Sleep walking remains a mysterious and challenging sleep disorder that can pose serious danger should the sleep walker fall down a flight of stairs or attempt to engage in complex behaviors such as cooking or driving. Much has been learned about sleep walking from years of research using nocturnal polysomnograpy to correlate certain brain states with sleep walking behaviors. Sleep walking typically occurs during partial arousals from deep sleep such that there is a state dissociation in which elements of sleep and wakefulness co-exist and allow for the unconscious production of potentially complex motor activity.

Sleep professionals use a number of treatment approaches for sleep walking. These include reassurance, safety measures, medications and hypnosis. Both children and adults may experience sleep walking and it can occur in almost anyone who experiences significant sleep deprivation or sleep disruption. It is most common in children and tends to diminish in adulthood, although it can reoccur at any time, especially if sleep is extremely limited or disrupted (perhaps due to a demanding work schedule or the onset of sleep apnea). Sleep walking is typically limited and usually does not involve dangerous activities such as driving. In many cases all that is needed is to reassure the person that sleep walking is usually benign, does not indicate the presence of a psychological disorder and usually decreases in frequency over time.

Further treatment is indicated for individuals with sleep walking related dangerous behaviors or if the sleep walking is causing concern for other members of the household or if it results in the person being excessively sleepy during the day. Most often an overnight sleep study is not necessary as part of the diagnostic work up for sleep walking. Situations where a sleep study is indicated occur when the behavior is very frequent, has resulted in injury, is associated with daytime sleepiness or involves medical or legal issues. (There have been forensic cases related to criminal behavior performed during an episode of sleep walking.)

If reassurance is insufficient then the next most important step is to implement safety measures. These measures include blocking stairways, hiding car keys, or putting a pressure sensitive alarm in the bed so that the person is awakened if getting out of bed while still asleep during the night. (Some safety measures are particularly important for children with sleep walking.) In certain situations tricyclic antidepressants and benzodiazepines may be useful medications in the treatment of sleep walking.

But hypnosis? As a treatment for sleep walking? Yes. In small-scale studies conducted by researchers such as Peter Hauri, Ph.D., of the Mayo Clinic, results have shown that properly screened sleep walking patients can experience significant improvement with the use of clinical hypnosis. These techniques have been used in small-scale studies with remarkably positive effects. In fact, hypnosis has shown encouraging results for a range of parasomnias such as nightmares and sleep walking. In a recent five year follow up study published in the Journal of Clinical Sleep Medicine, Hauri, Silber and Boeve reported that sleep walkers treated with hypnotherapy had a 50% improvement after 18 months and 67% after 5 years. Improvement was defined as being "spell free or much improved." This was an uncontrolled study design with small numbers so the results are suggestive although not definitive. Further research is clearly warranted and clinical use is reasonable. The theory behind this approach makes good sense in that hypnosis involves relaxation and suggestions for future comfort and relaxation. When this successfully results in less disrupted sleep then we can reasonably expect an accompanying decrease in the frequency and severity of "spells" (sleep walking episodes) which arise from partial arousals in deep sleep.

So, yes- not only reassurance, safety measures and medications, but also hypnosis, can be effective as a treatment for sleep walking.

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