONAMBULISMO, Lunatismo, LUNATICO, Sonambulismo, Ambulação Durante o Sono, Ambulação Noturna por Sonambulismo
Spanish SONAMBULISMO, Sleepwalking, Walking in sleep, Somnambulism, Lunatismo, ANDAR DORMIDO, caminar dormido, sonambulismo (trastorno), sonambulismo, trastorno de caminar dormido, Sonambulismo, Ambulación Durante el Sueño, Deambulación Nocturna, Ambulacion Durante el Sueno, Deambulacion Nocturna
German SOMNAMBULISMUS, Mondsuechtigkeit, MONDSUECHTIGKEIT, SCHLAFWANDELN, Schlafwandeln [Somnambulismus], Nachtwandeln, Noktambulismus, Schlafwandeln, Somnambulismus, Mondsüchtigkeit, Nächtliches Wandern
Swedish Sömngång
Czech somnambulismus, Chození ve spánku, Somnambulismus, Náměsíčnost, náměsíčnost, lunatismus
Dutch somnambulisme, krankzinnigheid, slaapwandelen, somnabulisme, Slaapwandelen [somnambulisme], Slaapwandelen, Somnambulisme
Italian Pazzia, Camminare nel sonno, Disturbo da sonnambulismo, Camminare durante il sonno, Sonnambulismo
Japanese 睡眠時遊行症, ｽｲﾐﾝｼﾞﾕｳｺｳｼｮｳ, ﾑﾕｳｼｮｳ, 夢中遊行, 夢遊症, 夢遊, 夢遊病
Finnish Unissakävely
Russian SOMNAMBULIZM, СОМНАМБУЛИЗМ
Korean 몽유병
Polish Lunatyzm, Somnambulizm, Sennowłóctwo
Hungarian Holdkórosság, Alvajárás, Somnambulismus
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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