Gibberish, Urine, And Utter Chaos – What Happens When You Sleepwalk

Understanding Sleepwalking

From mumbling fantastical gibberish to devouring blocks of cheese in the nude, sleepwalking can manifest in a variety of peculiar behaviors. Although mostly benign, sleepwalking can occasionally lead to dangerous situations. It’s estimated that around 18% of people sleepwalk at least once in their lives. But what exactly is sleepwalking?

To understand sleepwalking, we first need to recognize how many of our daily activities do not require our active attention. The prefrontal cortex, our brain’s conscious, deliberate, decision-making control hub, might decide to get up and walk, but the intricate coordination of sensory inputs and muscles that follow does not require any attention. Instead, it’s mostly executed by a network of specialized nerve cells along the lower part of the brain and spinal cord, sometimes called “central pattern generators.” These areas govern automatic movements and basic actions related to survival.

REM Sleep Behavior Disorder vs. Sleepwalking

People with a REM sleep behavior disorder may enact their dreams while they’re in REM sleep, usually keeping their eyes closed. However, this is a separate condition. Sleepwalking arises from a very different stage of sleep—the deepest stage of non-REM sleep, which is called “slow-wave sleep.” In this state, the cortex, including the prefrontal cortex, is essentially turned off.

When someone is roused from this stage, they’ll usually appear groggy before either dozing off again or becoming fully conscious. For that moment, though, they’re in an intermediate state straddling sleep and wakefulness. A sleepwalking episode is, essentially, an extreme, prolonged version of this. When sleepwalking, the prefrontal cortex remains inactive, so the person doesn’t possess executive, deliberate control over their actions. But other parts of their brain are active. And, as we know, the body is capable of a lot without involving the prefrontal cortex.

What Sleepwalkers Can Do

Sleepwalkers avoid obstacles, walk, and speak—though it’s often nonsense. Most sleepwalkers can do basic things, operating in a peaceful, unemotional, dreamless state. In rare cases, sleepwalkers perform more complex tasks like cooking and driving. They’re occasionally guided by physical urges, like eating or pursuing sexual activities. Some episodes involve the brain’s fight or flight system, during which the person might suddenly perceive an imminent danger, and vocalize, cry, or even jolt out of bed and run away. These episodes, called “sleep terrors,” are more common in young children and usually result naturally.

Causes and Treatment of Sleepwalking

Indeed, sleepwalking is generally more common in children, perhaps because the brain areas that control the transition between sleep and wakefulness are still developing. However, the exact mechanisms that cause sleepwalking remain unclear. Many cases appear to run in families, while others are more mysterious. Anything that could lead to partial awakening is thought to increase the likelihood. This includes factors that promote deeper slow-wave sleep—like sedatives, hot sleep environments, and operating on too little sleep—or things that disrupt sleep— like stress and other sleep disorders, such as sleep apnea and restless leg syndrome.

Doctors will usually evaluate these factors and promote habits that aid in healthy sleep, such as exercise, stress management, and a consistent and sufficient sleep schedule. They’ll also often recommend safety measures, like hiding dangerous items, installing door alarms, and securing windows. If this doesn’t help, they’ll consider certain medications. However, many of the available treatments for sleepwalking haven’t yet been rigorously studied, so how they work and how effective they are is not entirely clear.

How to Handle a Sleepwalker

So, what should you do if you encounter a sleepwalker? A common misconception is that rousing a sleepwalker causes irreparable harm. Fortunately, this is not true. However, trying to forcefully wake them can cause confusion and distress. The best practice seems to be to gently guide them back to bed; and, if they resist, to simply ensure they’re safe until the episode resolves.