Sleepwalking and Sleep Talking in Adults: Is There a Way to Stop It?

Unusual behaviors during sleep, like walking or talking, fall under a category called parasomnias, which are sleep disorders. Sleepwalking affects up to 17% of children and 4% of adults, while sleep talking is seen in 50% of young children and 5% of adults. Although these behaviors are often harmless, severe cases can pose risks. Fortunately, there are treatments available to help manage these sleep-related antics.

What are sleepwalking and sleep talking?

Sleepwalking is characterized by partial arousal during slow-wave sleep and may have adverse health outcomes due to injury to self or others because of impaired perception and processing. Sleepwalking as a disorder is classified by recurrent episodes, contact with others during them, and amnesia of the event upon waking. Additionally, reoccurring events have to cause clinically significant distress or impair social, occupational, or other areas of functioning.

Sleepwalking occurs when the brain is aroused and becomes partially awake during non-rapid-eye-movement (NREM) sleep. It can result in strange or even dangerous behavior, as the person may climb out of a window or attempt driving in extreme cases. The episode may end mid-action, leaving the sleepwalker in an unusual place, or the person may return to bed whilst still sleepwalking.

Sleep talking can occur during any sleep stage and vary in the level of comprehensibility, ranging from a few words to an entire conversation. The talker is usually unaware of this happening; however, it may disturb their bed partner.

Sleepwalking and sleep talking are both examples of parasomnias, which are abnormal behaviors that occur during sleep. While they are related in the sense that they both occur during sleep, they are distinct phenomena. Sleepwalking involves physical actions during sleep, while sleep talking involves vocalizations. Sleepwalking typically arises from disruptions in deep sleep stages, influenced by factors like genetics, stress, medication, and medical conditions like sleep apnea.

Sleep talking can occur across various sleep stages, often linked to stress, fever, medications, and underlying sleep disorders like sleep apnea or REM sleep behavior disorder. The causes of these phenomena can overlap in some cases due to factors such as underlying sleep disorders, stress, and genetic predispositions.

What are the differences between sleepwalking and sleep talking?

Here's a table to summarize the differences between sleepwalking and talking:

SleepwalkingSleep talking
Involves physical actions during sleepInvolves vocalizations during sleep
Walking, sitting up, complex movementsMumbling, making sounds, speaking
Typically occurs during non-REM sleepCan occur during any sleep stage
Less commonMore common
Triggered by sleep deprivation, genetics, stress and anxiety, underlying sleep disorders, medications
Triggered by stress, fever, medications, genetics, sleep disorders
Typically unaware of actionsMay or may not be aware of talking
Injury from falls or accidentsUsually harmless
Disturbs the sleep of othersDisturbs the sleep of others

Why do you experience sleepwalking and sleep talking?

In adults, these behaviors can be caused by various factors that disrupt the normal sleep cycle, leading to incomplete arousals from deep sleep stages, which may trigger sleepwalking or disturbances in sleep patterns that can contribute to sleep talking.

Factors contributing to sleepwalking:

  • Genetics. One or both parents are sleepwalkers. Associated with DQB1 gene.
  • Sleep deprivation. Lack of sufficient sleep can trigger an episode.
  • Stress and anxiety. Emotional stress can disrupt sleep and thus trigger sleepwalking episodes.
  • Underlying sleep disorders. Sleep apnea and restless leg syndrome may contribute to sleepwalking.
  • Medications. Certain medications, such as sedative-hypnotics, may increase the risk of sleepwalking.

Factors contributing to sleep talking:

  • Stress. Stress can lead to increased instances of sleep talking.
  • Fever. Elevated body temperature during illness can trigger sleep talking.
  • Medications. Some medications, such as antidepressants and sleep aids, may induce sleep talking by altering sleep states.
  • Sleep disorders. Conditions like sleep apnea and REM sleep behavior disorder may be associated with sleep talking.
  • Genetic predisposition. A family history of sleep talking can contribute to its occurrence.

Research suggests a potential relationship between sleepwalking, sleep talking, and mental health, although the exact nature of this association is still being explored.

Some studies have found associations between sleep talking and psychiatric disorders such as anxiety, depression, and post-traumatic stress disorder. Research also suggests that sleepwalkers have a higher prevalence of psychiatric disorders such as anxiety disorders, mood disorders, and personality disorders, hinting at a potential bidirectional relationship.

Psychological stressors and emotional disturbances have been identified as triggers for sleepwalking episodes, indicating a potential bidirectional relationship between stress and sleepwalking. Sleep talking has also been associated with increased stress and anxiety levels, with individuals experiencing more frequent episodes during times of heightened stress.

Can mental health issues cause these behaviors?

Some mental health disorders can potentially heighten sleep walking and talking. Anxiety disorders, characterized by excessive worry and fear, may increase the likelihood of experiencing sleepwalking and sleep-talking episodes due to heightened arousal levels during sleep. Individuals with PTSD, who often experience disturbed sleep patterns and nightmares, may be at higher risk of sleepwalking as a result of sleep disturbances and hyperarousal states.

Depression, characterized by persistent sadness and loss of interest, may cause increased sleep talking, possibly due to alterations in sleep architecture and emotional processing, but no direct link has been found. However, depression seems to have a stronger link to insomnia and sleep terrors, a different kind of parasomnia, than to sleepwalking and talking.

Is it a sign of parasomnia?

Differentiating normal sleepwalking and sleep talking from parasomnias involves assessing the frequency, severity, and impact on daily functioning. If these behaviors occur frequently, disrupt sleep, or pose safety concerns, it may indicate parasomnia. A person should be concerned if sleepwalking or sleep talking occurs regularly, leads to injury, or causes significant distress or impairment. Consulting a healthcare professional can help determine if further evaluation or treatment is needed.

How to cope with sleepwalking and talking?

Sleepwalking and sleep talking may be supported with lifestyle changes that include:

  • Establishing a consistent sleep schedule. Maintaining a regular sleep schedule can help regulate sleep patterns and reduce the likelihood of sleepwalking and sleep-talking episodes.
  • Creating a relaxing bedtime ritual. Engaging in relaxing bedtime activities, such as reading, can promote relaxation, reduce stress, and improve sleep quality, potentially reducing parasomnia episodes.
  • Comfortable sleep environment. Keep the bedroom dark, quiet, and at a comfortable temperature to facilitate restful sleep and minimize disturbances.
  • Reducing stress and anxiety. Practice stress-reduction techniques, such as meditation, deep breathing exercises, or progressive muscle relaxation, to alleviate anxiety and promote relaxation before bedtime.
  • Limiting stimulants and alcohol before bed. Caffeine, nicotine, or alcohol close to bedtime may disrupt sleep and increase the likelihood of parasomnias.
  • Safety precautions. Remove obstacles or hazards from the sleep environment to prevent injury during sleepwalking episodes. Safety gates on stairs and lock windows may also need to be considered.
  • Cognitive behavioral therapy (CBT). Cognitive-behavioral therapy techniques, such as imagery rehearsal therapy, may help individuals manage and reduce the frequency of sleepwalking or sleep-talking episodes.

When to seek professional help?

If sleepwalking and/or talking episodes are frequent, severe, pose safety risks, persist despite self-help efforts, and have a significant impact on daily life, you should seek professional help. If you have a family history of parasomnias and live alone, it might be worth mentioning it to your doctor, as you may be sleepwalking or talking without remembering.

Your primary care doctor plays a crucial role in addressing parasomnia by examining potential underlying health issues. Treatment options are tailored to your symptoms and age, with medications such as antidepressants, dopamine agonists, or benzodiazepines like clonazepam being recommended for frequent or recurring cases. However, if medications cause your symptoms, your doctor may recommend alternatives or a different dose. You mustn't stop taking any regular medication without your doctor's approval.

Common myths

Here are some common myths associated with parasomnias:

Only children sleepwalk or talk in their sleep

Sleepwalking and sleep talking can occur in both children and adults. While these behaviors are more common in children, they can persist into adulthood or develop later in life.

You should never wake up a sleepwalker

While it's commonly believed that waking up a sleepwalker is dangerous, it's generally safe to gently guide them back to bed. However, sudden awakening may startle them, so it's best to approach calmly to prevent confusion or disorientation.

Mental health has no effect on sleep behaviors

Mental health issues, such as anxiety disorders and depression, may influence sleep patterns and affect sleepwalking and talking. Stress and emotional disturbances may also trigger parasomnias, highlighting the connection between mental health and sleep.

Drinking alcohol before bed prevents sleepwalking

Alcohol consumption before bed may actually increase the likelihood of sleepwalking and other sleep disturbances. Alcohol disrupts sleep architecture and can lead to fragmented sleep, potentially exacerbating parasomnias.

Only people with sleep disorders sleep talk or walk

While sleepwalking and sleep talking are more prevalent in individuals with sleep disorders, such as sleep apnea or restless legs syndrome, they can also occur in otherwise healthy individuals. Stress, shift work, sleep deprivation, and other factors can trigger these behaviors even in the absence of a diagnosed sleep disorder.

Sleepwalking and sleep talking are types of parasomnias affecting both children and adults, with various triggers including stress, genetics, and sleep disorders. Usually, the episodes are harmless; however, they can disturb the sleep of the patient and their bed partner, and in some cases, an injury can occur. While self-help strategies like maintaining a regular sleep schedule and creating a relaxing bedtime routine can be beneficial, seeking professional help may be necessary for frequent or severe episodes.

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