Prevention

Children are more likely to sleepwalk or experience sleep terrors when they are overtired or anxious. Providing an early bedtime with relaxing activities before bedtime may help to prevent sleep disturbances.

Avoid sleepwalking injuries by making the bedroom and house as safe as possible. Consider the following precautions:

• Don't let the child sleep in a bunk bed.

• Make sure there are no sharp or breakable objects near the bed.

• Install gates on stairways.

• Lock doors and windows.

Treatment

Usually, treatment is not necessary. Most episodes of sleepwalking or sleep terrors go away on their own. A parent or caretaker should focus on keeping the sleepwalking child safe.

To help a sleepwalking child return to normal sleep, gently lead the child back to bed. During an episode of sleep terrors, offer reassurance with repeated, soothing statements such as, "You are safe. You are home in your own bed." You don't need to wake the child, and you might not even be able to.

For children with frequent sleepwalking or night terrors, a technique called prompted awakenings may help to prevent future episodes. For several nights, record the length of time between when the child falls asleep and the beginning of the sleepwalking or night terrors. Then for seven nights in a row, awaken the child 15 minutes before the expected time of the episode. Tell the child at bedtime that you will try to wake him or her quickly, and keep him or her fully awake for five minutes.

If psychological stress contributes to disordered sleep, counseling may help. Both children and adults may benefit from hypnosis or biofeedback.

In some cases, a doctor may prescribe short-acting sleep or antianxiety medications such as diazepam (Valium) or lorazepam (Ativan) to reduce or eliminate episodes.