Editing Sleepwalking (section)

==Signs and symptoms==
Sleepwalking is characterized by:<ref name=Stall2017/>
* partial arousal during non-rapid eye movement (NREM) sleep, typically during the first third of the night
* dreamy 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.<ref name="Mayo Clinic">{{Cite web|title=Sleepwalking - Symptoms and causes|url=https://www.mayoclinic.org/diseases-conditions/sleepwalking/symptoms-causes/syc-20353506/#:~:text=Overview,serious%20problems%20or%20require%20treatment.|url-status=live|archive-url=https://web.archive.org/web/20220218085440/https://www.mayoclinic.org/diseases-conditions/sleepwalking/symptoms-causes/syc-20353506|archive-date=18 February 2022|access-date=2022-02-18|website=Mayo Clinic|language=en}}</ref>

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 [[Somniloquy|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.<ref name="Schenck, Carlos H 2007">{{Cite book|last=Schenck|first=Carlos H.|url=https://books.google.com/books?id=VLp5uoHCRi8C|title=Sleep: The Mysteries, the Problems, and the Solutions|pages=105–109|date=March 2007|publisher=[[Avery Publishing]]|isbn=978-1-58333-270-2|oclc=1265420054|language=en}}</ref>

===Associated disorders===
Most studies look at sleep disorders in adults but children can also be affected. In the ten percent of the population that experience sleep-related disorders, children are mainly affected due to their youthful brains.<ref>{{Cite journal |last=Willock |first=Brent |date=April 2022 |title=On dreaming, parasomnia, dream enactment, and murder. |url=http://doi.apa.org/getdoi.cfm?doi=10.1037/pap0000382 |journal=Psychoanalytic Psychology |language=en |volume=39 |issue=2 |pages=97–110 |doi=10.1037/pap0000382 |s2cid=244209446 |issn=1939-1331|url-access=subscription }}</ref> A study conducted in Australia,<ref name=":02">{{Cite journal |last1=Stallman |first1=Helen M |last2=Kohler |first2=Mark J |last3=Biggs |first3=Sarah N |last4=Lushington |first4=Kurt |last5=Kennedy |first5=Declan |date=2017-09-25 |title=Childhood Sleepwalking and Its Relationship to Daytime and Sleep Related Behaviors |url=http://www.sleepandhypnosis.org/ing/abstract.aspx?MkID=221 |journal=Sleep and Hypnosis - International Journal |pages=61–69 |doi=10.5350/Sleep.Hypn.2016.18.0122|doi-access=free }}</ref> looked at sleepwalking and its association with sleep behaviors in children. It was found that sleepwalking could be associated with children's bedtime routines. Those who have behavioral problems are more likely to develop a sleep disorder and should be assessed. The relationship between sleepwalking and the behavioral and emotional problems are more associated than their bedtime routines. This may very well be because sleep related disorders and sleepwalking happen simultaneously; one cannot exist without the other.<ref name=":02" />

In the study "Sleepwalking and Sleep Terrors in Prepubertal Children"<ref>{{cite journal|url=https://pediatrics.aappublications.org/content/111/1/e17|title=Sleepwalking and Sleep Terrors in Prepubertal Children: What Triggers Them?|journal=Pediatrics|first1=Christian|last1=Guilleminault|first2=Luciana|last2=Palombini|first3=Rafael|last3=Pelayo|first4=Ronald D.|last4=Chervin|date=1 January 2003|volume=111|issue=1|pages=e17–e25|via=pediatrics.aappublications.org|doi=10.1542/peds.111.1.e17|pmid=12509590|doi-access=free|url-access=subscription}}</ref> it was found that, if a child had another sleep disorder{{spnd}}such as [[restless leg syndrome]] (RLS) or [[Sleep-related breathing disorder|sleep-disorder breathing]] (SDB){{spnd}}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; [[apnea]]s 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]]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.<ref>{{Cite web|url=https://www.mayoclinic.org/diseases-conditions/sleep-terrors/symptoms-causes/syc-20353524|title=Sleep terrors (night terrors) - Symptoms and causes|website=Mayo Clinic|language=en|access-date=2019-03-25}}</ref>

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".<ref name="A.H. Crisp et al.">{{cite journal |doi=10.1136/bmj.300.6721.360 |last1=Crisp |first1=A.H. |last2=Matthews |year=1990 |first2=BM |last3=Oakey |first3=M |last4=Crutchfield |first4=M |title=Sleepwalking, night terrors, and consciousness |journal=British Medical Journal |volume=300 |issue=6721 |pages=360–362 |pmid=2106985 |pmc=1662124 |display-authors=etal}}</ref> Another suggested that "A higher incidence [of sleepwalking events] has been reported in patients with [[schizophrenia]], hysteria and [[Neurosis|anxiety neuroses]]".<ref>Orme, J.E. (1967), "The Incidence of Sleepwalking in Various Groups", Acta Psychiatrica Scandinavica, Vol 43, Iss 3, pp 279–28.</ref> Also, patients with [[migraine]] headaches or [[Tourette syndrome]] are 4–6 times more likely to sleepwalk.

===Consequences===
During the amnesic state sleepwalkers are in, many things can happen without their recollection. One thing that can happen is a sleep disorder called [[sexomnia]], where an individual can engage in sexual behaviors with oneself or others.<ref>{{Cite journal |last1=Idir |first1=Yannis |last2=Oudiette |first2=Delphine |last3=Arnulf |first3=Isabelle |date=August 2022 |title=Sleepwalking, sleep terrors, sexsomnia and other disorders of arousal: the old and the new |url=https://onlinelibrary.wiley.com/doi/10.1111/jsr.13596 |journal=Journal of Sleep Research |language=en |volume=31 |issue=4 |pages=e13596 |doi=10.1111/jsr.13596 |pmid=35388549 |s2cid=248000922 |issn=0962-1105|url-access=subscription }}</ref> Its occurrence is rare, but can happen during sleepwalking.<ref>{{Cite journal |last1=Idir |first1=Yannis |last2=Oudiette |first2=Delphine |last3=Arnulf |first3=Isabelle |date=August 2022 |title=Sleepwalking, sleep terrors, sexsomnia and other disorders of arousal: the old and the new |url=https://onlinelibrary.wiley.com/doi/10.1111/jsr.13596 |journal=Journal of Sleep Research |language=en |volume=31 |issue=4 |pages=e13596 |doi=10.1111/jsr.13596 |pmid=35388549 |s2cid=248000922 |issn=0962-1105|url-access=subscription }}</ref> Sleep-related eating disorder, in which sleepwalkers eat involuntarily, can also happen. The events can include eating/drinking regular foods or odd combinations of food.<ref>{{Cite journal |last1=Idir |first1=Yannis |last2=Oudiette |first2=Delphine |last3=Arnulf |first3=Isabelle |date=August 2022 |title=Sleepwalking, sleep terrors, sexsomnia and other disorders of arousal: the old and the new |url=https://onlinelibrary.wiley.com/doi/10.1111/jsr.13596 |journal=Journal of Sleep Research |language=en |volume=31 |issue=4 |pages=e13596 |doi=10.1111/jsr.13596 |pmid=35388549 |s2cid=248000922 |issn=0962-1105|url-access=subscription }}</ref> [[Insomnia]] and [[Excessive daytime sleepiness|daytime sleepiness]] can also occur.<ref>{{Cite journal |last1=Idir |first1=Yannis |last2=Oudiette |first2=Delphine |last3=Arnulf |first3=Isabelle |date=August 2022 |title=Sleepwalking, sleep terrors, sexsomnia and other disorders of arousal: the old and the new |url=https://onlinelibrary.wiley.com/doi/10.1111/jsr.13596 |journal=Journal of Sleep Research |language=en |volume=31 |issue=4 |pages=e13596 |doi=10.1111/jsr.13596 |pmid=35388549 |s2cid=248000922 |issn=0962-1105|url-access=subscription }}</ref> Most sleepwalkers get injuries at some point during sleepwalking, often minor injuries such as cuts or bruises.<ref>Milliet N, Ummenhofer W. Somnambulism and trauma: case report and short review of the literature. J Trauma. 1999;47(2):420–2</ref><ref>Sillesen NH, Nielsen LT, Bonde C. Complex injuries associated with somnambulism. Ugeskr Laeger. 2010;172(50):3489–90</ref> In rare occasions, however, sleepwalkers have fractured bones and died as the result of a fall.<ref>{{Cite web |url=https://www.mirror.co.uk/news/uk-news/sleepwalker-rob-williams-dies-after-2981951 |title=Sleepwalker dies after falling from hotel window following night out with work colleagues |website=[[Daily Mirror]]|date=2014-01-03}}</ref><ref>{{Cite news |url=https://www.telegraph.co.uk/news/uknews/10546766/Tragedy-as-sleepwalker-plunges-to-death-from-hotel-window.html |archive-url=https://ghostarchive.org/archive/20220112/https://www.telegraph.co.uk/news/uknews/10546766/Tragedy-as-sleepwalker-plunges-to-death-from-hotel-window.html |archive-date=2022-01-12 |url-access=subscription |url-status=live |title=Tragedy as sleepwalker plunges to death from hotel window |date=2014-01-02}}{{cbignore}}</ref> Sleepwalkers may also face embarrassment of being found naked in public.<ref>{{Cite web |url=https://www.mirror.co.uk/news/uk-news/naked-sleepwalker-stumbles-out-city-8026101 |title=Naked sleepwalker stumbles out of city hotel then makes an odd request to police |website=[[Daily Mirror]] |date=2016-05-22}}</ref><ref>{{Cite web |url=https://www.news24.com/World/News/Sleep-walker-mows-lawn-naked-20050321 |title=Sleep walker mows lawn naked |date=2005-03-21}}</ref>