Sleepwalking Not An Isolated Problem

By Kurniawati Kamarudin KUALA LUMPUR, Aug 6 (Bernama) – Sleepwalking, though not a life threatening disorder, poses serious risk to the sleepwalker and others, such as in the case of a Danish tourist who was involved in a fatal crash that killed three people near Nilai, Negeri Sembilan, one of the 13 states that constitutes Malaysia. In the July 2010 incident at km 277.5 of the northbound lane of the North-South Highway, the Dane's car crashed onto another car, killing three of its occupants. Based on the medical records adduced by the defence, the court was convinced that the Dane was literally 'sleep driving' at the time of the incident. While Kenneth Jakobsen, 29, sighed in relief over the verdict, the incident serves as a grim reminder on the dangers posed to others and themselves by those who sleep walk. Moreover, sleepwalking is not an isolated disorder and is quite common in children and young adolescents. People with this problem not only walk, but also do other things such as drive, talk, open doors, etc. In the worst case scenario, they can injure or even kill someone unintentionally. PREVALENT IN CHILDREN AND ADOLESCENT Pantai's Hospital Psychiatric Consultant Dr Daniel Zainal Abdul Rahman describes sleepwalking as something quite common in children and adolescents, especially those in the 3 to14-years age group. "Normally the disorder disappears when one gets older," he said. Children and adolescents are at greater risk of sleepwalking compared with adults as their sleep cycle has yet to mature, unlike the adults. Each normal Rapid Eye Movement (REM) and non-REM and sleep cycle takes between 90 and 100 minutes and each night a person goes through several cycles of REM and non-REM sleep. Each of these cycles are divided into five stages and sleepwalking is said to occur during deep, non-REM sleep (stage three or stage four sleep) early in the night. Dr Daniel Zainal pointed out that an adult, on average, normally reaches the fourth and fifth stage, but children and adolescents probably only reach up to stage four. Moreover, the third and fourth stage sleep cycle in children and adolescents differ from adults. "There is some developments in their brain during stage 3 and 4 that prompts sleepwalking. That is why during late adolescence 80 to 90 per cent lose their sleepwalking problem because their brain has matured," he said. SLEEPWALKING BEHAVIOUR Dr Daniel noted that while sleepwalkers might not harm themselves, they do face risks such as tripping or losing their balance. "Even if the sleepwalker talks, he or she often mumbles and their speech is incoherent. "Normally, these sleepwalkers will sit up on their bed and start walking or repeat their actions. Do not awaken them, slowly lead them back to the bed. "Sleepwalking does not occur every night, it in fact happens periodically, maybe once a week, or once a month," he said. FACTORS BEHIND SLEEPWALKING Apart from the genetic factor, sleepwalking is also contributed to by psychological factors like depression. The problem can also occur among traumatised children, such as those who were sexually abused by family members and are emotionally depressed. Also, 'post traumatic stress disorder' that involves extraordinary trauma, such as the effects from war, earthquakes, typhoons, or the loss of someone very close, can cause one to lose sleep, have dreams or nightmares and walk in their sleep. "Emotional stress disturbs their sleep pattern and this also contributes to sleepwalking. "As for children, and even adults whose sleeping time is irregular, they suffer from the same consequences," he said. According to Dr Daniel, children suffering from epilepsy, fever, or irregular heartbeats often end up sleepwalking. As for adults, the problem may originate from prescribed drugs such as sleeping pills and stimulating drugs like syabu. "On the whole, those who are facing inner conflicts and feel depressed are most vulnerable to the condition. "These conditions have to be addressed beforehand and normally they will recover in two weeks if they don't have other problems. "Nonetheless, there are cases where the problem continues until adulthood, especially among those with emotional stress. This calls for close monitoring," he said. IS THERE A WAY TO OVEROME SLEEPWALKING? Speaking of the diagnosis, Dr Daniel pointed out that doctors would initially identify factors that contribute to the problem before taking the next course of action. For example, if sleepwalking is due to having an irregular heartbeat, he will refer patients to a heart specialist. However, if it involves emotional stress, terrible trauma, or irregular sleep, then several steps have to be taken to mitigate these. "The hypnosis technique may be used to dwell into the problems and techniques are introduced to calm their emotions and anxiety, apart from prescribing anti depression pills," he said. Among the techniques to calm emotions include meditation, yoga or chanting for Muslims. And to help sleepwalkers, the safety of rooms and homes should be taken into consideration to prevent injuries. "Though they may not harm themselves, it is feared that they may suffer injuries due to falls or from sharp objects," he said. The other safety precautions are to place safety doors outside rooms or at the staircase and add a security key on the door to prevent sleep walkers from leaving the house. -- BERNAMA