Additional education in psychology. Somnambulistic state: signs, causes, treatment State of somnambulism

The scientific name of sleepwalking is somnambulism (from the Latin Somnus - sleep and Ambulare - to walk, walk), and the second “folk” synonym is this state is "sleepwalking". In fact, this pathology has nothing to do with the moon, but is named so, probably because it is often detected on bright moonlit nights. This is one of the forms of sleep disorders, the manifestation of which is unconscious sleep walking.

Somnambulism is a very common phenomenon; according to statistics, every fiftieth inhabitant of our planet suffers from it. The overwhelming number of people suffering from sleepwalking are children aged 4 to 10-16 years. About why sleepwalking occurs, how it manifests itself, how to deal with this condition and we'll talk in our article.

Causes of sleepwalking

As mentioned above, children, especially boys, most often suffer from sleepwalking. This is probably due to the functional immaturity of the central nervous system. Children are naturally emotional and impressionable, and the stress on the nervous system today is so great that, absorbing new information During the day, the brain continues to work actively at night, during the child’s sleep. Evening quarrels between the child and family members, worries about parents’ quarrels, and active games, playing on the computer, watching cartoons or TV shows before bed: under the influence of these factors, the tired nervous system in the evening becomes excited and does not have time to calm down before bed. In such situations, sleepwalking may be accompanied by other disorders of the nervous system - involuntary urination(enuresis), neurosis obsessive states, neurosis-like tics, .

Other risk factors for sleepwalking in children include:

• genetic predisposition (it is known that if one of the child’s parents suffers or has suffered from sleepwalking, the probability of developing symptoms of this disorder in the child is approximately 40%, and if both of them increase to 65%);
• high temperature during illness;
• epilepsy (somnambulism can either accompany epilepsy, being one of its symptoms, or be a predictor of this disease, developing even several years before its onset).

In adults, somnambulism develops much less frequently and, as a rule, is secondary. The main causes of sleepwalking in adults are:

• chronic lack of sleep;
• acute and chronic stress;
• migraine;
• neuroses;
• senile dementia;
• epilepsy;
• cerebral aneurysms;
• cardiac dysfunction (severe arrhythmias);
• obstructive sleep apnea syndrome;
• pregnancy and menstruation in women;
• nocturnal attacks of bronchial asthma;
• diabetes mellitus (due to nocturnal hypoglycemia, or a decrease in sugar levels below normal at night);
• a hearty dinner before bed;
• poor nutrition, containing a large amount of unrefined foods, leading to a deficiency of the microelement magnesium in the body;
• taking alcohol and drugs;
• taking some medicines(in particular, antipsychotics, sedatives and hypnotics).

When does sleepwalking occur?

As you know, sleep includes 2 phases: slow and fast. The slow-wave sleep phase consists of 4 stages - from falling asleep to deep sleep. Phase REM sleep accompanied by active movements of the eyeballs; it is during this phase that a person dreams. The sleep cycle, which includes 2 large phases, lasts on average 90-100 minutes and is repeated up to 10 times during the night. Sleepwalking usually occurs during the deep sleep phase (that is, at the end of the 1st phase) of the first or second cycles. During the day, somnambulism occurs extremely rarely, since the duration nap insufficient.

In children younger age The slow-wave sleep phase is longer, and sleep in this phase is deeper than in adults: these features also increase the likelihood of them developing sleepwalking.

As for physiology, sleepwalking occurs when, during sleep, inhibition of the functions of the central nervous system does not extend to the areas of the brain responsible for motor functions. That is, the overwhelming number of body functions are inhibited, but the movement function is not.

Symptoms of sleepwalking

The main and main symptom of somnambulism is sleepwalking. The person seems to have fallen asleep, but suddenly gets up and goes somewhere or performs certain actions. The duration of an attack of sleepwalking can range from several seconds to half an hour, in rare cases – up to 50 minutes.

Some patients do not walk, but simply sit up in bed, sit for a few seconds or minutes, and go back to bed.

Most people suffering from sleepwalking get out of bed, then they can turn on the light, or they can walk around the room in the dark, performing any actions, and even go outside the home - into the entrance, into the yard, they can get into the car and even start it .

Some sources contain information that while in a dream, some “sleepwalkers” can drive a car, but this is a myth: reflexes become dull during sleep and a person cannot adequately respond to events happening around him, which means that even if he manages to start the car , then he will not go far: an accident will immediately occur.

In some cases, a person, without even getting out of bed, makes certain stereotypical movements (adjusts his pajamas, rubs his eyes, and so on): this can also be a manifestation of sleepwalking.

During sleepwalking, a person’s eyes are wide open, but they seem to be glass - the gaze is directed into emptiness, it is “absent”, the face does not express any emotions at all, the movements are slow and smooth. If you turn to the sleepwalker at this moment, he will not hear and will not answer questions, but he can utter words and incoherent sentences on his own or simply mutter something under his breath.

The episode of sleepwalking ends spontaneously: the patient returns to his bed or falls asleep in another place. In the morning he remembers absolutely nothing about his nightly adventures and, waking up in a bed that is not his own, can be very surprised. If the phase of active sleepwalking was prolonged, during the day a person feels weak, drowsiness, fatigue, and decreased ability to work.

Episodes of sleepwalking are rarely daily: as a rule, they occur with a frequency of several times a week to 1-2 times a month or less.

During an episode of somnambulism, all types of senses are dulled, so the patient is not aware of the danger: he can calmly walk on the roof, use a knife, or jump out of a window. A person can harm himself (a quarter of somnambulists are injured during sleepwalking) and the people around him without knowing it, therefore, living under the same roof with a sleepwalker, a number of measures must be taken to avoid this. We will talk about what these events are below.

Diagnosis of sleepwalking

If the episode of sleepwalking happened for the first time, and you can associate it with what you experienced the day before stressful situation or overwork, then with an appeal for medical care You can wait. In the case when such episodes are repeated more than once, you should still seek help from a neurologist, neuropsychiatrist or psychiatrist to establish the cause of these phenomena.

To help a specialist make a diagnosis, you or your relatives should:

• note on paper the time of falling asleep, after what time the episode of sleepwalking begins, how long it lasts, the patient’s behavior during this period, morning awakening;
• think over and note the reasons that could provoke somnambulism (listed at the beginning of the article);
• make a list of the most commonly eaten foods and regularly taken medications.

When going to the reception, it is very advisable to take with you a witness to your nightly “travels”.

The doctor will talk with the patient, ask him a number of necessary questions, conduct an objective examination and prescribe additional methods studies confirming or refuting the diagnosis. Typically, such studies are:

• electroencephalography (definition electrical activity brain; it is this method that makes it possible to diagnose the presence of epileptic foci in the brain);
• polysomnography (the patient spends the night in a special sleep laboratory, where, before falling asleep, sensors will be connected to him and changes occurring in the nervous system during sleep will be monitored);
• ultrasound examination of cerebral vessels (will determine the nature of blood flow in them);
• computed tomography or magnetic resonance imaging (will detect neoplasms, if any, or changes of any other nature);
• consultations with related specialists (endocrinologist, cardiologist, pulmonologist) for the diagnosis of somatic diseases that could provoke the development of sleepwalking.

Principles of treatment of somnambulism

Full sleep and eliminating active games before falling asleep will help in the treatment of sleepwalking.

In most children, this disorder goes away on its own as the child grows older.

If sleepwalking occurs infrequently and no pathological changes not detected in the body, treatment consists of lifestyle modification, namely minimizing the impact of risk factors:

• regular, long-term (7-8 hours) night sleep;
• before bed – a relaxing ritual (for example, you can take a warm bath with relaxing oils, listen to calm music, have a soothing massage, drink mint tea, etc.);
• Avoid watching TV and working on the computer at least 2 hours before bedtime;
• eliminate alcohol consumption;
• avoid stress at work and at home, and if it happens, then try not to bring it into the house, but, so to speak, leave it at the door;
• if a child suffers from sleepwalking, then it is necessary to ensure that he adheres to the daily routine; make sure he sleeps enough to get enough sleep; limit watching TV and playing on the computer, before going to bed do not play active games, but play calm ones (for example, board games), draw, read a book or listen to pleasant music.

If the cause of sleepwalking is any medications taken by the patient, they should be discontinued or at least the dosage reduced.

If sleepwalking occurs against the background of epilepsy, the patient will be prescribed antiepileptic drugs, and when the cause is neurosis, tranquilizers and.

If the disease is not of a neurological nature, the disease that caused it is treated (for arrhythmia, antiarrhythmics are prescribed, for diabetes mellitus– adequate glucose-lowering therapy, and so on).

If, even during treatment of underlying diseases, episodes of sleepwalking do not stop, disrupting the patient’s daily activity, and there is a risk of injury during this time, the patient may be prescribed medications that affect sleep phases. They are prescribed in low doses, the duration of treatment is from 3 to 6 weeks.

You should not wake up a somnambulist during the period of sleepwalking - this can frighten him, provoking the development of other mental disorders. You should calmly take him by the hand or shoulders and, speaking in a quiet voice, lead him into the room and put him to bed.

Sometimes psychiatrists and psychotherapists use hypnosis as a method of treating sleepwalking.

How to avoid injury

We have already written above that sleepwalkers can harm their health and the health of others during sleepwalking. To prevent this from happening, the following measures should be observed:

• do not leave the patient alone in the room at night (if you are nearby, you will notice the onset of the episode in time and put the patient to bed);
• remove bunk beds, arranging a sleeping place for the patient on the first floor;
• during sleep, remove all light sources (floor lamps, bedside lamps, draw curtains so that moonlight does not pass through the window);
• block the doors and windows of the bedroom before going to bed, and if this is not possible, install bars on the windows (patients may confuse the window with the door and try to “go out” through it);
• if possible, “smooth out” sharp corners on furniture;
• before going to bed, remove objects from under the feet that the patient may stumble over, sharp and fragile objects that could injure him;
• turn off electrical appliances before going to bed, do not leave electrical wires under your feet;
• hide the keys from front door and from the car;
• in severe cases, you can even tie the patient to the bed, but sometimes sleepwalkers somehow untie themselves in their sleep;
• you can also place a basin with cold water or lay it soaked in cold water a rag - when getting up, a person will dip his feet in the water and wake up from this.

In conclusion, I would like to repeat that in the vast majority of cases, sleepwalking is not dangerous and ends in recovery even without treatment, but sometimes it accompanies the course of quite serious diseases. Therefore, in order not to miss these very serious illnesses and to prevent injury to a person during sleepwalking, you should not “wait for the weather by the sea” or treat the sleepwalker yourself: the right decision would be to seek help from a doctor.

Channel One, “Live Healthy” program with Elena Malysheva on the topic “Sleepwalking: symptoms and treatment”:

The program “Doctor on Duty” about sleepwalking:

National Geographic TV channel, documentary film “Sleepwalking. Myths and reality":

In the practice of a medical psychologist, we often have to meet with the parents of children who are in the hospital. And, unfortunately, one of the most common questions is:
- My child gets up at night, talks, walks around the room. What is this? Is it dangerous? How to deal with this?
Let's try to understand this issue...

What is somnambulism?

Somnambulism- lat. Somnus- sleep and ambulare- walk, walk, wander.
Somnambulism is a form of complex behavior that appears to be purposeful, but is unconscious to the person, and is carried out in a dream. Synonyms of somnambulism, in everyday usage - sleepwalking, sleepwalking. Somnambulism called a pronounced sleep disorder, when a sleeping person gets out of bed and moves around undirectedly or in accordance with a dream, the next morning the memory of this is vague or completely absent.”

Somnambulism- occurs if inhibition of the central nervous system during sleep does not extend to the areas of the brain that determine motor functions. An example of incomplete, shallow inhibition is when a sleeping person speaks in his sleep or sits up in bed.

Episodes of somnambulism usually begin 1-1.5 hours after falling asleep during slow-wave sleep.

Picture of somnambulism:subject gets out of bed and makes a series of stereotypical and coordinated movements with his eyes open, his actions may also be of an antisocial nature. During somnambulism, pupils constricted, gaze frozen. Spontaneous transition from an episode somnambulism does not occur during wakefulness, the episode usually ends with a return to normal physiological sleep after 10 - 15 minutes, sometimes longer (20-30 to 50 minutes). When waking up in the morning, there are no memories of what happened in the middle of the night somnambulism.

Who experiences somnambulism?

Somnambulism - most often found in children and adolescence when the nervous system has not yet strengthened. Due to overload associated with intensive training or stress, this sleep disorder can occur.

Sleep disorders

There are several sleep disorders. One of the most common - insomnia. The usual reason is nervous fatigue, prolonged intense mental work, sometimes excitement caused by troubles, and sometimes pleasant experiences, noisy games or reading before bed. A large dinner or large amounts of liquid drunk shortly before bedtime can also cause insomnia. The best remedy for insomnia - establishment correct mode work and rest, regular stay at fresh air, sufficient exercise stress. For insomnia, it can be useful to take a warm (not hot) foot bath at night, drink an infusion of motherwort or valerian root 30 minutes before going to bed. If these measures do not help, you need to seek help from a neurologist who will recommend suitable treatment methods.

A widely known and common sleep disorder is somnambulism- manifests itself in the fact that the sleeper, without waking up, gets out of bed and begins to wander around the house, showing amazing dexterity in his movements. Typically, within a short period of time, he returns to his room and goes to bed. The next morning, the somnambulist usually does not remember anything about his nightly “adventures.”

Who suffers more often from somnambulism - children or adults?

Sleepwalking is quite common in children, but usually goes away with age. Like night terrors, episodes of sleepwalking occur more often during periods of tension and anxiety, while children are completely mentally healthy.

Causes of somnambulism:

Somnambulism maybe or manifestation of twilight states consciousness, when wandering in a dream with externally ordered actions is subsequently amnesic (forgotten) OR one of the first epilepsy symptoms as the nonconvulsive equivalent of seizures OR as a manifestation twilight darkness consciousness during hysteria. It happens that sleepwalking is caused by poisoning worms.

Somnambulism is a fairly common phenomenon.. About 2% of all people periodically sleepwalk.

In adults sleepwalking requires more serious attention. It can be caused by stress, anxiety, and sometimes epilepsy. Therefore, adults need medical help, in particular the use of tranquilizers, antidepressants or hypnosis. If sleepwalking associated with epilepsy, requires the prescription of anticonvulsants.

Suffering somnambulism should contact a neurologist for examination and treatment.

With the phenomenon sleepwalking There are many legends associated with it: it was considered a sign of madness; they said that it was dangerous to wake up a sleepwalker and that he was acutely aware of danger and could not harm himself. None of this is true. Somnambulism is by no means a sign of madness; It is very difficult to wake up a sleepwalker- it is better to carefully guide him back to bed; about 25% of sleepwalkers cause various injuries to themselves during night wanderings. It happens that somnambulists fall out of windows, mistaking them for doors. Sometimes you hear stories about how you are able somnambulism people drove cars, flew airplanes, and did other things complex species activities. In fact, this is unlikely. Although, being in a state of confusion, a somnambulist is able to get into a car and start the engine, he will not be able to drive it normally due to the lack of quick reflexes at such moments - an accident will immediately occur.

A lunatic should never be frightened, you must try to carefully put him to bed or very calmly, quietly wake him up. Sleepwalking is treatable. Sleepwalking should be interrupted in the same manner as sleep - calmly, in a quiet voice.

Is it curable or not?

Yes. You need to see a neuropsychiatrist. He may recommend doing an electroencephalogram (EEG), Dopplerography of the vessels of the head and cervical region spine, others necessary research and will refer you to an ophthalmologist to examine the fundus.

Isolated, rare cases of somnambulism do not require special treatment. In case of neurotic disorders, it is necessary to eliminate or disactualize, that is, make less significant, traumatic effects on the psyche (psychologist, psychotherapist). It is possible to prescribe sedatives and restoratives. An increase in attacks may indicate organic disorders and requires immediate consultation with a specialist.

Is it a defense of the body or a disorder?

Somnambulism- this is a disorder. In occurrence somnambulism, can often play a role conflict situations: child’s reactions to insult, quarrel, punishment, fear. Somnambulism may occur as a manifestation general neurosis(hysteria, neurasthenia).

Of great importance are the psycho-emotional characteristics of the individual, as well as acute chronic and somatic diseases, perinatal (congenital) pathologies, neuroinfections and traumatic brain injuries.

Can this be overcome?
Can you live with this?

Somnambulism- (aka sleepwalking, aka sleepwalking) represents a potentially dangerous condition.

During an attack somnambulism falls and injuries are possible, as a result of which the sleeping person wakes up. To avoid accidents, the windows and doors of the room where a person suffering from somnambulism sleeps should be kept closed, electrical appliances should be turned off, open fire should be removed, etc. Sleepwalking should be interrupted in the same manner as sleep - calmly, in a quiet voice.

Do not self-medicate, consult a doctor!

Medical psychologist
Igor Aleksandrovich Stepanov

Somnambulism (sleepwalking) is pathological condition, in which a person can, in a state of sleep, perform actions unusual for a sleeper. If you don’t delve into it and don’t pay close attention to it, then by the nature of its movements, its activity may seem adequate and purposeful. However, such an impression is deceptive, since the person’s consciousness at this moment is clouded, since he is in a state of half-asleep and is not aware of his own actions.

The danger of somnambulism lies in the fact that a half-asleep patient can perform actions that a dream prompts him to do and this is beyond his control. A person can cause harm to himself, which often manifests itself in falls and physical injuries. In an extremely rare form of the disease, the patient may show aggression towards other people. Most often this happens to those who are trying to help, stop, return the person to bed, or simply get in the way.

In its usual uncritical form, somnambulism manifests itself in the fact that a person can walk in his sleep or simply sit on the bed. The period of half sleep and half wakefulness lasts in most cases no more than one hour, after which the patient falls asleep normally, returning to his bed. Waking up in the morning, people have absolutely no memory of their nightly adventures.

Sleepwalking is most common in children of preschool and primary school age. In adolescence, manifestations of somnambulism are associated with hormonal changes in the body. In most cases, sleepwalking occurs without any pathological consequences as the child grows up.

In adults, somnambulism indicates mental, psychological, neurological and physiological nature. If the manifestations of sleepwalking in children are quite simple to observe and promptly correct if necessary, then the reasons for this condition in an adult must be carefully clarified. If you don't timely diagnosis and treatment, the patient’s condition may worsen, attacks may become more frequent and ultimately result in serious deviations.

In the past, this pathology was called “sleepwalking,” but in modern medicine it is considered incorrect. It comes from a combination of the Latin words “moon” and “madness.” However, in fact, somnambulism is not associated with the cycles of the moon, as was believed in ancient times; the term sleepwalker is sometimes used out of habit.

Causes of somnambulism

Sleep is divided into two phases: slow and fast. The slow phase is the longest, accounting for 80% of the entire night's rest. It is divided into several states - drowsiness, medium and deep sleep. The REM sleep phase takes significantly less time, on average about 20%.

A full night's sleep includes from 3 to 5 cycles, each of which lasts from one and a half to two hours. First, the person falls into a short nap, then falls asleep deeply. NREM sleep makes up the first 2-3 cycles, REM sleep is short-term and is typical for the pre-dawn and morning hours.

Slow, deep sleep constitutes the bulk of our rest. Fast has this name not only because of its brevity, but also because at this time a person’s eyes move quickly in a dream. This happens before waking up, when a person dreams.

Somnambulism manifests itself in the deep sleep phase, when a person’s consciousness is most detached. This condition is thought to be caused by sudden bursts of electrical nerve activity in certain neurons in the brain. In this condition, part of the brain sleeps, while the other part continues to be active. To put it simply, we can say that the part of the brain responsible for conscious, meaningful activity is in a state of sleep, and the centers that control motor coordination are active.

In children, sleepwalking in most cases is associated with immaturity and insufficient development of the central nervous system. Children, due to their emotionality and impressionability, perceive information received during the day very sensitively. Due to the functional immaturity of the nervous system and excessive stress, they experience a state of partial sleep. Active games, strong emotional experiences, overexcitation due to computer games, cartoons, video programs in evening time or too much information. In fact, the child’s brain simply does not have time to calm down and this manifests itself in night walking.

Other causes of somnambulism in children include the following factors:

• heredity - manifestations of somnambulism occur in almost half of children, one of whose parents suffered from sleepwalking at some point in their lives;
• illness with high fever;
• stress that the child’s psyche could not cope with;
• epilepsy - sleepwalking may be one of the signs, and may also be one of the early manifestations diseases.

In adults, sleepwalking is a rather rare phenomenon; it can be triggered by the following diseases:

• neuroses of various etiologies, most often hysterical and obsessive-compulsive neurosis;
• vegetative-vascular dystonia with attacks of panic attacks;
• diabetes mellitus with manifestation of nocturnal hypoglycemia;
• migraine;
• intoxication with brain damage;
• state of chronic stress;
• obstructive sleep disorders;
• syndrome chronic fatigue;
• magnesium deficiency in the body (due to poor diet or illness);
• consequences of traumatic brain injury;
• vascular diseases of the brain;
• epilepsy;
• brain tumors;
• senile dementia;
• drug addiction, alcoholism;
• cardiac arrhythmia;
• taking certain medications.

Sleepwalking can be caused by a sharp loud sound or a sudden flash of light that disturbs the peace of a sleeping person. It was this factor that led to the fact that sleepwalking in the past was directly associated with the effects of the full moon. In fact, there is nothing mystical about somnambulism; it is caused by disorders of the brain.

Symptoms of somnambulism

Not all people susceptible to somnambulism walk in their sleep. Other manifestations of partial sleep may also be signs of the disease. Passive symptoms of somnambulism include a condition in which the patient sits on the bed in a dream with with open eyes and a fixed gaze. As a rule, after sitting like this for a short time, he goes to bed and continues to sleep peacefully until the morning.

IN difficult cases the patient can move around the house and even go outside. At the same time, all movements from the outside look calm and purposeful. The eyes are open, but the eyeballs do not move, the gaze is absent and unconscious. Some patients perform a whole range of actions - taking certain things, changing clothes, leaving the house, walking on the roof, balancing at a dangerous height and unstable surface.

For all manifestations of somnambulism, a number of generalizing factors have been identified:

1. Lack of awareness. When performing any actions, a person does not react in any way to the speech addressed to him, does not perceive hazardous conditions in their movements. This, as mentioned above, is a sign that part of the brain is in a state of sleep.
2. An absent look. The eyes of a somnambulist are always open, their gaze focused on something distant. Even if someone comes close to the patient and tries to attract attention, he looks through him. Consciousness is asleep.
3. Detachment. A person in a state of half-sleep cannot show any emotions, his face does not express them at all, facial expressions in most cases are completely absent, as happens during deep sleep.
4. Lack of memories. A sleeping consciousness is not able to record in memory a person’s nightly adventures. In the morning he remembers absolutely nothing about what happened to him during the night attack.
5. Same ending. For all somnambulists, the end of the attack occurs in the same way - he falls asleep in a normal sleep. If he managed to return to his own bed, he spends the night there until he awakens. But the end of REM sleep may find him far from his bed, then he goes to sleep wherever he has to. In the morning, such people experience a real shock, because having fallen asleep in their bed, it is unclear how they ended up in another place.

Diagnosis of somnambulism

To assign the correct effective treatment sleepwalking, you must first find out the reason that provoked it. To do this, you need to contact a specialist - a neurologist or psychiatrist.

The first stage of diagnosis is interviewing the patient with careful identification of details. You can help the doctor if someone close to you marks the time of going to bed, the beginning and end of an attack of somnambulism, and the time of waking up in the morning. Also important factors The specialist will have a list of medications taken and basic foods from the daily diet.

Depending on the results of the examination and questioning of the patient, the doctor may prescribe instrumental, laboratory research and consultations with specialized specialists - endocrinologist, pulmonologist, cardiologist. Instrumental studies used in such cases include:

• electroencephalography;
• polysomnography;
• Ultrasound of cerebral vessels;
• fundus examination;
• MRI of the brain.

Laboratory tests are carried out according to indications. You may need to check for hormones, infection, and blood levels of vitamins and minerals. Based on the collected data, the cause of sleepwalking is identified, based on which therapy is prescribed.

Treatment of somnambulism

In children, the disease goes away on its own as the brain grows and develops. Treatment of a child suffering from somnambulism most often comes down to correcting the daily routine, nutrition and psychological stress.

In the case of an illness in an adult, the treatment process is not so simple and straightforward, since the reasons for its origin are much deeper and more serious. Sleepwalking therapy is carried out using psychotherapy and medications. If attacks of night movements appear after stress, emotional or mental stress, then first of all the help of a psychologist or psychotherapist is needed.

Drug treatment

According to individual indications, the patient may be prescribed sedatives or sleeping pills, and in some cases tranquilizers are used. Choice drug therapy- a very important moment; the specialist takes into account many factors before prescribing this or that drug.

If the patient has vascular, neurological, endocrine or cardiac diseases therapy focuses on treating the underlying disease. For example, if the cause of sleepwalking is attacks of severe arrhythmia, then it is the heart disease that should be treated. In cases where the problem is caused by brain tumors, surgery will likely be required.

Mainly during treatment, it is important to create conditions under which a person will feel calm and confident. You can relieve fatigue and anxiety using physiotherapeutic methods and relaxation practices.

Forecast and prevention of somnambulism

In general, experts give a favorable prognosis for getting rid of sleepwalking. By using medicines, physiotherapy, psychotherapy and preventive measures manifestations of somnambulism in adults can be eliminated. Problems can arise only in the case of paroxysmal (epileptic) sleepwalking. In such situations, treatment can be lengthy and provide only temporary results. However, with the help of complex methods, even in this case it is possible to achieve stable and long-term remission.

Prevention of somnambulism is primarily based on eliminating psychologically traumatic factors from the patient’s life, correcting sleep and wakefulness patterns, and selecting a diet. Experts say that most often the cause of somnambulism is psychological factors, mental and physical stress. Relapse prevention concerns simple rules- a person must have proper rest, sleep at least 8 hours a day, eat a balanced diet, minimize stress and eliminate chronic fatigue syndrome.

Speaking about preventive measures, one cannot fail to mention the creation of safe conditions for the somnambulist before, during and after treatment. It is necessary to ensure that the windows and doors in the patient’s bedroom are always closed, and that there are no sharp objects or corners. This is necessary to reduce the risk of injury during night attacks.

Somnambulism- a special abnormal state of the central nervous system, in which an individual carries out any actions while being in one of the stages of sleep - the deep slow-wave sleep phase. This disorder colloquially referred to as “sleepwalking” or “sleepwalking.”

According to official data, somnambulism has been recorded in more than 2% of the planet's inhabitants. In most cases, sleepwalking is determined in persons with mental disorders or neurotic diseases, however, this phenomenon can be occasionally observed in objectively healthy people. Most often, somnambulism is defined in the age category from 17 to 23 years, regardless of gender.

Somnambulism manifests itself in the fact that a sleeping person, being in special condition: half asleep, half awake, gets out of bed and carries out actions familiar to him. The somnambulist is able to walk around the apartment, turn on electrical appliances, open water taps, get dressed, and put his appearance in order. In some cases, the sleepwalker commits extreme dangerous actions, for example: driving a car, making suicide attempts.

An attack of sleepwalking lasts on average from 10 to 30 minutes, but cases of somnambulism lasting about three hours have been recorded. At the end of his nightly “walks,” the somnambulist returns to bed, and in the morning he does not remember his “adventures” at all.

Causes of somnambulism

Sleepwalking is most often recorded when there is an incorrect transition from the deep slow-wave sleep phase to the second stage. In some cases, somnambulism is a kind of continuation of nightmares that arise when the brain works in the delta rhythm.

The phenomenon of sleepwalking in most cases is determined in persons who suffer from depressive states, in particular, have a history of bipolar disorder. Often sleepwalking is a companion initial stages schizophrenia. Sleepwalking is also recorded in neurological patients with the following conditions:

• with neurasthenia;
• with hysterical neurosis;
• with obsessive-compulsive disorder;
• with chronic fatigue syndrome;
• in Parkinson's disease.

One of the common causes of sleepwalking is epilepsy. Also, somnambulism can develop after a strong emotional shock or being in a chronic state of stress. Often, episodes of sleepwalking are detected in people with chronic lack of sleep due to persistent insomnia.

External factors can also trigger somnambulism:

• loud conversation or sharp sounds in the room of a sleeping person;
• sudden flash of bright light;
• excessive lighting in the room, which can also be the result of saturated moonlight during a full moon.

A hereditary predisposition to sleepwalking has been established: at risk are 45% of people whose one parent suffered from somnambulism and 60% of people whose both ancestors had this condition.

The mechanism of development of somnambulism

In healthy people, the sleep process starts with the first phase of orthodox (slow) sleep, the scientific name of which is Non-REM sleep. The duration of this stage ranges from 5 to 10 minutes. Brain activity operates in theta wave mode in the range from 4 to 8 Hz. Characteristic phenomena for this state are drowsiness, fantasies and dreams, thoughts of illogical content, hallucinogenic visions, visual illusions.

After this comes the second phase - lung stage sleep, the duration of which is approximately 20 minutes. The appearance of the sigma rhythm is recorded - rapid alpha waves in the range from 12 to 20 Hz. During this period, consciousness switches off and the threshold of perception increases significantly.

The next stage of sleep, lasting from 30 to 45 minutes, is the phase of slow and deep slow delta sleep, corresponding to the third and fourth stages of sleep. The rhythm of the brain consists of high-frequency delta waves at a frequency of 2 Hz. It is at this stage that a person experiences nightmares and bouts of sleepwalking.

At the end of the fourth phase, the sleeping person returns to the second stage, after which the first segment of paradoxical (rapid eye movement) sleep begins, called REM sleep, the duration of which does not exceed 15 minutes. The range of brain activity is beta waves with a frequency of 14 to 30 Hz. It is assumed that fast-wave sleep provides a kind of protection to the human psyche, processes incoming information, and establishes connections between consciousness and the subconscious sphere.

The above sequence is called sleep cycles, the number of which during a night’s rest is five episodes. Failure during the fourth stage of sleep is a trigger for somnambulism.

Characteristics of somnambulism

Somnambulism is characterized by a combination of two states: the sleepwalker exhibits signs of drowsiness and signals of wakefulness, so the state of the brain can be conditionally called half-asleep-half-awake. The brain of a somnambulist reacts to tactile stimuli and sound signals, but it is not able to connect the received signs into a single chain due to the fact that the vigilance function is “turned off.”

During sleepwalking, a person’s eyes are in most cases open, the pupils are significantly dilated. An increased heart rate and more frequent intermittent breathing are detected. The somnambulist is able to maintain body balance and deftly carry out various movements, for example: skillfully bypass existing obstacles. The person retains the ability to perform complex actions that require coordinated movements, for example: driving a car.

The main danger of somnambulism: the disappearance of feelings and emotions, the inability to logically control one’s actions. In this abnormal state, clarity of consciousness disappears: the sleepwalker lacks a sense of fear, a sense of threat and danger. That is why he can perform such actions that he would never dare to do in a waking state. Due to the lack of conscious control, the somnambulist can cause harm to himself or cause significant harm to others.

The absence of any sensations in the emotional aspect is evidenced by a person’s “detached” and impartial face. Even in case real threat for life, there will be no changes in the appearance of the sleepwalker. A person’s gaze during sleepwalking is concentrated, but it is not fixed on any object, but is directed into the distance.

After getting up in the morning, the somnambulist has no memory of how unusually he spent the night. An individual often learns about his nocturnal adventures from relatives, and at the same time perceives information about himself as an absurd, evil prank.

All episodes of somnambulism end according to one scenario: the person returns to bed or goes to bed in some other place and continues to sleep. In the same way, a somnambulist will continue his sleep if close people put him to bed.

What to do with a sleepwalker: algorithm of actions

Doctors do not recommend trying to wake up a sleepwalker: this can be dangerous for mental health person and cause him psychological discomfort. You should not try to rouse a somnambulist by using physical violence against him. In the event of a violent awakening, a strong attack of fear is likely to develop, during which a person can commit acts dangerous to himself and others.

It is advisable to carefully take the person by the hand and lead her back to bed. Almost all sleepwalkers react to calls to him and gestures from loved ones, so it would be appropriate to address him with “setting” words, for example: “You are sleeping and will continue to sleep.”

Treatment methods for somnambulism

In the case of isolated manifestations of somnambulism, there is no need to conduct therapeutic measures. However, if you suffer from chronic sleepwalking, you should seek medical help, as there is high risk a person commits life-threatening actions. Treatment is focused on eliminating the underlying disease for which therapy is used. pharmacological agents various classes. The choice of a specific medication is based on clinical picture main ailment and general condition patient's health.

A safe and harmless alternative drug treatment with somnambulism is hypnosis. During hypnotic sessions, a person is immersed in a state of somnambulism - the deepest stage of hypnosis. At the same time, it is possible to achieve the functioning of the brain in such a mode when it is possible to subordinate all the properties and characteristics of the psyche to the required idea, the necessary feeling, the necessary experience. The criteria for assessing this state during hypnosis can be considered amnesia - memory loss and the appearance of hallucinations when the client’s eyes are closed. With deep slow delta sleep, it is possible to influence directly the cause of the painful condition: neurotic, anxious, post-stress or depressive disorders, thereby saving a person from sleepwalking once and for all.

“- Please tell me where should I go from here?
-Where do you want to go? - answered the Cat.
“I don’t care...” said Alice.
“Then it doesn’t matter where you go,” said the Cat.
“...just to get somewhere,” Alice explained.
“You’ll definitely end up somewhere,” said the Cat. “You just have to walk long enough.”

Somnambulism (deep stage of hypnosis) is a mode of brain operation in which all mental forces are subordinated to one idea or feeling. The criterion for achieving this state can be considered amnesia (memory loss) and hallucinations (with eyes closed).

• Audio recordings for achieving ultra-deep stages of hypnosis.

For therapeutic purposes, “somnambulism light” is usually used - middle stage hypnosis (two points according to Katkov, the level of eyelid catalepsy in Elman’s induction), but even this level of immersion will require courage from you. It will be necessary to give up everyday fears about hypnosis (“they will turn you into zombies, break your psyche”) and think about why the two-century practice of using hypnosis in medicine has not led to licensing of hypnotherapy activities? Having answered this question within yourself, think about the purpose of going into somnambulism. Do you want to get rid of psychosomatic illness or just experience the feeling of hypnotic nirvana? Both are good, but in the first case you need to be prepared for the fact that familiar symptoms will arise at some stage. After all, you want to get rid of them? Then, while listening to the recording, you will have to not only put up with them, but also hold on to them and even savor them. This is necessary so that the process of therapy can begin in the free layers of the psyche that you have uncovered.

Please use audio recordings freely. You can turn on any of them from the place where you can surrender to the surging emotions: sob excitedly, and laugh convulsively, and have hysterics, and express thoughts out loud. You can use both tracks alternately, switching from the first to the second or vice versa as soon as any obstacle arises. The main thing is not to forget that this is not a treatment, but a “tester” - a game of hypnotherapy. The hypnostimulator is designed to create an advertising and propaganda effect so that you become more serious about the possibilities of hypnotherapy. Therefore, smoothing or even complete disappearance painful symptoms should not mislead you - you just got the opportunity to make sure that hypnotherapy is indicated for you. Now you know for sure that you should make an appointment with a live specialist to undergo a full course of treatment.

Sleepwalking - this is an altered state of human consciousness, that is, a dream in which people walk and make movements without realizing or controlling them. Therefore, in medicine the Latin term is used somnambulism, which accurately reflects the essence of this phenomenon, because it is translated as “sleepwalking.”

If for a person suffering from sleepwalking. people watch, they see how the sleeping person gets out of bed and begins to get dressed, walk around the room, move things or light furniture, he can also leave the house and go for a “walk” along the street. Such “travels” can end happily and somnambulists return to their bed in the morning, or they can end in failure – patients receive injuries and injuries (25%) or die (they can “go out” of the window, climb onto high buildings, hit your head, fall hard, get hit by a car – 0.02%).

This phenomenon is not uncommon; as is commonly believed, every 50th person on Earth has experienced at least one episode of sleepwalking in their life.

Main objective signs of the disease:

• a person is sleeping, but his eyes are open;
• while moving, patients touch cabinets, chairs, tables, and may stumble and fall;
• the somnambulist’s face is mask-like, impassive;
• patients do not hear calls to them;
• upon awakening, patients do not remember anything or are disoriented under the impression of blurry and fragmentary memories.

Episodes of sleepwalking last on average 10-25 minutes, for some people they last a couple of seconds, and for others they can take an hour or even more.

Video:

ICD-10 code

IN official medicine somnambulism
refers to sleep disorders that do not have organic pathology. It is included in the group of diseases with code F51.

When sleep and wakefulness disturbances are characterized as persistent and persistent for accurate diagnosis This code is used in combination with the code for the underlying underlying disease (mental or physical disorder). If the disease is based on neurotic and emotional factors, sleepwalking is indicated by the symbols - F51.3.

In the international medical classification of diseases, sleepwalking is defined as a disorder that combines sleep and wakefulness at the same time. That is, in the process of inhibition of neurons in the cerebral cortex in the slow-wave sleep phase, alpha activity predominates in all zones, and beta activity predominates in areas responsible for movement (they remain under the influence of the excitation wave). Due to this imbalance, the phenomenon arises sleepwalking.

Causes

Why does the disease appear? This issue has not been fully studied. Assumptions about what provokes a change in the balance between the processes of excitation and inhibition in somnambulists are theoretical in nature, unconfirmed by a sufficient number of practical studies.

American scientists have put forward a version of the presence in human body a special fragment of the 20th DNA chromosome that contributes to the development of sleepwalking. Their research shows that this chromosomal part increases the risk of developing the disease by 50%.

However, the scientific community was unable to identify the specific gene that carries this mutation. In addition, it does not exclude the possibility that several genetic structures can simultaneously cause somnambulism.Therefore, the causes and treatment of sleepwalking are based on the analysis of empirical data, or, more simply, on the experience of doctors and their practical observations.

Factors provoking the disease are:

• immaturity (in children) or functional disorders work of the central nervous system (in adults);
• psycho-emotional problems: increased anxiety or suspiciousness, phobias, chronic stress, mental trauma, neurasthenia;
• migraine, tension headaches;
• low adaptive abilities when constant acclimatization is necessary (moving, business trips, etc.);
• heredity (frequent cases of carriage of the disease in the family);
• epileptic conditions;
• bruises, contusions or concussions;
• insomnia;
• increased meteosensitivity;
• increased mental stress or performing tasks that require attention and responsibility;
• acute infections or chronic diseases.

In children

As an episodic phenomenon, recurring 1-2 times a year, sleepwalking affects about 30% of children from early to school age. Sleepwalking is a constant problem in only 5% of children.

Most often, the disease manifests itself at the age of 6 years and older.Although there are also cases of early sleepwalking (at 2-4 years). Its prevalence among boys is greater than among girls.

Childhood somnambulism usually self-destructs when the child reaches 15-16 years of age. Only in rare cases (1%) the disease continues to manifest itself in young and adulthood.

In adults

Symptoms of sleepwalking at the age of 20-50 years and older appear quite rarely, usually against the background of chronic pathologies:

• neoplasms or brain injuries;
• vegetative-vascular disorders and degenerative processes in nerve cells;
• bronchial asthma;
• Parkinson's disease;
• diabetes mellitus;
• mental disorders (schizophrenia, manic-depressive psychosis);
• vascular pathologies (atherosclerosis, aneurysms);
• drug addiction and (or) alcoholism.

Sometimes the development of sleepwalking attacks is provoked by taking medications: psychotropic, neuroleptic, sleeping pills, sedatives or tonics, excessive workload, prolonged lack of sleep, air travel, emotional stress.

Treatment

There are many ways to get rid of sleepwalking.

• For the true form of the disease (inorganic), consultations and sessions with a psychologist are needed.
• In most cases, somnambulism does not require drug therapy unless it is caused by injury, brain disease, or internal organs. In order to exclude them, a comprehensive examination of the child or adult is carried out, with using EEG(electroencephalogram), x-ray, MRI, biochemical and general analyzes blood, hormonal tests, etc.

• To identify sleepwalking due to emotional disturbances, chronic fatigue, neuroses or depression, it is important to consult a psychotherapist or psychiatrist. These specialists will help identify the underlying problems that provoke sleepwalking and determine how to treat the disease. By selecting special corrective techniques and therapeutic exercises, they will give patients the opportunity to understand the root cause of somnambulism and develop ways to eliminate it, as well as to restore a normal state of mind.

Pharmacological agents are rarely used in the treatment of this disease, in the presence of concomitant mental disorders or persistent functional disorders in the functioning of the nervous system or in organic pathologies.

Safety precautions for sleepwalkers

1. Appropriate furnishings in the bedroom (cutting, piercing, breakable objects are removed at night).
2. Bars are placed on the windows.
3. The internal door of the room is equipped with a bell, and the external door with reliable locks.

Close people and those around them should treat those suffering from somnambulism with understanding: help protect themselves, support with words, and console. You cannot ridicule the disease and make jokes about night “walks”; this can traumatize patients and aggravate their condition.