“Turjo is a 10years old child who read in class 4. He belongs to a Muslim family in Bangladesh. He is a very energetic and active boy. He lives with his grandmother and grandfather. He sleeps with his grandmother at night. Since he was 5 or 6 years her grandmother noticed a strange thing in him. The strange thing is that turjo start to walk during sleep. He woke up in the middle of the night and start to walk. At first, his grandmother didn’t understand that. But one night her grandmother woke up from sleep to go to the toilet, and suddenly she noticed that turjo wasn’t in his bed. She was scared and start to find her grandson. Then suddenly she saw his grandson walking on the verandah. She called him and said “what are you doing baby? Come here.” But he didn’t respond. His eyes were open, he was walking but didn’t listen to her grandmother. After a while, he fell asleep in his own bed. After that night her grandmother started noticing him from time to time. She observed that turjo woke up almost 3/4nights in a weak and walked quietly and back to sleep. She was very tense and shared it with her husband. Her husband didn’t pay any attention to this. So she decided that she would talk with her niece who is a psychiatrist. Talking to the psychiatrist, she realized that it was a mental illness and needed to be treated very quickly.”
What are you understand by reading this case study? Have you or anyone close to you ever had to face this problem? Is it really a mental illness? To answer these questions we need to know about sleepwalking. Let’s know about it…
Sleepwalking
Sleepwalking is one kind of parasomnias. Parasomnias are disorders characterized by abnormal behavioral, experiential, or physiological events occurring in association with sleep, specific sleep stages, or sleep-wake transitions.
According to DSM V sleepwalking is a symptom of Non-rapid Eye Movement sleep arousal Disorders. In sleepwalking a person has recurrent episodes of rising from bed during the first third of the major sleep period and walking. While sleepwalking the person has a blank, staring face, unresponsive, and can be awakened only with great difficulty. Amnesia for the episode is present. No impairment of cognitive functioning within minutes if awaking. Episodes cause clinically significant distress. the symptoms are not due to the effects of a substance or drug or in General Medical condition.
According to ICD-10, in sleepwalking a person faces recurrent episodes of rising from bed, usually during the first third of nocturnal sleep and walking about. The person is blank, staring face and unresponsive during an episode. No recollection of the episode upon awakening. No cognitive or behavioral impairment within the several minutes of walking the episode. There is no evidence of an organic mental disorder or a physical disorder such as epilepsy.
In sleepwalking, which typically lasts about 10-20 minutes, sometimes more than that. A person usually leaves the bed, may get dressed, and walks unresponsively about the house, and is resistant to awakening. the main danger with sleepwalking is that the person will be inadvertently injured during the episode.
So we can say, sleepwalking also called somnambulism, a behavioral disorder of sleep in which a person sits up and performs various motor actions, such as standing, walking about, talking, eating, screaming, dressing, going to the bathroom, or even leaving the house. Sometimes these are the symptoms of a mental health condition and may cause psychological distress and interfere with relationships, work, and even overall life satisfaction.
Epidemiology
Generally prevalence peaks between 5 to 10 years of age. 10-20% of children and 1 to 4% of adults are affected. From 10% to 30% of children have had at least one episode of sleepwalking and 2% to 3% sleepwalk often. the prevalence of sleepwalking disorder marked by repeated episodes of impairment to distress, is much lower, probably in the range of 1%-5%.
CAUSES OF SLEEPWALKING
The main etiology is unknown. This disorder occurs most commonly in childhood and diminishes in frequency with increasing age. The onset of sleepwalking in adults with no prior history of sleepwalking as children. Some sleep experts proposed that it has genetic causes. Family history for sleepwalking may occur in up to 80% of individuals who sleepwalk. The exact mode of inheritance is unknown.
There are some environmental causes that also exist. These are :
- Sleep deprivation
- stress and anxiety
- fever and infection
- Certain uses of drugs such as sedatives.
- Sleep-wake schedule disruption
- Fatigue
- Drinking too much Alcohol
- Travel and sleep interruption. Etc.
Sometimes it occurs due to other disorders such as breathing-related sleep disorder, nightmare disorder, night eating syndrome, etc.
Treatment
Treatments of sleepwalking depend on a person’s age, the severity of the disorder, how dangerous or disruptive the episodes are. That means it is based on impairment or distress as well as a degree of danger to the individual or others. There are some treatments for sleepwalking. These are given below:
- A regular sleep schedule.
- Avoidance of sleep deprivation.
- Safe sleep and a home environment (e.g. locking of windows, sleeping on the ground floor) may be beneficial.
- Make sure the bedroom is quite calm, cool, and comfortable.
- Avoid any kind of stimulation.
- Limit stress.
- Therapy such as relaxation exercise, breathing exercise, and so on.
- Medication such as Clonazepam and other benzodiazepine receptor agonists can be used without tolerance developing in the individual. Etc.
After a long discussion about, we can say that sleepwalking is not only a behavioral disorder but also a mental illness. Though etiology is not clear there may be many causes of this disorder. So if any of us or any of our relatives are suffering from this disorder, we should take treatment as soon as possible. So at last we reach In a conclusion that “sleepwalking is a mental illness”.
