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Sleepwalking, also known as somnambulism or noctambulism, is a phenomenon of combined
sleep Sleep is a sedentary state of mind and body. It is characterized by altered consciousness, relatively inhibited sensory activity, reduced muscle activity and reduced interactions with surroundings. It is distinguished from wakefulness by a de ...
and
wakefulness Wakefulness is a daily recurring Human brain, brain state and state of consciousness in which an individual is conscious and engages in coherent cognition, cognitive and behavioral responses to the external world. Being awake is the opposite of ...
. It is classified as a
sleep disorder A sleep disorder, or somnipathy, is a medical disorder of an individual's sleep patterns. Some sleep disorders are severe enough to interfere with normal physical, mental, social and emotional functioning. Polysomnography and actigraphy are test ...
belonging to the
parasomnia Parasomnias are a category of sleep disorders that involve abnormal movements, behaviors, emotions, perceptions, and dreams that occur while falling asleep, sleeping, between sleep stages, or during arousal from sleep. Parasomnias are dissociat ...
family. It occurs during slow wave stage of sleep, in a state of low consciousness, with performance of activities that are usually performed during a state of full consciousness. These activities can be as benign as talking, sitting up in bed, walking to a bathroom, consuming food, and cleaning, or as hazardous as cooking, driving a motor vehicle, violent gestures and grabbing at hallucinated objects.Swanson, Jenifer, ed. "Sleepwalking". ''Sleep Disorders Sourcebook''. MI: Omnigraphics, 1999. 249–254, 351–352. Although sleepwalking cases generally consist of simple, repeated behaviors, there are occasionally reports of people performing complex behaviors while asleep, although their legitimacy is often disputed. Sleepwalkers often have little or no memory of the incident, as their consciousness has altered into a state in which memories are difficult to recall. Although their eyes are open, their expression is dim and glazed over.Lavie, Peretz, Atul Malhotra, and Giora Pillar. ''Sleep disorders: diagnosis, management and treatment: a handbook for clinicians''. London: Martin Dunitz, 2002. 146–147. This may last from 30 seconds to 30 minutes. Sleepwalking occurs during slow-wave sleep (N3) of
non-rapid eye movement sleep Non-rapid eye movement sleep (NREM), also known as quiescent sleep, is, collectively, sleep stages 1–3, previously known as stages 1–4. Rapid eye movement sleep (REM) is not included. There are distinct electroencephalographic and other cha ...
(NREM sleep) cycles. It typically occurs within the first third of the night when slow-wave sleep is most prominent. Usually, it will occur once in a night, if at all.


Signs and symptoms

Sleepwalking is characterized by: * partial arousal during non-rapid eye movement (NREM) sleep, typically during the first third of the night * dream content that may or may not be recalled when awake * dream-congruent motor behavior that may be simple or complex * impaired perception of the environment * impaired judgement, planning and problem-solving. Despite how it is portrayed in many cultures (eyes closed and walking with arms outstretched), the sleepwalker's eyes are open but may appear as a glassy-eyed stare or blank expression and pupils are dilated. They are often disoriented, consequent to awakening: the sleepwalker may be confused and perplexed, and might not know why or how they got out of bed; however, the disorientation will fade within minutes. They may talk while sleepwalking, but the talk typically does not make sense to the observer. There are varying degrees of amnesia associated with sleepwalking, ranging from no memory at all, vague memories or a narrative.


Associated disorders

In the study "Sleepwalking and Sleep Terrors in Prepubertal Children" it was found that, if a child had another sleep disordersuch as
restless leg syndrome Restless legs syndrome (RLS), also known as Willis-Ekbom disease (WED), is generally a long-term disorder that causes a strong urge to move one's legs. There is often an unpleasant feeling in the legs that improves somewhat by moving them. This ...
(RLS) or sleep-disorder breathing (SDB)there was a greater chance of sleepwalking. The study found that children with chronic parasomnias may often also present SDB or, to a lesser extent, RLS. Furthermore, the disappearance of the parasomnias after the treatment of the SDB or RLS periodic limb movement syndrome suggests that the latter may trigger the former. The high frequency of SDB in family members of children with parasomnia provided additional evidence that SDB may manifest as parasomnias in children. Children with parasomnias are not systematically monitored during sleep, although past studies have suggested that patients with sleep terrors or sleepwalking have an elevated level of brief EEG arousals. When children receive polysomnographies, discrete patterns (e.g., nasal flow limitation, abnormal respiratory effort, bursts of high or slow EEG frequencies) should be sought; apneas are rarely found in children. Children's respiration during sleep should be monitored with nasal cannula or pressure transducer system or esophageal manometry, which are more sensitive than the thermistors or thermocouples currently used in many laboratories. The clear, prompt improvement of severe parasomnia in children who are treated for SDB, as defined here, provides important evidence that subtle SDB can have substantial health-related significance. Also noteworthy is the report of familial presence of parasomnia. Studies of twin cohorts and families with sleep terror and sleepwalking suggest genetic involvement of parasomnias. RLS and SDB have been shown to have familial recurrence. RLS has been shown to have genetic involvement. Sleepwalking may also accompany the related phenomenon of
night terror Night terror, also called sleep terror, is a sleep disorder causing feelings of panic or dread and typically occurring during the first hours of stage 3–4 non-rapid eye movement (NREM) sleep and lasting for 1 to 10 minutes. It can last long ...
s, especially in children. In the midst of a night terror, the affected person may wander in a distressed state while still asleep, and examples of sufferers attempting to run or aggressively defend themselves during these incidents have been reported in medical literature. In some cases, sleepwalking in adults may be a symptom of a psychological disorder. One study suggests higher levels of dissociation in adult sleepwalkers, since test subjects scored unusually high on the hysteria portion of the "Crown-Crisp Experiential Index". Another suggested that "A higher incidence f sleepwalking eventshas been reported in patients with
schizophrenia Schizophrenia is a mental disorder characterized by continuous or relapsing episodes of psychosis. Major symptoms include hallucinations (typically hearing voices), delusions, and disorganized thinking. Other symptoms include social withdra ...
, hysteria and anxiety neuroses". Also, patients with
migraine Migraine (, ) is a common neurological disorder characterized by recurrent headaches. Typically, the associated headache affects one side of the head, is pulsating in nature, may be moderate to severe in intensity, and could last from a few hou ...
headaches or
Tourette syndrome Tourette syndrome or Tourette's syndrome (abbreviated as TS or Tourette's) is a common neurodevelopmental disorder that begins in childhood or adolescence. It is characterized by multiple movement (motor) tics and at least one vocal (phonic) ...
are 4–6 times more likely to sleepwalk.


Consequences

Most sleepwalkers get injuries at some point during sleepwalking, often minor injuries such as cuts or bruises. In rare occasions, however, sleepwalkers have fractured bones and died as the result of a fall. Sleepwalkers may also face embarrassment of being found naked in public.


Causes

The cause of sleepwalking is unknown. A number of, as yet unproven, hypotheses are suggested for why it might occur, including: delay in the maturity of the central nervous system, increased slow wave sleep,Pressman. "Factors that predispose, prime and precipitate NREM parasomnias in adults: clinical and forensic implications." ''Sleep Med Rev'' 11.1 (2007):5–30. sleep deprivation, fever, and excessive tiredness. There may be a genetic component to sleepwalking. One study found that sleepwalking occurred in 45% of children who have one parent who sleepwalked, and in 60% of children if both parents sleepwalked. Thus, heritable factors may predispose an individual to sleepwalking, but expression of the behavior may also be influenced by environmental factors. Genetic studies using common fruit flies as experimental models reveal a link between night sleep and brain development mediated by evolutionary conserved transcription factors such as AP-2 Sleepwalking may be inherited as an autosomal dominant disorder with reduced penetrance. Genome-wide multipoint parametric linkage analysis for sleepwalking revealed a maximum logarithm of the odds score of 3.14 at chromosome 20q12-q13.12 between 55.6 and 61.4 cM. Sleepwalking has been hypothesized to be linked to the neurotransmitter
serotonin Serotonin () or 5-hydroxytryptamine (5-HT) is a monoamine neurotransmitter. Its biological function is complex and multifaceted, modulating mood, cognition, reward, learning, memory, and numerous physiological processes such as vomiting and vas ...
, which also appears to be metabolized differently in migraine patients and people with
Tourette syndrome Tourette syndrome or Tourette's syndrome (abbreviated as TS or Tourette's) is a common neurodevelopmental disorder that begins in childhood or adolescence. It is characterized by multiple movement (motor) tics and at least one vocal (phonic) ...
, both populations being four to nine times more likely to experience an episode of sleepwalking. Hormonal fluctuations have been found to contribute to sleepwalking episodes in women, with the likeliness to sleepwalk being higher before the onset of menstruation. It also appears that hormonal changes during pregnancy decrease the likelihood of engaging in sleepwalking Medications, primarily in four classes—benzodiazepine receptor agonists and other GABA modulators,
antidepressants Antidepressants are a class of medication used to treat major depressive disorder, anxiety disorders, chronic pain conditions, and to help manage addictions. Common side-effects of antidepressants include dry mouth, weight gain, dizziness, hea ...
and other
serotonergic agents Serotonergic () or serotoninergic () means "pertaining to or affecting serotonin". Serotonin is a neurotransmitter. A synapse is serotonergic if it uses serotonin as its neurotransmitter. A serotonergic neuron ''produces'' serotonin. A substance ...
,
antipsychotics Antipsychotics, also known as neuroleptics, are a class of Psychiatric medication, psychotropic medication primarily used to manage psychosis (including delusions, hallucinations, paranoia or disordered thought), principally in schizophrenia but ...
, and
β-blockers Beta blockers, also spelled β-blockers, are a class of medications that are predominantly used to manage abnormal heart rhythms, and to protect the heart from a second heart attack after a first heart attack (secondary prevention). They are al ...
— have been associated with sleepwalking. The best evidence of medications causing sleepwalking is for
Zolpidem Zolpidem, sold under the brand name Ambien, among others, is a medication primarily used for the short-term treatment of sleeping problems. Guidelines recommend that it be used only after cognitive behavioral therapy for insomnia and behavior ...
and
sodium oxybate Sodium oxybate, sold under the brand name Xyrem among others, is a medication used to treat two symptoms of narcolepsy: sudden muscle weakness and excessive daytime sleepiness. It is used sometimes in France and Italy as an anesthetic given i ...
; all other reports are based on associations noted in case reports. A number of conditions, such as
Parkinson's disease Parkinson's disease (PD), or simply Parkinson's, is a long-term degenerative disorder of the central nervous system that mainly affects the motor system. The symptoms usually emerge slowly, and as the disease worsens, non-motor symptoms becom ...
, are thought to trigger sleepwalking in people without a previous history of sleepwalking.


Diagnosis

Polysomnography Polysomnography (PSG), a type of sleep study, is a multi-parameter study of sleep and a diagnostic tool in sleep medicine. The test result is called a polysomnogram, also abbreviated PSG. The name is derived from Greek and Latin roots: the Gre ...
is the only accurate assessment of a sleepwalking episode. Because this is costly and sleepwalking episodes are usually infrequent, other measures commonly used include self-, parent-, or partner-report. Three common diagnostic systems that are generally used for sleepwalking disorders are
International Classification of Diseases The International Classification of Diseases (ICD) is a globally used diagnostic tool for epidemiology, health management and clinical purposes. The ICD is maintained by the World Health Organization (WHO), which is the directing and coordinating ...
(ICD-10), the
International Classification of Sleep Disorders The International Classification of Sleep Disorders (ICSD) is "a primary diagnostic, epidemiological and coding resource for clinicians and researchers in the field of sleep and sleep medicine". The ICSD was produced by the American Academy of Slee ...
(ICSD-3), and the
Diagnostic and Statistical Manual The ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM; latest edition: DSM-5-TR, published in March 2022) is a publication by the American Psychiatric Association (APA) for the classification of mental disorders using a common langua ...
. The Diagnostic and Statistical Manual defines two subcategories of sleepwalking, although sleepwalking does not need to involve either behaviours: * sleepwalking with sleep-related eating. * sleepwalking with sleep-related sexual behavior ( sexsomnia). Sleep eating involves consuming food while asleep. These sleep eating disorders are more often than not induced for stress related reasons. Another major cause of this sleep eating subtype of sleepwalking is sleep medication, such as Ambien for example (Mayo Clinic). There are a few others, but Ambien is a more widely used sleep aid. Because many sleep eaters prepare the food they consume, there are risks involving burns and such with ovens and other appliances. As expected, weight gain is also a common outcome of this disorder, because food that is frequently consumed contains high carbohydrates. As with sleepwalking, there are ways that sleep eating disorders can be maintained. There are some medications that calm the sleeper so they can get longer and better-quality rest, but activities such as yoga can also be introduced to reduce the stress and anxiety causing the action.


Differential diagnoses

Sleepwalking should not be confused with alcohol- or drug-induced blackouts, which can result in amnesia for events similar to sleepwalking. During an alcohol-induced blackout (drug-related amnesia), a person is able to actively engage and respond to their environment (e.g. having conversations or driving a vehicle), however the brain does not create memories for the events. Alcohol-induced blackouts can occur with blood alcohol levels higher than 0.06g/dl. A systematic review of the literature found that approximately 50% of drinkers have experienced memory loss during a drinking episode and have had associated negative consequences similar to sleepwalkers, including injury and death. Other differential diagnoses include
Rapid eye movement sleep behavior disorder Rapid eye movement sleep behavior disorder or REM behavior disorder (RBD) is a sleep disorder in which people act out their dreams. It involves abnormal behavior during the sleep phase with rapid eye movement (REM) sleep. The major feature of ...
, confusional arousals, and
night terrors Night terror, also called sleep terror, is a sleep disorder causing feelings of panic or dread and typically occurring during the first hours of stage 3–4 non-rapid eye movement (NREM) sleep and lasting for 1 to 10 minutes. It can last long ...
.


Assessment

An assessment of sleepwalking via
polysomnography Polysomnography (PSG), a type of sleep study, is a multi-parameter study of sleep and a diagnostic tool in sleep medicine. The test result is called a polysomnogram, also abbreviated PSG. The name is derived from Greek and Latin roots: the Gre ...
poses the problem that sleepwalking is less likely to occur in the sleep laboratory, and if an episode occurs, it is usually less complex than what the patient experiences at home. Therefore, the diagnosis can often be made by assessment of sleep history, time-course and content of the sleep related behaviors. Sometimes, home videos can provide additional information and should be considered in the diagnostic process. Some features that should always be assessed include: * Age of onset * When the episode occurs during the sleep period * How often these episodes occur (frequency) and how long they last (duration) * Description of the episode, including behavior, emotions, and thoughts during and after the event * How responsive the patient is to external stimuli during the episode * How conscious or aware the patient is, when awakened from an episode * If the episode is remembered afterwards * The triggers or precipitating factors * Sleep–wake pattern and sleep environment * Daytime sleepiness * Other sleep disorders that might be present * Family history for NREM parasomnias and other sleep disorders * Medical, psychiatric, and neurological history * Medication and substance use history The assessment should rule out differential diagnoses.


Treatment

There have been no clinical trials to show that any psychological or pharmacological intervention is effective in preventing sleepwalking episodes. Despite this, a wide range of treatments have been used with sleepwalkers. Psychological interventions have included psychoanalysis, hypnosis, scheduled or anticipatory waking, assertion training, relaxation training, managing aggressive feelings, sleep hygiene, classical conditioning (including electric shock), and play therapy. Pharmacological treatments have included tricyclic antidepressants (imipramine), an anticholinergic (biperiden), antiepileptics (carbamazepine, valproate), an antipsychotic (quetiapine), benzodiazepines (clonazepam, diazepam, flurazepam and triazolam), melatonin, a selective serotonin reuptake inhibitor (paroxetine), a barbiturate (sodium amytal) and herbs. There is no evidence to show that waking sleepwalkers is harmful or not, though the sleepwalker is likely to be disoriented if awakened as sleepwalking occurs during the deepest stage of sleep. Unlike other sleep disorders, sleepwalking is not associated with daytime behavioral or emotional problems. This may be because the sleepwalker's sleep is not disturbed—unless they are woken, they are still in a sleep state while sleepwalking. Maintaining the safety of the sleepwalker and others and seeking treatment for other sleep problems is recommended. Reassurance is recommended if sleepwalking is not causing any problems. However, if it causes distress or there is risk of harm, hypnosis and scheduled waking are recommended as treatments.


Safety planning

For those whose sleepwalking episodes are hazardous, a door alarm may offer a measure of protection. There are various kinds of door alarms that can attach to a bedroom door and when the door is opened, the alarm sounds. The intention is that the sound will fully awaken the person and interrupt the sleepwalking episode, or if the sleepwalker lives with others, the sound will prompt them to check on the person. Sleepwalkers should aim to have their bedrooms on the ground floor of a home, apartment, dorm, hotel, etc. Sleepwalkers should not have easily accessible weapons (loaded guns, knives) in the bedroom or any room of the house for that matter. If there are weapons, they should be locked away with keys secluded from the sleepwalker. For partners of sleepwalkers who are violent or disturb their sleep, sleeping in another room may lead to better sleep quality and quantity.


Epidemiology

The lifetime prevalence of sleepwalking is estimated to be 4.6%–10.3%. A meta-analysis of 51 studies, that included more than 100,000 children and adults, found that sleepwalking is more common in children with an estimated 5%, compared with 1.5% of adults, sleepwalking at least once in the previous 12 months. The rate of sleepwalking has not been found to vary across ages during childhood.


History

Sleepwalking has attracted a sense of mystery, but was not seriously investigated and diagnosed until the 19th century. The German chemist and parapsychologist
Baron Karl Ludwig von Reichenbach Carl Ludwig von Reichenbach (full name: Karl Ludwig Freiherr von Reichenbach; February 12, 1788January 1869) was a German chemist, geologist, metallurgist, naturalist, industrialist and philosopher, and a member of the Prussian Academy of Scie ...
(1788–1869) made extensive studies of sleepwalkers and used his discoveries to formulate his theory of the
Odic force The Odic force (also called Od µd Odyle, Önd, Odes, Odylic, Odyllic, or Odems) is the name given in the mid-19th century to a hypothetical vital energy or life force by Baron Carl von Reichenbach. Von Reichenbach coined the name from that of ...
. Sleepwalking was initially thought to be a dreamer acting out a dream. For example, in one study published by the Society for Science & the Public in 1954, this was the conclusion: "Repression of hostile feelings against the father caused the patients to react by acting out in a dream world with sleepwalking, the distorted fantasies they had about all authoritarian figures, such as fathers, officers and stern superiors."Society for Science & the Public. "Sleepwalking Cause." ''The Science News-Letter''. 27 February 1954: 132. This same group published an article twelve years later with a new conclusion: "Sleepwalking, contrary to most belief, apparently has little to do with dreaming. In fact, it occurs when the sleeper is enjoying his most oblivious, deepest sleep—a stage in which dreams are not usually reported."Society for Science & the Public. "Sleepwalker Not Dreaming." ''The Science News-Letter'', 25 June 1966: 508 More recent research has discovered that sleepwalking is actually a disorder of
NREM Non-rapid eye movement sleep (NREM), also known as quiescent sleep, is, collectively, sleep stages 1–3, previously known as stages 1–4. Rapid eye movement sleep (REM) is not included. There are distinct electroencephalographic and other char ...
(non-rapid eye movement) arousal. Acting out a dream is the basis for a REM (rapid eye movement) sleep disorder called
REM Behavior Disorder Rapid eye movement sleep behavior disorder or REM behavior disorder (RBD) is a sleep disorder in which people act out their dreams. It involves abnormal behavior during the sleep phase with rapid eye movement (REM) sleep. The major feature of ...
(or REM Sleep Behavior Disorder). More accurate data about sleep is due to the invention of technologies, such as the electroencephalogram (
EEG Electroencephalography (EEG) is a method to record an electrogram of the spontaneous electrical activity of the brain. The biosignals detected by EEG have been shown to represent the postsynaptic potentials of pyramidal neurons in the neocortex ...
) by Hans Berger in 1924 and
BEAM Beam may refer to: Streams of particles or energy *Light beam, or beam of light, a directional projection of light energy **Laser beam *Particle beam, a stream of charged or neutral particles **Charged particle beam, a spatially localized grou ...
by Frank Duffy in the early 1980s. In 1907,
Sigmund Freud Sigmund Freud ( , ; born Sigismund Schlomo Freud; 6 May 1856 – 23 September 1939) was an Austrian neurologist and the founder of psychoanalysis, a clinical method for evaluating and treating psychopathology, pathologies explained as originatin ...
spoke about sleepwalking to the Vienna Psychoanalytic Society (Nunberg and Federn). He believed that sleepwalking was connected to fulfilling sexual wishes and was surprised that a person could move without interrupting their dream. At that time, Freud suggested that the essence of this phenomenon was the desire to go to sleep in the same area as the individual had slept in childhood. Ten years later, he speculated about somnambulism in the article "A Metapsychological Supplement to the Theory of Dreams" (1916–17 915. In this essay, he clarified and expanded his hypothetical ideas on dreams. He described the dream as a fragile equilibrium that is destabilized by the repressed unconscious impulses of the unconscious system, which does not obey the wishes of the ego. Certain preconscious daytime thoughts can be resistant and these can retain a part of their
cathexis In psychoanalysis, cathexis (or emotional investment) is defined as the process of allocation of mental or emotional energy to a person, object, or idea. Origin of term The Greek term ''cathexis'' (κάθεξις) was chosen by James Strache ...
as well. Unconscious impulses and day residues can come together and result in a conflict. Freud then wondered about the outcome of this wishful impulse: an unconscious instinctual demand that becomes a dream wish in the preconscious. Freud stated that this unconscious impulse could be expressed as mobility during sleep. This would be what is observed in somnambulism, though what actually makes it possible remains unknown. As of 2002, sleepwalking has not been detected in non-human primates. It is unclear whether it simply hasn't been observed yet, or whether sleepwalking is a uniquely human phenomenon.


Society and culture


Opera

Vincenzo Bellini Vincenzo Salvatore Carmelo Francesco Bellini (; 3 November 1801 – 23 September 1835) was a Sicilian opera composer, who was known for his long-flowing melodic lines for which he was named "the Swan of Catania". Many years later, in 1898, Giu ...
's 1831 Italian
opera semiseria Opera semiseria ('semi-serious opera') is an Italian genre of opera, popular in the early and middle 19th century. Related to the opera buffa, opera semiseria contains elements of comedy but also of pathos, sometimes with a pastoral setting. It can ...
,
La sonnambula ''La sonnambula'' (''The Sleepwalker'') is an opera semiseria in two acts, with music in the ''bel canto'' tradition by Vincenzo Bellini set to an Italian libretto by Felice Romani, based on a scenario for a ''ballet-pantomime'' written by Eu ...
, the plot of which is centered on the question of the innocence of the betrothed and soon-to-be married Amina, who, upon having been discovered in the bedchamber of a stranger, and despite the assurances of that stranger that Amina was entirely innocent, has been rejected by her enraged fiancé, Elvino — who, then, decides to marry another. In fact, when stressed, Amina was susceptible to somnambulism; and had come to be in the stranger's bedchamber by sleep-walking along a high parapet (in full view of the opera's audience). Elvino, who later observes the (exhausted by all the fuss) Amina, sleep-walking across a very high, very unstable, and very rickety bridge at the local mill, realizes his mistake, abandons his plans of marriage to the other woman, and re-unites with Amina.


Jenny Lind and James Braid

In August 1847, the famous soprano Jenny Lind visited
Manchester Manchester () is a city in Greater Manchester, England. It had a population of 552,000 in 2021. It is bordered by the Cheshire Plain to the south, the Pennines to the north and east, and the neighbouring city of Salford to the west. The t ...
, and gave two performances as Amina. The outstanding difference between Lind and her contemporaries was that, "whilst the beauty of her voice was far greater than any other in living memory (thus, the ''Swedish Nightingale''), what really set her apart was her outstanding ability to act"; and, moreover, in performing as Amina, rather than walking along a wide and well-protected walkway (as the others did), she routinely acrobatically balanced her way along narrow planks. While she was in Manchester—on the basis that, at the time, many characterized "''hypnotism''" as "''artificial somnambulism''", and that, from a rather different perspective, her stage performance could also be described as one of "artificial" (rather than spontaneous) somnambulism—her friends arranged for her to visit the local surgeon James Braid, who had discovered hypnotism in 1841: ::"Mr. Braid, surgeon, whose discoveries in hypnotism are well known, having invited the fair impersonator of a somnambulist to witness some of the abnormal feats of a real somnambulist, artificially thrown into that state, it was arranged that a private séance should take place
n Friday, 3 September 1847 N, or n, is the fourteenth letter in the Latin alphabet, used in the modern English alphabet, the alphabets of other western European languages and others worldwide. Its name in English is ''en'' (pronounced ), plural ''ens''. History ...
" ''Manchester Guardian'', 8 September 1847.


Drama

* The sleepwalking scene (Act V Scene 1) from
William Shakespeare William Shakespeare ( 26 April 1564 – 23 April 1616) was an English playwright, poet and actor. He is widely regarded as the greatest writer in the English language and the world's pre-eminent dramatist. He is often called England's nation ...
's tragic play ''
Macbeth ''Macbeth'' (, full title ''The Tragedie of Macbeth'') is a tragedy by William Shakespeare. It is thought to have been first performed in 1606. It dramatises the damaging physical and psychological effects of political ambition on those w ...
'' (1606) is one of the most famous scenes in all of literature. * In
Walley Chamberlain Oulton Walley Chamberlain Oulton (1770?–1820?) was an Irish playwright, theatre historian and man of letters. Life Born in Dublin, he was educated there in a private school. While a schoolboy he achieved some reputation as a writer of farces and musica ...
's two act farce ''The Sleep-Walker; or, Which is the Lady'' (1812), "Somno", a histrionic failed-actor-turned-manservant relives his wished-for roles when sleepwalking.


Literature

* In
Bram Stoker Abraham Stoker (8 November 1847 â€“ 20 April 1912) was an Irish author who is celebrated for his 1897 Gothic horror novel '' Dracula''. During his lifetime, he was better known as the personal assistant of actor Sir Henry Irving and busine ...
's novel '' Dracula'', the character
Lucy Westenra Lucy Westenra is a fictional character in the 1897 novel ''Dracula'' by Bram Stoker. The 19-year-old daughter of a wealthy family, she is Mina Murray's best friend and Count Dracula's first English victim. She subsequently transforms into a vam ...
is described as a sleepwalker. It is while sleepwalking that
Count Dracula Count Dracula () is the title character of Bram Stoker's 1897 gothic horror novel '' Dracula''. He is considered to be both the prototypical and the archetypal vampire in subsequent works of fiction. Aspects of the character are believed by som ...
lures and attacks her.


Sleepwalking as a legal defense

As sleepwalking behaviours occur without volition, sleepwalking can be used as a legal defense, as a form of legal automatism. An individual can be accused of non-insane or insane automatism. The first is used as a defense for temporary insanity or involuntary conduct, resulting in acquittal. The latter results in a "special verdict of not guilty by reason of insanity."
Canadian Legal Information Institute The Canadian Legal Information Institute (CanLII; french: Institut canadien d'information juridique) is a non-profit organization created and funded by the Federation of Law Societies of Canada in 2001 on behalf of its 14 member societies. CanLII ...

''R v. Parks''
1992.
This verdict of insanity can result in a court order to attend a mental institution.Lederman, Eliezer. "Non-Insane and Insane Automatism: Reducing the Significance of a Problematic Distinction." ''The
International and Comparative Law Quarterly The ''International & Comparative Law Quarterly'' is a law review published quarterly by thBritish Institute of International and Comparative Law It was established in 1952 and covers comparative law as well as public and private international la ...
'' 34.4 (1985): 819.
In the 1963 case ''
Bratty v A-G for Northern Ireland ''Bratty v Attorney-General for Northern Ireland'' 963AC 386, 9613 All ER 523, 961UKHL 3 is a House of Lords decision relating to non-insane automatism. The court decided that medical evidence is needed to prove that the defendant was not aware o ...
'', Lord Morris stated, "Each set of facts must require a careful examination of its own circumstances, but if by way of taking an illustration it were considered possible for a person to walk in his sleep and to commit a violent crime while genuinely unconscious, then such a person would not be criminally liable for that act." While the veracity of the cases are disputed, there have been acts of
homicide Homicide occurs when a person kills another person. A homicide requires only a volitional act or omission that causes the death of another, and thus a homicide may result from accidental, reckless, or negligent acts even if there is no inten ...
where the prime suspect may have committed the act while sleepwalking. Alternative explanations to homicidal or violent sleepwalking include
malingering Malingering is the fabrication, feigning, or exaggeration of physical or psychological symptoms designed to achieve a desired outcome, such as relief from duty or work. Malingering is not a medical diagnosis, but may be recorded as a "focus of c ...
, drug-induced amnesia, and other disorders in which sleep-related violence may occur, such as
REM Sleep Behavior Disorder Rapid eye movement sleep behavior disorder or REM behavior disorder (RBD) is a sleep disorder in which people act out their dreams. It involves abnormal behavior during the sleep phase with rapid eye movement (REM) sleep. The major feature of ...
,
fugue state Dissociative fugue (), formerly called a fugue state or psychogenic fugue, is a mental and behavioral disorderDrs; that is classified variously as a dissociative disorder,Dissociative Fugue (formerly Psychogenic Fugue) 'DSM-IV 300.13, Diagnost ...
s, and episodic wandering.


Historical cases

* 1846,
Albert Tirrell Albert Jackson Tirrell (1824–1880) was a man whose trial for the murder of the prostitute for whom he had left his wife scandalized Boston society in 1846. He used sleepwalking as a defense against charges of murder, marking the first ti ...
used sleepwalking as a defense against charges of murdering Maria Bickford, a prostitute living in a Boston brothel. *1961, Sergeant Willis Boshears confessed to strangling a local woman named Jean Constable in the early hours on New Years Day 1961, but claimed that he was asleep and only woke to realize what he had done. He pled not guilty on the basis of being asleep at the time he committed the offence and was acquitted. * In 1981, Steven Steinberg of Scottsdale,
Arizona Arizona ( ; nv, Hoozdo Hahoodzo ; ood, AlÄ­ á¹£onak ) is a state in the Southwestern United States. It is the 6th largest and the 14th most populous of the 50 states. Its capital and largest city is Phoenix. Arizona is part of the Fou ...
was accused of killing his wife and acquitted on the grounds of temporary insanity. * 1991, ''
R v Burgess R v Burgess 9912 QB 92 was an appeal in the Court of Appeal of England and Wales that adjudged sleepwalking entailing violence from an internal, organic cause amounts to insane automatism. At first instance he was likewise found not guilty ''b ...
'': Burgess was accused of hitting his girlfriend on the head with a wine bottle and then a video tape recorder. He was found not guilty at
Bristol Crown Court The Bristol Crown Court is a Crown Court venue in Bristol, England. It is located at the Law Courts in Small Street. Until 1993 the Crown Court met in the Guildhall, on the opposite side of the road. The new Crown Court, which has ten courtrooms ...
, by reason of ''insane automatism''. * 1992, '' R. v. Parks'': Parks was accused of killing his mother-in-law and attempting to kill his father-in-law. He was acquitted by the
Supreme Court of Canada The Supreme Court of Canada (SCC; french: Cour suprême du Canada, CSC) is the Supreme court, highest court in the Court system of Canada, judicial system of Canada. It comprises List of Justices of the Supreme Court of Canada, nine justices, wh ...
.Broughton ''et al.'' Homicidal Somnambulism: A Case Report. ''Sleep'' (1994); 17(3):253-64 * 1994, ''Pennsylvania v. Ricksgers'': Ricksgers was accused of killing his wife. He was sentenced to life in prison without parole.Lyon, Lindsay
"7 Criminal Cases that Involved the 'Sleepwalking Defense.'"
'' U.S. News & World Report''. May 2009.
* 1999, ''Arizona v. Falater'': Scott Falater, of
Phoenix, Arizona Phoenix ( ; nv, Hoozdo; es, Fénix or , yuf-x-wal, Banyà:nyuwá) is the List of capitals in the United States, capital and List of cities and towns in Arizona#List of cities and towns, most populous city of the U.S. state of Arizona, with 1 ...
, was accused of killing his wife. The court concluded that the murder was too complex to be committed while sleepwalking. Falater was convicted of first-degree murder and sentenced to life with no possibility of parole. * 2001, ''California v. Reitz:'' Stephen Reitz killed his lover, Eva Weinfurtner. He told police he had no recollection of the attack but he had "flashbacks" of believing he was in a scuffle with a male intruder. His parents testified in court that he had been a sleepwalker from childhood. The court convicted Reitz of first-degree murder in 2004. *In 2001, Antonio Nieto murdered his wife and mother-in-law and attempted to murder his daughter and son, before being disarmed. Nieto claimed to have been asleep during the attack and dreaming that he was defending himself against aggressive ostriches. However, his children stated that he had recognized them and had told his son to not turn on the lights because their mother (gravely injured already) was sleeping. In 2007, Nieto was sentenced to 10 years internment in a psychiatric hospital and ordered to pay 171,100 euros as compensation to the victims. *Jules Lowe confessed to causing the death of his father Edward in 2004, but did not remember committing the act. Jules used automatism as his defense, and was found not guilty by reason of insanity and detained indefinitely in a secure hospital. He was released after ten months. * Brian Thomas was accused of killing his wife in 2008 while dreaming that he was fighting off intruders. He was freed in 2009 by a judge, who found him not guilty of murder.


See also

*
Rapid eye movement sleep behavior disorder Rapid eye movement sleep behavior disorder or REM behavior disorder (RBD) is a sleep disorder in which people act out their dreams. It involves abnormal behavior during the sleep phase with rapid eye movement (REM) sleep. The major feature of ...


References


Sources

*Walker, N., ''Crime and Insanity in England Volume One: The Historical Perspective'', Edinburgh: Edinburgh University Press (1968)


External links

{{Authority control Parasomnias Sleep disorders