Broughton (2000) once mentioned that “The term parasomnia refers to a group of acute, episodic, physical phenomena that either occur exclusively during sleep or seem to be exaggerated by sleep” (as cited in Pegram, McBurney, Harding & Makris, 2004, p. 200). The generally more typical encountered NREM sleep parasomnias consist of “sleepwalking”, “sleep terrors, confusional arousal, sleep talking, and bruxism” (Pegram et al., 2004, p.200). Sleepwalking, also known as somnambulism in its medical term, is considered the least harmful sleep disorders as compared to insomnia and sleep apnea which might cause damages to one's health. However, when the sleepwalker wanders too far away or carry out some dangerous activities, accidents could possibly occur at any one time. For instance, there was a very interesting case of sleepwalking where a 33 year-old lady named Donna Sheppard-Saunders attempted to murder her mother while sleeping. She held a pillow over her mother's face for about 30 seconds and stopped after that as the mother struggled and called for help (Crompton, 2009, para. 1).
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Sleepwalking episodes more often than not come from an arousal during the deepest stages of sleep. These stages are otherwise known as slow-wave sleep. Later on, actions such as sitting up may be stimulated due to the incompletion of such arousal during sleep. As a result, sleepwalking episode occurs. Nonetheless, soon after the sleepwalker is awakened and reaches full wakefulness, he or she might not remember anything at all that has happened while he or she sleepwalks (Chambers, 2000, p. 311). Sleepwalking episodes usually affects children more than adults. Dr. Irshaad Ebrahim (2008) states that “[t]he condition affects 15 per cent of children but only between 2 and 4 per cent of adults” (para. 5). In this case, Chambers (2000) believes that this could be because slow-wave sleeps have the tendency to decrease as a person gets older (p. 311).
However, the occurrence of this disorder is not fixed. Depending on the seriousness of sleepwalking, a person can sleepwalk once in a while, or even, almost every night. Not only that, sleepwalking is hereditary and it runs in some family, too. Nevertheless, there are several factors that cause sleepwalking to occur for some people during their sleep. Thus, self care method can be used to treat sleepwalking patients while not interrupting their daily lifestyles.
One of the reasons would be stress. Negative stress, also known as distress, is bad as it can impair a person's health. It often relates to problems such as anxiety, loss of appetite, unable to concentrate well, loss of sex drive, irrational behavior, easily feel irritated or annoyed. Other than that, it also causes physical effects that include discomfort of stomach, tense muscles causing neck, back or shoulder ache, and even missing periods in some women, with attention to depression. Therefore, sleepwalking is often said to be triggered when a person is overly distressed.
Nevertheless, stress is not the only reason behind this sleeping disorder. Other causes such as not getting an adequate amount of sleep can indirectly lead to sleepwalking as well. Other than that, anxiety - usually initiated by stress - and sleeping with a full bladder are very much interconnected with night terrors and nightmares which in turn contribute towards the sleep disorder. In Science, Roger J. Broughton (1968) points out that “bladder contraction, producing enuresis; sensorium impairment” can result in the occurrences of somnambulism (p. 1077). Sleepwalking, acknowledged by Dr. Ebrahim (2008), is more likely to happen if some particular factors are present and these factors include stress, sleep deprivation and alcohol consumption. He also added that “[t]rigger factors may be internal, such as snoring or excessive limb movements, or external, such as noise or being touched” (para. 6)
In addition, those who are born in a family with sleepwalking history are more likely to sleepwalk compared to others when they feel stress. There was a case study where Carl Edmonds (1967) provided evidences regarding the family history of somnambulism. A patient with sleepwalking background was accepted for treatment after consecutive incidents of parasomnias since he was very young. It was then which both the therapist and the patient knew, as told by the parents that his father used to sleepwalk when a young man. To make the point even stronger, the paternal grandmother was also a sleepwalker in adult life. Furthermore, his three sisters were as well affected in different ways (p. 237). In this case, it is logically proven that people with a family history of sleepwalking have greater chances of sleepwalking or encountering other parasomnias compared to that of others. Although milder cases of sleepwalking are not harmful, however, there are several things that need to be taken care of to decrease the chances of potential harms when sleepwalking occurs due to carrying out certain activities unconsciously while sleeping.
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Contrary to many beliefs, sleepwalking does not necessarily always mean walking while sleeping. Sleepwalking activities may include sitting up and appearing awake, when in fact, the sleepwalker is asleep. Besides that, common behaviors of sleepwalking also consist of dressing and undressing or more complex activities. For instance, moving furniture and preparing a meal. To some extent, sleepwalking is frequently considered not dangerous unless the occurrence of sleepwalking continues into the adulthood and posts a threat of potential harm to the sleepwalker or the people around. Until then, it is vital to seek for help from doctors or counselors (Ebrahim, 2008, para. 8). Hence, in extreme cases, sleepwalking can cause harm to self or the people around. Dr. Ebrahim (2008) also mentions that this disorder should be taken care of immediately if it disrupts the sleepwalker's daily lifestyle. There should be noticeable daytime symptoms of which include sleepiness or irritability due to lack of sleep the night before (para. 8).
Take for example; a sleepwalker can actually commit crimes like murder while sleeping. It often becomes a challenge to the juries so as how suspect can do so much including driving normally but not distinguish the person he or she is attacking while sleepwalking. To further note it, the sleepwalkers do not seem to be able to perceive sound made by their victims when they cry out for help during a sleepwalking violence scenario. Sleepwalkers can also hardly register the pain when they accidentally injure themselves. This could only mean that the hormonal changes or brain pathways might still be in a sleeping state whilst the complex motor behaviours such as attacking people take place (Cartwright, 2004, p. 1152). Another similar case would be “How sleepwalking can lead to killing”. In this news article, Laura Smith-Spark (2005) reported that Jules Lowe, 32 year old man who had committed a murder by killing his 82 year old father while he was sleeping. He had experienced retrograde amnesia where he did not remember anything about the brutal incident (para. 1). Dr. Ebrahim (2005) believes that the sleepwalking episodes occurred partly due to the fact that Mr. Lowe has had a history of sleepwalking. Other than that, it was also because Mr. Lowe previously had consumption of alcohol and plus other factors such as death of step-mother (as cited in Smith-Spark, 2005, para. 6-7).
To further illustrate, Jack Malvern (2008) reported that “[a] teenage rugby player fell to his death from a fourth-storey window because he was sleepwalking” (para. 1) in the headline “Teenage tourist sleepwalked to his death”. This tragic case of Ross Kimpton was believed to have been due to over-consumption of alcohol, therefore triggered the factor of which led to sleepwalking. To add on, Kimpton may also have been bothered by the noise coming from outside of the room through the opened window (Malvern, 2008, para. 6-7).
Though sleepwalking may seem horrifying, just like any other disorders, there is always at least a method to treat this disorder. One obvious treatment will be medication. Medication may be used in cases where episodes are much severe, aggressive, frequent, or disruptive. With the help of medication, occurrence of sleepwalking can be visibly reduced. Take for example, drugs such as ProSom and Klonopin can be terminated a few weeks without recurrence of sleepwalking. Also, therapy usually consists of either a benzodiazepine or a tricyclic antidepressant. Depending on the patient, they may or may not result in fewer episodes of sleepwalking. Even if the episodes of sleepwalking reduce, however, sleepwalking will still increase briefly after discontinuing the medication. Therefore, the self care method is much safer and easier to make use of.
Besides that, hypnosis is also known as a way to cure this sleep disorder. This method is pleasant for the person receiving it. When attending a hypnosis session, the hypnotist will get to know the patient so that it is possible to create the most pleasure during the session. When a person sleeps, there is a mechanism that helps to keep him or her from walking in their dreams. Often dreams seem so real that a person who sleepwalk moves and talks in his or her sleep. Thus, hypnosis helps by signifying to the patient as he awakens immediately when his feet are in contact with the ground. By doing this, the patient will have a more restful sleep at night. Nonetheless, similarly to using medication to treat sleepwalking, hypnosis sessions can be very costly. On the other hand, self care method does not cost a penny because it can be easily carried out by sleepwalkers themselves.
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Another possible treatment that can be taken into consideration towards the management of sleepwalking is consulting a doctor and most preferably, attending a few counseling sessions. Perhaps, through the course of counseling, sleepwalkers can identify their causation root of sleepwalking. In the treatment of sleepwalking in children, primary causal of sleepwalking can highly be related to the stress at home and school. Hence, these areas can be explored thoroughly before taking a step further in managing children's cases of sleepwalking. To further illustrate, children of which experience the divorcing parents or possibly receive the pressure to achieve top in school greatly increases the chances of sleepwalking. These cases or more severe ones sometimes fail to respond to counseling (The British Medical Journal, 1980, p. 1660). In other words, seeking a counselor may not be the best solution. That is why the self care method is still preferred as the better solution in taking care of children's safety.
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Though sleepwalking seems like a complicated disorder, milder cases of sleepwalking can be reduced or treated effortlessly at home by taking certain safety measures, known as the self care method. This solution is set to teach the sleepwalkers the right way to take care of themselves when they are asleep. First of all, sleepwalkers have to adopt a good sleeping pattern so as to ensure that they are getting enough sleep. This can be done by preparing a schedule whereby the time to time to go to bed has to be approximately the same every day. By listening to soft music before going to sleep can help to soothe and relax the mind so as to make sure sleepwalkers will not have active minds while they are asleep. Exercises can help in reducing stress as it regulates the body's internal activity and therefore help to achieve homeostasis. For this reason, people with sleepwalking history are strongly encouraged to exercise regularly, so that they can reduce the occurrences of sleepwalking. In addition, having a good way of coping with stress can as well greatly cut down the possibilities of sleepwalking. For instance, by finding and understanding the source of stress enable people to seek the right way to overcome stress easily. To add on, relaxing is believed to be one of the techniques to cope stress.
To add on, taking safety measures and precautions is vital in keeping sleepwalkers safe when sleepwalking. For instance, obstacles should be removed from hallways so that sleepwalkers will not trip and fall on them. If possible or when needed, sleepwalkers can sleep in a bedroom on the ground floor and also try to avoid bunk beds. Not only that, it is necessary to hide all sharp objects that are easily reached in cabinets and make sure they are securely locked. Usually, the main door has to be locked for safety just in case sleepwalkers may wander outside - roaming around outside at night can be very dangerous. So, the self care method is still regarded as the better way to help sleepwalkers, rather than starting a medication treatment.
Not only that, meditation can also help in relaxing one's mind. Just like exercising, meditation can be practiced easily - provided that he or she is in a suitable environment. According to Kathleen McDonald (2005), a person has to be in a very quiet room and make sure that there are no distractions at all. In addition to that, the seat has to be set up properly so that it is comfortable to sit on (p. 15). Then all there is left to do is relax the mind - switch off from all thoughts. However, it is always easier said than done. So, it is important to focus on the breathing rate, that is, follow each breath that is inhaled and exhaled. In this way, all other unnecessary thoughts can be put aside for the time being. When meditating, it helps the mind to reach a certain level of tranquility thus creating a very relaxed surrounding. As a result, stress level which usually contributes towards the occurrence of sleepwalking can be reduced. At the state of achieving the tranquility, the blood pressure is lowered and then it will decrease the muscle tension. Moreover, it balances a person's physical, emotional and mental state. Benefits of meditation are useful in curing many stress related sicknesses, with sleepwalking being one of them. Thus, meditation is proven to be very useful towards the treatment of sleepwalking.
In a nutshell, to guarantee a safe environment, self care method should be performed well. It is highly probable that sleepwalking is due to sleep deprivation and distress. Although this sleep disorder is incurable in most cases, however, the regularity of the episode can be effectively minimized in a long span of time. Thus, self care is a very useful method that can help decrease the chances of the occurrence or at least lessen the number of hazard towards the sleepwalker.