Sleepwalking more common in young boys

There's one subject I can talk about in my sleep. It surfaces so often in pediatric practice that I can dish out advice for all age groups -- and that topic is: Sleep.

From the colicky infant who won't sleep, to the 3-year-old who can't get to sleep on his own, all the way up to the college student who isn't getting enough sleep, sleep questions come up on a daily basis.

That's why I was a little surprised to hear about one fascinating sleep issue that is rarely discussed during regular office visits. Twice in the last few weeks parents have brought up childhood sleepwalking. A 7-year-old was in for his annual physical when his mom voiced concerns about his sleepwalking. During a sick visit a few days later, a father mentioned that his teenage son did sleepwalk, but he was relieved to add that the episodes were occurring less frequently as the boy matured.

Two things not all that surprising were that both patients were boys, and sleepwalking was not being observed as often in the older child. Sleepwalking, which appears to have some genetic link, is more common in males and usually fades by the mid-teen years. Studies show that no more than 1 percent of the adult population sleepwalks.

According to experts at the University of Iowa, sleepwalking falls into the category of parasomnias, or movements associated with sleep. Like its cousin, the night terror, sleepwalking occurs during the first one-third of the night when the child is in deep delta sleep.

Sleepwalking treatment is generally not medical, but focuses on injury prevention. The sleepwalker's room and usual pathway must be made as accident-proof as possible. Dangerous objects should be kept out of reach, and all windows and doors securely fastened and locked. Some parents put an alarm on their sleepwalking child's bedroom door to alert them of any nighttime wanderings.

Most experts agree that the best response to a sleepwalking child is to gently lead the youngster back to his room, allowing him to settle into bed for the rest of the night -- never making a big fuss about the event the following morning.

Some researchers feel that anticipatory waking can, in some cases, help reduce the incidence of sleepwalking. The theory is that if a child sleepwalks at a predictable, consistent time of the night, waking him 15 minutes prior to the expected walk can interrupt the cycle and gradually prevent the episodes from happening. This is obviously not a useful tactic if sleepwalking episodes are already few and far between.

While in most cases the condition is not considered a pathological or harmful phenomenon, sleepwalking is classified as severe if it occurs one or more times per week. If episodes are frequent, if the child is regularly putting himself in harm's way (leaving the house or trying to drive), or if he is planning an outdoor camping trip where he cannot be protected, consider a consultation with a sleep disorder specialist for further evaluation and discussion of potential medical therapies.