Sleeping and sleeping( sleepwalking, somnambulism) - Causes, symptoms and treatment. MF.

Perhaps sleepwalking is one of the most interesting topics in doubt, which causes the most questions:
• Sleeping and sleeping( sleepwalking) - what is it really?
• Is this related to any disease?
• Is the person at that moment conscious?
• Is sleepwalking dangerous for health, and what can it talk about?

In itself, the notion of "sleepwalking" means the same as "sleepwalking", "dreaming", "somnambulism" is a sleep disorder of the type of wake-up disorder that is more often observed in children and is accompanied by automatic actions during sleep. In the morning, "sleepwalkers," as they are called to be called, can not remember what is happening.

In itself, the state of sleepwalking is rare, only 2-3% of the world's population. Most often this phenomenon is observed in children from 6 to 16 years of age, of this age group, about one in six children( 15%) at least once in their life experienced a joint or a dream.

Possible causes of sleepwalking

Explanation of sleeping and sleeping is easy. Normally, during sleep, muscles are relaxed, we rest. Upon awakening, the brain begins to send impulses to the muscles, and they become active. Sleepwalking occurs when the muscles "wake up" before the brain. That is, the person is still asleep, can even dream to see, but is already able to move his arms and legs, open his eyes. This is often frightening.

Several reasons can cause this in children:

• Heredity. Sleepwalking is often inherited, which is associated with family cases of falling asleep.
• Nervous tension due to feelings, conflicts in the family or a very intense training program.
• Fever during illness.
• Migraine( specific headaches).
• Epilepsy is sometimes manifested for the first time by somnambulism.

In adults, sleepwalking meets much less often, and is usually associated with various diseases, that is, it is secondary. In this case, sleep is disturbed by internal processes in the body.
Among the most common causes are:

• Lack of sleep.
• Circadian sleep disorders( eg, jet lag after flights).
• Epilepsy.
• Migraine.
• Neoplasms of the brain.
• Vascular lesions of the brain( eg, an aneurysm of the artery).
• Heart disease, such as arrhythmias.
• Bronchial asthma.
• Syndrome of obstructive sleep apnea.
• Diabetes mellitus( single cases of development of sleepwalking are described against the background of a night drop in the sugar level in type 1 diabetes).
• Diseases of the nervous system.
• Reception of toxic substances, in particular drugs, alcohol.
• Side effects of drugs, especially sedatives, some sleeping pills.

Possible symptoms of sleepwalking

The most common actions that can occur with sleepwalking are walking, getting up, sitting on the bed, uttering words or sounds, answering the phone, sweeping hand movements, kicks. Their distinctive feature will be that they have long been memorized, stereotyped and, more often than not, repeated every day.

A dream can begin with standing up, standing in front of the bed, then a person can go and do something out of habit, for example, turn on the light. Run and walk long distances rarely. Even more rarely is it possible to perform a complex action on the type of driving a car. Sleepwalkers can demonstrate sexual behavior, especially if they sleep with their partner. Such cases often become an occasion for curious stories, films and art works.

There are two types of splicing, when a sleepwalker speaks clear words, sometimes coherent phrases, and when he utters vague sounds more like mooing or groaning. Quite often there are cries. Coupling can be combined with sleeping.

For a lunatic person, all actions during an attack will appear to be conscious, understandable and logical. They will obey the reality that exists for somnambulists in a dream. However, as in any dream, events can unfold differently than in reality. And here you can understand that in fact a person sleeps, and does not talk with you or does something unconsciously.

Observers of episodes of sleepwalking note that the answers to questions and requests at some point may be absent or slow and out of place, the sequence of actions may be violated, unmotivated aggression may appear. The most frightening of others, and at the same time give lunatic, open "glass" eyes. This is a characteristic sign of somnambulism.

Diagnosis of sleepwalking

Diagnosis of sleepwalking is performed by a somnologist, neurologist or general practitioner. It is based on a conversation between a doctor and a lunatic and his relatives or eyewitnesses of bouts of seizure or collapse.

Questions that should be clarified before the consultation so that the doctor could make a complete picture of the situation:

• Detailed description of the episode of the ascendancy.
• The level of consciousness before, during and after the attack of sleepwalking.
• Time of occurrence of episodes.
• Daytime sleepiness.
• Injury.
• Memorization of events.
• Family history of sleepwalking.
• Provoking factors.

Diagnosis of ascendancy does not require the passage of polysomnography, in contrast to wake-up disturbances during fast sleep, however, in order to clarify the reasons for this condition, it may be necessary to do a follow-up:

• Electroencephalography( EEG) with stress tests to exclude epilepsy.
• EEG monitoring - long-term monitoring of brain activity.
• Magnetic resonance imaging( MRI) or computed tomography( CT) of the head to exclude brain damage.

To establish the diagnosis of sleepwalking, it is necessary to match the diagnostic criteria of somnambulism.

Diagnostic criteria of sleepwalking. International classification of sleep disorders, 2013.

1. Getting up during sleep.
2. Saving sleep, altered state of consciousness or blurred consciousness during the ascent is confirmed by at least one of the following:
i. It is difficult to wake a patient.
ii. Confusion of thoughts after the final awakening.
iii. Amnesia of events( full or partial).
iv. Conventional behavior occurs at an inopportune time.
v. Inappropriate or ridiculous behavior during the episode.
vi. Dangerous or potentially dangerous behavior during the course of a journey.
3. The condition can not be explained by other sleep disorders, somatic or neurological diseases, mental disorders, medication or other substances.

Treatment of sleepwalking

In olden times, sleepwalking was carefully concealed and treated with folk remedies( there are references to the use of borage), though unsuccessfully.

In Soviet times, and sometimes also in ours, the first thought of the parents of a lunatic or adult child who learned about his somnambulism was to find a good psychiatrist, psychotherapist or psychologist. Someone turned to the neurologist, which is also understandable and understandable. Immediately prescribed sedative, hypnotics, sedatives, sometimes tranquilizers( so as not to run away) and even antipsychotics. A number of doctors were limited to physiotherapy or injections with nootropics and vitamins. As a result, either the dream was even more disturbed, or the sleepwalker walked all day "like in a fog" and could not really do anything.

To date, the official position of treating sleepwalking is this: there is no need to treat the somnambulist. To survey - yes, to treat - is not present.

Lifestyle features for sleepwalking

What should I do if you or your child has sleepwalking? The main principle is to ensure the safety of the "sleepwalker".It is important that the sleeper, who can get up and walk at night, there was no way to go out onto the street or onto the balcony. For this reason, it is necessary to close doors and windows, and if possible, to the key. This is due to the fact that somnambulists can open them, as well as during the day, especially if earlier they did it more than once.

It is also important that there is no possibility of injury from sharp corners of furniture, lying objects( for example, combs), glasses and mirrors, which can break when stuck on them. It is best to remove the excess and leave in the bedroom only what moves with great difficulty. To smooth out sharp corners, special silicone or plastic pads are created, which are attached to the furniture.

Possible complications of sleepwalking

Sleepwalking itself is not dangerous and does not cause any diseases. The only serious complication can be considered injuries that can occur during an attack of sleepwalking, and causing harm to others.
Very rarely, but still possible, somnambulists show aggression. Cases of harm to health are even described. This may be due either to the initial excitement of a sleepwalker during an episode( for example, against a dream of a frightening character), or to attempts to prevent sleepwalking, argue with him, or respond to his aggression. You do not need to convince the sleepwalker, it is important to adjust to him and send him to the bed, after which he himself falls asleep.

To avoid complications, you just need to find out the cause and ensure proper prevention of injuries.

Prevention of sleepwalking

Since sleepwalking should not be treated, then the first place is taken by measures to prevent snowshooting. First of all, it is compliance with sleep hygiene and sleeping conditions. Here are the following points:

• Before going to bed, 2-3 hours before bedtime, you need to tune in to sleep.
• It is useful to take a walk and switch from the events of the past day. Excessive play sports is not worth it, it will only cheer. It is better to postpone serious workouts in the morning.
• Refuse to watch TV, movies, gadgets and computers. Especially avoid flashing objects on the screen and white bright light.
• Eating, drinking alcohol before falling asleep, should not be. It will make sleep worse and can trigger sleepwalking.
• It is also better to dim the lights at home. This will give drowsiness and improve the quality of sleep and falling asleep.
• Read the instructions for the medications you are taking. Some of them can themselves cause sleepwalking. Most often these are drugs that affect the nervous system.
• Timely diagnostics of possible causes of sleepwalking will help to avoid the recurrence of episodes of a dream in the future.

Elena Tsareva, doctor-somnologist,
"Unison-clinic",
www.clinic.unisongroup.en