What Exactly Are Sleepwalking and Night Terrors?
Sleepwalking and night terrors are not just weird dreams or bad habits-they’re real medical events that happen during deep sleep. Both fall under a group of disorders called parasomnias, which are abnormal behaviors that occur while you’re asleep. Unlike nightmares, where you wake up scared and remember every detail, these episodes happen during deep, non-REM sleep. Most people have no memory of them at all.
Sleepwalking can look like someone getting out of bed, walking around the house, even opening cabinets or trying to leave. Night terrors are more intense: screaming, thrashing, rapid heartbeat, sweating, and extreme fear-often with eyes wide open but not really seeing anything. These aren’t tantrums or attention-seeking. They’re automatic brain responses during deep sleep.
They’re most common in kids between ages 3 and 8. About 1 in 5 children will sleepwalk at least once. Night terrors affect about 1 in 20 kids. Most outgrow them by puberty. But they don’t disappear in all cases. Around 1 in 25 adults still experience them, often linked to stress, sleep deprivation, or other sleep disorders like sleep apnea.
Why Do These Episodes Happen?
The brain doesn’t shut down fully during deep sleep. In sleepwalking and night terrors, part of the brain is still in deep sleep mode while another part is partially awake-like a computer stuck in hibernation but trying to run a program. This mismatch causes the body to move or react without conscious control.
These episodes almost always happen in the first third of the night, right after falling asleep, when slow-wave sleep is strongest. That’s why you rarely see them after midnight. They’re not caused by bad dreams or trauma. They’re triggered by things that increase deep sleep pressure: lack of sleep, irregular sleep schedules, fever, or even sleeping in a new environment.
Genetics play a big role. If one parent had sleepwalking as a kid, their child has a 45% chance of doing it too. If both parents did, that jumps to 60%. Research in 2023 found a specific gene variant (DEC2) linked to familial sleepwalking with 87% accuracy in affected families.
Adult-onset parasomnias are a red flag. If someone starts sleepwalking or having night terrors after age 18, it could signal an underlying neurological issue, sleep apnea, or even a side effect of medication. That’s why doctors recommend evaluation if it begins in adulthood.
How Dangerous Are These Episodes?
The biggest risk isn’t the episode itself-it’s what happens during it. People sleepwalk into walls, down stairs, or outside. One study found 73% of families reported at least one injury from sleepwalking. Most are minor: bumps, cuts, bruises. But 8% have suffered fractures, and 5% have wandered into traffic or left the house entirely.
Night terrors are less physically risky because the person usually stays in bed. But the sheer intensity can be terrifying for witnesses. Heart rates spike to 120-140 beats per minute. Breathing becomes fast and shallow. Skin gets sweaty and flushed. It looks like a medical emergency-but it’s not. The person isn’t in danger from the episode itself, but they can hurt themselves if they thrash around or jump out of bed.
Parents often panic. They try to wake their child. That’s the worst thing to do. Trying to rouse someone during a night terror can make the episode last longer and cause confusion or aggression. The best move? Stay calm, gently guide them back to bed, and wait it out. They’ll settle down on their own.
First Step: Make the Bedroom Safe
Before anything else-medication, therapy, or sleep schedules-secure the environment. This isn’t optional. It’s non-negotiable.
- Lock all windows and exterior doors. Use alarms that sound when opened (cost: $20-$50).
- Remove sharp objects, glass tables, or anything breakable within 10 feet of the bed.
- Place a mattress on the floor if the person sleeps on a high bed. This cuts fall injuries by 75%.
- Install gates at the top of stairs.
- Keep keys, phones, and shoes out of reach.
One parent in Christchurch installed a door alarm after her 6-year-old walked out into the street at 2 a.m. She said, “It didn’t stop the episodes, but it stopped the panic.”
These safety steps work for kids and adults alike. You don’t need to be a genius to do them. You just need to be consistent.
Behavioral Fixes That Actually Work
Medication isn’t the first answer. In fact, most cases don’t need it at all. The most effective treatments are simple, low-tech, and free.
Scheduled Awakenings
This is the #1 recommended method for sleepwalking. It works for about 70-80% of cases.
Here’s how: Figure out when the episode usually happens. Most occur 90-120 minutes after falling asleep. Set an alarm for 15-30 minutes before that time. When it goes off, gently wake the person up. Keep them fully awake for 5-10 minutes-talk to them, have them sit up, maybe drink water. Then let them go back to sleep.
Do this every night for 7-14 days. You’re interrupting the deep sleep cycle right before the episode would start. Over time, the brain learns not to trigger it.
Sleep Extension
When you’re sleep-deprived, your brain compensates by pushing harder into deep sleep. That’s when parasomnias happen. Adding just 30-60 minutes of extra sleep per night can cut episodes by 65%.
For kids, aim for 9-11 hours. For teens and adults, 8-9 hours. Go to bed earlier. Skip late-night scrolling. Turn off screens an hour before bed. One adult in a 2023 study went from 7.2 to 8.5 hours of sleep over eight weeks-and stopped sleepwalking entirely.
Consistent Sleep Routine
Your brain loves predictability. Going to bed and waking up within a 30-minute window every day-even on weekends-reduces episode frequency by 40-50%. That’s more effective than most medications.
Also, keep the bedroom cool (60-67°F), dark, and quiet. A hot, bright, noisy room increases arousal during sleep, making episodes more likely.
When to See a Doctor
You don’t need to rush to a specialist for every episode. But these five signs mean it’s time:
- Episodes happen more than twice a week.
- There’s violence-hitting, yelling, or attacking someone during an episode.
- Confusion lasts longer than 15 minutes after waking.
- It started in adulthood.
- You suspect sleep-related eating (getting up to eat, even while still asleep).
Adult-onset parasomnias are often linked to sleep apnea, restless legs syndrome, or even neurological conditions like Parkinson’s. A sleep study (polysomnography) can confirm the diagnosis and rule out other causes.
Most GPs don’t know much about this. If you’re dismissed, ask for a referral to a sleep specialist. The American Board of Sleep Medicine has over 7,800 certified specialists in the U.S. alone. You’re not overreacting. You’re being smart.
What About Medication?
Medication is a last resort. Only 5-10% of cases need it. But when it’s needed, it can be life-changing.
Clonazepam (a benzodiazepine) works for 60-70% of severe night terrors. But it carries risks: drowsiness, dependence, and tolerance. After three months, it often stops working.
Melatonin is safer. It helps regulate sleep cycles and reduces episodes in 40-50% of cases. Dose: 3-6 mg, taken 30 minutes before bed. No addiction risk. Side effects are rare.
There’s also a new FDA-approved option: the Nightware System. It’s an Apple Watch app that detects rising heart rate before a night terror starts. It then gently vibrates to interrupt the episode before it fully kicks in. In trials, it cut episodes by 35% over six months.
For adults with both sleep apnea and sleepwalking, treating the apnea with a CPAP machine often eliminates the parasomnia entirely.
What Doesn’t Work
Don’t waste time on these myths:
- **Waking someone during an episode**-it makes it worse.
- **Hypnosis or dream interpretation**-no strong evidence it helps parasomnias.
- **Herbal remedies like valerian or chamomile**-may help sleep quality, but not the episodes themselves.
- **Scaring or punishing the person**-this increases stress, which makes episodes more likely.
Also, don’t assume it’s “just a phase.” While most kids outgrow it, untreated adult cases can persist for decades. And they can be dangerous.
Support for Families and Caregivers
This isn’t just about the person having the episodes. It’s about the whole household. Parents lose sleep. Partners get scared. Siblings are disturbed. The emotional toll is real.
Keep a sleep diary for 4-6 weeks. Note the time, duration, what happened, and any triggers (stress, illness, late meals). This helps your doctor spot patterns.
Join a support group. Online forums like Reddit’s r/sleep or the Sleepwalking Foundation have thousands of people sharing real stories. One parent wrote: “I thought I was the only one. Then I found others who knew exactly what I meant.”
And remember: You’re not failing. This isn’t your fault. These are brain-based events, not behavioral problems.
What’s Next in Research?
Science is moving fast. In 2023, researchers found that people with restless legs syndrome have a 30-40% higher chance of developing parasomnias. That’s why screening for RLS is now part of standard care.
New drugs like daridorexant-an orexin receptor antagonist-are showing promise. In trials, they cut night terrors by 55%, with fewer side effects than clonazepam.
Apps like Sleepio now offer cognitive behavioral therapy for parasomnias (CBT-P) through smartphones. One 2023 study showed a 48% drop in sleepwalking episodes after eight weeks of app-based therapy.
By 2024, the American Academy of Sleep Medicine will release new guidelines specifically for adult parasomnias. Right now, 73% of adult patients say their doctor doesn’t know how to help them. That’s changing.
Final Takeaway: You Can Manage This
Sleepwalking and night terrors aren’t curable in the traditional sense. But they’re highly manageable. Most kids outgrow them. Most adults can reduce episodes dramatically with simple, safe steps.
Start with safety. Then fix sleep habits. Track episodes. Wait it out. Only turn to meds if absolutely necessary.
It’s not about stopping the episodes completely. It’s about stopping the fear. Stopping the injuries. Stopping the exhaustion.
With the right approach, you can get your nights-and your peace-back.
