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WHAT CAN HAPPEN WHEN SLEEPERS WALK By Mary Grodio Sleepwalking is an episode that occurs among approximately six percent of the population. For some, it is an uncommon experience that occurs in the course of growing. For others, it is an event that leads to deadly results. Somnambulism, the scientific term for sleepwalking, is the most common parasomnia, which is a category of disorders that describes any activity associated with being awake that occurs during sleep, including urinating and talking. Sleepwalking disorder occurs more frequently in children than in adults and children tend to outgrow the disorder by adolescence. Approximately fifteen percent of children between the ages of five and twelve have isolated experiences of sleepwalking. Therefore, it has been suggested that immaturity of the central nervous system plays a role in sleepwalking. Dr. Richard Ferber, director of the Center for Pediatric Sleep Disorder at the Children's Hospital in Boston agrees that sleepwalking is more commonly found among children. "It is much more common to see sleepwalking in children than it is in adults," said Farber. Aside from genetics, sleepwalking has reportedly been a result of a specific setting, stress, fatigue, and physical illness. These psychological disturbances however, have only been found in adults, not children. In most cases it is found that fatigue and lack of sleep can lead to more frequent episodes of sleepwalking. Arizona Diamondback pitcher Brian Anderson experienced a sleepwalking episode as an adult, in a Cincinnati hotel room, according to the Plain Dealer. "I guess as soon as the door closed behind me I woke up," said Anderson, "I looked around and said 'What am I doing here?'" Anderson wandered from his hotel room wearing only a pair of socks. It is quite possible that work related stress or fatigue was a cause of Anderson's episode. According to the DSM IV (Diagnostic Statistical Manual), Sleepwalking Disorder encompasses a number of characteristics. It is recognized by repeated episodes of rising from bed during sleep and walking about, usually occurring during the first third of the major sleep episode. While sleepwalking, the person maintains a blank, staring face and is relatively unresponsive to the efforts of others to communicate with him or her. Generally, the sleepwalker can be awakened only with great difficulty. Upon awakening, either from the sleepwalking episode or the next morning, the person has amnesia for the episode. Within the first few minutes after awakening, there is no impairment of mental activity or behavior however, there may initially be a short period of confusion or disorientation. On a larger scale, sleepwalking can cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. The disorder is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition. Sleepwalking is thought to have a genetic component and this is generally supported with the results of twin studies. Studies show that if one identical twin sleepwalks, the other twin is six times as likely to sleepwalk than other siblings are. In other cases, sleepwalking can be symptom of psychological conflict, medical, or neurological disorder. Veronica Sullivan, the mother of twin girls, Jenna and Mikayla and son Tyler, found support for this statement. "When the girls were five, Jenna experienced a few sleepwalking episodes within a four week span," said Sullivan, "And a few months later Mikayla had two episodes, but Tyler never had one." The act of sleepwalking usually begins within the first one to three hours following the onset of sleep, during the deep sleep stage (NREM). Since dreaming occurs within the REM stage of sleep, the idea that sleepwalking occurs in response to dreaming appears invalid. The episode, which can last anywhere from five to twenty minutes, may include the sleepwalker performing routine acts such as dressing and undressing, opening and closing doors, and turning lights on and off. "I was a little worried at first," admitted Sullivan, "But I consulted my kids' doctor and he said it was normal for children to have sleepwalking episodes." Sullivan also addressed Jenna's episodes by staying awake until the estimated time that the episode would occur, to be sure that nothing dangerous happened. "My husband and I would wait up until we thought the episode would occur to make sure Jenna didn't hurt herself," said Sullivan, "We also put a gate at the top of the stairs, so she couldn't fall down." Although the Sullivan's took proper precautions, nothing harmful ever happened to Jenna. "Normally she would just walk to the bathroom and wash her hands or open and close the cabinet doors," said Sullivan. Although it is not considered abnormal for sleepwalking to occur, children are often frightened by the experience. The following is a testimony, in the form of a poem, of a child who suffered from sleepwalking episode. "I awoke vertical. Eyes half-open, arms limp at my sides. Red painted toes sinking in emerald-green grass. Sleepshirt blowing easily. Then the coldness. Pure icy chills over and over. Up your spine. Giving you goosebumps. I turned. When my eyes met it. I froze. My mind said I was dreaming. My body knew I wasn't. My heart said, 'Run inside!' But I couldn't run inside that huge dark unfriendly-looking house. Which I thought wold always be comforting to me. So I stood there, darkness pouring down on me and vowed never to sleepwalk again." Some incidents of sleepwalking are more than just a little frightening. The following is an example of a sleepwalking episode that turned deadly. On January 16, 1997 Scott Falater killed his wife, Yarmilar Falater. He stabbed her repeatedly and then hid is stained clothes in his car. Then he put his wife's body in the family's' swimming pool. Falater was arrested the next day and later found guilty by panel of jurors, after much controversy over whether or not the murder was committed uncontrollably during a sleepwalking episode. Falater's family has a history of sleepwalking. Although sleepwalking cannot be fully prevented there are measures and precautions that can be taken to prepare for episodes. To prevent sleepwalkers, especially children, from being hurt, gates can be put on stairways, special locks (above children's reach) can be fastened to doors, and bunked beds should be avoided. Also, making sure a child gets plenty of sleep on a routine basis can help reduce the chances of having a sleepwalking episode. In the event of an episode, it is recommended to first lead the sleepwalker to the bathroom, as her or she may be looking to urinate. Then, gently lead the sleepwalker back to bed. It is not recommended to attempt to wake a sleepwalker during the episode, as it is usually impossible. The following is a recommended procedure to take to attempt to reduce the incident of sleepwalking in children who frequently have episodes. For several nights note how many minutes pass from the time the child falls asleep to the time he or she starts sleepwalking. Then on the following nights awaken the child fifteen minutes before the time that he or she is expected to start sleepwalking. Remind the child at bedtime that when you do this, he or she should wake up quickly. Upon waking the child, keep him or her awake for five minutes. Continue these prompted awakenings for seven nights in a row. Should the sleepwalker start to have episodes again, repeat the seven-night training process. Dr. Farber recommends allowing the episode to occur. "During the event it's usually best just to allow it to run its course," said Farber, "The only job a parent really has is to make sure the child doesn't do anything injurious."