Sleepwalking in adults is a sleep disorder in which part of the brain stays asleep while another part wakes, so you get up and move or act without being aware of it. It usually happens in deep non-REM sleep during the first third of the night. About 3.6% of US adults sleepwalked in the past year. Common triggers include sleep deprivation, stress, alcohol, untreated sleep apnea, some medications, and depression. The main goal is safety: lock doors and windows, clear the floor, and fix the trigger. See a sleep doctor if episodes are frequent, cause injury, or follow a new sleep medicine. The FDA has a boxed warning for sleepwalking with zolpidem, eszopiclone, and zaleplon. This is educational information, not medical advice.
What is sleepwalking in adults?
Sleepwalking, also called somnambulism, is a parasomnia. That means an unwanted event that comes along with sleep. It is an arousal from non-REM (NREM) sleep, the deepest stage of sleep. During an episode, the brain is partly awake, so you can do complex things, but you are not consciously aware of your actions. The American Academy of Sleep Medicine (AASM) says episodes most often occur in the first third of the night.
It is not just a childhood problem. The AASM says up to 4% of adults sleepwalk. In a large US survey, about 3.6% of adults had an episode in the past year, and most people who sleepwalked as children had stopped. Sleepwalking was not strongly linked to gender, and it seemed to decrease with age.
Here is what an adult episode can look like:
- You sit up in bed with your eyes open and a blank stare.
- You get up and walk or do routine tasks, such as opening doors or moving things around.
- You respond slowly or not at all, and you may seem confused.
- You remember nothing in the morning.
- You may return to bed on your own, or fall asleep somewhere else.
Adults may dream or hallucinate during an episode, according to the AASM. Sleepwalking also often occurs with sleep terrors, which come from the same stage of sleep.
What causes sleepwalking in adults?
There is rarely one cause. Most adults have a built-in tendency plus triggers that tip them over. Here are the common ones:
- Family history and genes. About 30% of sleepwalkers in a large US survey had a family history. A gene variant called HLA-DQB1*05:01 was found in 35% of sleepwalkers in one study, compared with about 13% of people without a sleep disorder.
- Sleep deprivation and a disrupted schedule. The Mayo Clinic lists sleep deprivation, stress, fever, and schedule changes such as travel.
- Alcohol. Drinking can interfere with sleep and may trigger sleepwalking.
- Sleep apnea and other sleep disorders. The AASM says sleepwalking can occur when sleep is fragmented by other sleep problems, and treating sleep apnea may improve it.
- Depression, anxiety, and obsessive-compulsive disorder. People with depression were 3.5 times more likely to sleepwalk in the 2012 survey, and people with obsessive-compulsive disorder were four times more likely.
- Medications. Over-the-counter sleep aids and prescription hypnotics were linked to sleepwalking. Zolpidem, eszopiclone, and zaleplon carry an FDA boxed warning, covered below.
Because adult sleepwalking is more likely to be confused with, or to exist alongside, other sleep and medical conditions, a sleep doctor usually looks at the whole picture. Our article on Ambien side effects covers what the FDA warnings say.
Is sleepwalking in adults dangerous?
It can be. Do not assume it is harmless. Injuries can happen from falls, walking into objects, or leaving the house. The AASM notes that in adults, men are more likely to show aggressive behavior during an episode.
In a study of 100 adult sleepwalkers (ages 18 to 58, median age 30), researchers found more daytime sleepiness, fatigue, insomnia, depressive and anxiety symptoms, and a lower quality of life than in people who did not sleepwalk. The lead author said that adult sleepwalking, usually thought of as benign, is a potentially serious condition whose consequences should not be ignored.
In a small 2002 conference report of 16 patients, 32% reported violent incidents and 19% reported injuries during sleepwalking. That sample is tiny, so treat the numbers as a flag, not a prediction.
Are you sleepwalking, or waking exhausted and unsure why? If you would like to see how we might be able to help you with this deeper, schedule a free consult here.
How is sleepwalking in adults diagnosed?
A sleep doctor reviews your medical history and symptoms, and your bed partner’s account is valuable. The AASM says the doctor will try to find anything that causes it or makes it worse, such as another sleep disorder, and may order a sleep study.
It matters to tell sleepwalking apart from lookalikes:
- Sleep terrors also come from NREM sleep and often happen alongside sleepwalking.
- REM sleep behavior disorder happens in REM sleep, when the body normally cannot move, and involves acting out dreams. The two can overlap in some adults.
- Other conditions can look like sleepwalking. MedlinePlus notes that in older adults, new sleepwalking may signal a medical problem that affects mental function, so it deserves a medical evaluation.
Want the wider picture of night-time behaviors? See our guides to sleep talking in adults, sleep paralysis, and hypnic jerks, or our parasomnias overview.
How do you stop sleepwalking in adults? A step-by-step plan
Start with safety and triggers, then see a doctor if it continues. The Mayo Clinic says treatment generally focuses on promoting safety and eliminating causes or triggers. Here is a practical order:
- Make the bedroom safe. Lock doors and windows, clear the floor, and move sharp or breakable objects. A researcher who led the largest US survey advises making sure there is a lock on the door and window. Consider a chime or alarm on the bedroom door.
- Protect your sleep. Keep a regular schedule and get enough hours. Sleep deprivation is a common trigger.
- Cut back on alcohol, especially in the evening.
- Review your medicines with your prescriber or pharmacist. If you sleepwalk or do things you do not remember after zolpidem, eszopiclone, or zaleplon, the FDA says to stop the medicine and contact your health care professional right away.
- Treat other conditions. Sleep apnea, insomnia, depression, and anxiety can all play a part. Read our complete guide to sleep apnea.
- Keep notes. Write down when episodes happen, how long they last, and what you did. It helps your doctor.
- Ask about treatment if episodes continue or are dangerous. A sleep specialist can discuss options such as cognitive behavioral therapy, scheduled awakenings, and hypnosis, and in selected cases medicine.
If you share a home, here is common-sense advice. Stay calm, and gently guide a sleepwalking person back to bed rather than confronting them. Some people are confused or aggressive when woken. Keep your distance if they seem agitated.
What the Research Shows
It is more common in adults than people thought. A 2012 Neurology study surveyed 19,136 adults in 15 US states by phone. About 3.6% (about 8.4 million people) had a sleepwalking episode in the past year, and about 1% had two or more in a month. Lifetime prevalence was 29.2%, largely because of childhood episodes. Sleepwalking was not tied to gender, and it seemed to decrease with age. About 30% had a family history.
Depression, obsessive-compulsive disorder, and alcohol are linked. In the same survey, people with depression were 3.5 times more likely to sleepwalk, and those with obsessive-compulsive disorder were four times more likely. About 3.1% of people with depression sleepwalked twice a month or more, compared with 0.9% of those without it. For obsessive-compulsive disorder the figures were 7.3% versus 1%. Alcohol abuse was also associated. Over-the-counter sleep aids, hypnotics, and SSRIs were linked as well, although the lead author said the link with zolpidem was weaker than some reports suggest and that depression itself is the likelier root for SSRI users. The survey cannot show cause and effect.
Adult sleepwalking affects daytime life, and genes play a role. A 2013 study in SLEEP compared 100 adult sleepwalkers with controls and found more daytime sleepiness, fatigue, insomnia, depressive and anxiety symptoms, and altered quality of life. A 2003 study of 60 sleepwalkers found HLA-DQB10501 in 35% versus 13.3% of controls (odds ratio 3.5). A small 2002 report found 50% of 16 patients carried the HLA DQB105 susceptibility versus 24% of healthy people, and 11 of 53 patients tested had sleep apnea.
Treatment evidence is thin, and some sleep drugs cause sleepwalking. A 2023 systematic review in Sleep Medicine found 76 publications on behavioral and psychological treatments for NREM parasomnias, 44 of them in adults. Hypnosis was the most common treatment. Study designs and inconsistent outcome measures limited the evidence, but some supported multicomponent CBT, sleep hygiene, scheduled awakenings, and hypnosis. Separately, in 2019 the FDA added a boxed warning and a contraindication to eszopiclone, zaleplon, and zolpidem after finding 66 cases over 26 years of complex sleep behaviors that caused serious injuries, including deaths. These behaviors occurred even at the lowest recommended doses and after a single dose.
This article is for education only and is not medical advice. Talk with a qualified clinician about your own sleep, health conditions, and medications.
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When to Seek Professional Help
- Your episodes are frequent, you have been hurt, or you have put yourself or others at risk, for example by leaving the house, cooking, driving, or acting aggressively. See a sleep doctor promptly.
- Sleepwalking started after you began a sleep medicine, especially zolpidem, eszopiclone, or zaleplon. Contact your prescriber right away, as the FDA advises.
- Sleepwalking is new later in life, you act out dreams, or episodes involve stiffening, jerking, or repeat the same way several times a night. Ask for a medical evaluation, since other conditions can look like sleepwalking.
- You snore loudly, gasp or choke at night, or feel very sleepy by day. These can signal sleep apnea.
- You feel persistently sad, anxious, or hopeless, or have thoughts of self-harm. Contact a clinician right away, and in the US you can call or text 988 at any time.
Frequently Asked Questions
What causes sleepwalking in adults?
Adult sleepwalking usually comes from a mix of a built-in tendency and triggers. A family history is common, and one gene variant, HLA-DQB1*05:01, is more frequent in sleepwalkers. Triggers include sleep deprivation, irregular schedules, stress, fever, alcohol, sleep apnea, depression, anxiety, and some medicines. Episodes happen when the brain is partly awake during deep non-REM sleep, often in the first third of the night. A sleep doctor can look for the triggers that apply to you.
Is sleepwalking in adults a sign of a mental health problem?
Not necessarily, but there is a link. In a survey of more than 19,000 US adults, people with depression were 3.5 times more likely to sleepwalk, and those with obsessive-compulsive disorder were four times more likely. Alcohol problems were also associated. The study cannot show what causes what, and many sleepwalkers have no mental health condition. If you have mood or anxiety symptoms along with sleepwalking, mention both to your doctor.
How do I stop sleepwalking as an adult?
Start with safety and triggers. Lock doors and windows, clear the floor, and consider an alarm or chime on the bedroom door. Get enough sleep on a regular schedule, cut back on alcohol, and ask your doctor or pharmacist whether any medicines could be involved. Treat sleep apnea or other sleep disorders if you have them. If episodes continue or are dangerous, a sleep specialist can discuss options such as cognitive behavioral therapy, scheduled awakenings, hypnosis, or medicine.
Is sleepwalking hereditary?
It often runs in families. In a large US survey, about 30% of sleepwalkers had a family history of it. Researchers have also linked a gene variant called HLA-DQB1*05:01 to sleepwalking. It was found in 35% of sleepwalkers in one study, compared with about 13% of people without a sleep disorder. A gene does not guarantee you will sleepwalk. Triggers like sleep loss, alcohol, and stress still matter.
Can sleeping pills cause sleepwalking?
Yes, some can. In 2019, the FDA added its strongest warning to zolpidem (Ambien), eszopiclone (Lunesta), and zaleplon (Sonata) because of rare but serious complex sleep behaviors, including sleepwalking and sleep driving, that caused injuries and deaths. The behaviors can happen even at the lowest recommended doses and after a single dose. If you sleepwalk or do anything you do not remember after taking one of these medicines, stop it and contact your prescriber right away.
When to Work With a Sleep Consultant
We do not diagnose or treat sleepwalking, and a sleep doctor should rule out sleep apnea and other disorders first. What The Sleep Consultant can do is look for the root causes that fragment your sleep, such as an irregular schedule, a stressed nervous system, circadian rhythm problems, hormones, and nutrient gaps, so that your nights are calmer.
