Is There a Link Between Sleepwalking, Sleep Talking, and Mental Health?

An empty bed in a dark bedroom with the covers peeled backSleepwalking and sleep talking both belong to a group of behaviors called parasomnias—unusual or harmful behaviors that occur during sleep. Sleep talking is one of the most common parasomnias. A 2010 study found that 68.8% of people talk during their sleep at some point during their lives. According to the same study, 22.4% of people have sleepwalked at least once.

Both sleepwalking and sleep talking can happen for many reasons. Sometimes they are symptoms of a mental health condition, and both may cause psychological distress and interfere with relationships, work, and even overall life satisfaction.

What Causes Sleepwalking?

Sleepwalking, known sometimes as somnabulism, happens in deep sleep, when a person is very difficult to wake up. Normally, when a person sleeps, the body paralyzes skeletal muscles—the muscles responsible for walking and other complex behaviors. GABA, a neurotransmitter, is one of the primary chemicals involved in preventing sleepwalking. When GABA doesn’t work to paralyze the skeletal muscles, a person may walk, make food, or even try to drive during their sleep.

Sleepwalking is more common in children. Some research suggests this might be because the neurons that release GABA are still developing in children. Sleepwalking in children tends to peak between 8 and 12 years old. Children who sleepwalk may also have a condition called confusional arousal, which occurs when a person appears to be awake but is confused or unaware.

Though it’s difficult to wake a sleepwalking person, it’s a myth that doing so is dangerous. However, a person who is woken up from a sleepwalking episode may be confused or alarmed.

What Causes Sleep Talking?

Sleep talking, which used to be called somniloquy, is more common in children than adults. It typically happens during rapid eye movement (REM) sleep. Adults are more likely to talk in their sleep if they have depression, are experiencing a nightmare, or are under the influence of drugs or alcohol.

Is Walking or Talking in Your Sleep a Sleep Disorder?

Sleepwalking and sleep talking are both considered sleep disorders. They are more common in people who have other sleep disorders, such as sleep apnea, insomnia, or sleep behavioral issues. Both sleepwalking and sleep talking tend to run in families.

Sleepwalking and sleep talking are more common in boys than in girls, though researchers don’t know why. Both tend to decrease or disappear by the age of 12, but when they don’t, a person may be diagnosed with a sleep disorder.

Sleep behavioral disorders, which cause people to do unusual things when they are asleep, are closely related to sleepwalking. For instance, a person might drive their car or attempt to have sex with their partner while sleeping. Rarely, people even become violent in their sleep. A handful of rape defendants have successfully used a “sexsomnia” defense, arguing they did not intend to rape someone and instead were sleepwalking. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) recognizes sexsomnia as a mental health diagnosis.

Therapy can help with sleepwalking or sleep talking when these issues are due to a mental health condition or stress.

Mental Health Issues Associated with Sleepwalking and Sleep Talking

A number of mental health issues can cause sleepwalking and sleep talking. When sleep issues are related to a mental health issue, seeking treatment for the underlying mental health condition is usually the fastest way to resolve the sleep problem.

Any mental health condition can interfere with sleep and lead to unusual behavior at night. Sleep issues are especially prevalent in people who have:

Drugs and alcohol can cause some people to talk or walk in their sleep. Due to this, people with substance abuse issues, as well as those going through drug or alcohol withdrawal, may experience sleepwalking or sleep talking.

Medical Issues Linked to Sleepwalking and Sleep Talking

Certain medical issues have been linked to sleepwalking and sleep talking. Those include:

  • Sleep apnea, a disorder that causes frequent nighttime wakings due to breathing issues.
  • Breathing disorders such as asthma and chronic obstructive pulmonary disorder (COPD).
  • Cardiovascular health issues such as heart arrhythmias.
  • Infections and illnesses, especially when they cause a high fever.
  • Brain health issues such as tumors or a brain injury. This is a rare cause of sleep issues but is more likely if sleep issues appear suddenly or are severe.

Certain medications have also been linked to sleepwalking and sleep talking. Some sleeping medications, such as Ambien and Lunesta, can cause unusual nighttime behavior. Sleep eating is one of the most common medication-related behaviors, but driving and other unusual behaviors have also been reported.

Therapy can help with sleepwalking or sleep talking when these issues are due to a mental health condition or stress. Many people also find therapy helps them deal with the challenges of parasomnias, such as sleep deprivation or conflicts with a partner over sleep. The right therapist can help you craft a healthy sleep environment, set healthy sleep goals, and get better sleep.

According to the National Sleep Foundation, therapy can help with many sleep issues. Cognitive behavioral therapy (CBT) has proven especially effective.

Sleep issues can affect an entire family. When a child sleepwalks, parents may struggle to get a good night’s sleep, and siblings may feel anxious. A spouse who sleepwalks or sleep talks can trigger sleep issues in their partner. Nighttime sleep issues, such as sexsomnia or nighttime eating, can even be a source of marriage or relationship problems. Family or couples therapy can help families manage and understand these issues.

References:

  1. Bjorvatn, B., Grønli, J., & Pallesen, S. (2010). Prevalence of different parasomnias in the general population. Sleep Medicine, 10(11), 1031-1034. doi: 10.1016/j.sleep.2010.07.011
  2. Cognitive behavioral therapy for insomnia. (n.d.). Retrieved from https://www.sleepfoundation.org/sleep-news/cognitive-behavioral-therapy-insomnia
  3. Mohebbi, A., Holoyda, B. J., & Newman, W. J. (2018). Sexsomnia as a defense in repeated sex crimes. The Journal of the American Academy of Psychiatry and the Law, 46(1), 78-85. Retrieved from http://jaapl.org/content/46/1/78.long
  4. Oliviero, A. (2008, February 1). Why do some people sleepwalk? Retrieved from https://www.scientificamerican.com/article/why-do-some-people-sleepwalk
  5. Pediatric parasomnias. (n.d.). Retrieved from https://www.childrens.com/specialties-services/specialty-centers-and-programs/sleep/programs-and-services/sleep-medicine/nightmares-sleepwalking-sleep-talking-sleep-terror
  6. Post-traumatic stress disorder (PTSD) and sleep. (n.d.). National Sleep Foundation. Retrieved from https://www.sleephealthfoundation.org.au/pdfs/Post-Traumatic-Stress-Disorder.pdf
  7. Sexsomnia: A new DSM-5 diagnosis. (2014, October 28). Retrieved from https://www.psychiatryadvisor.com/sleep-wake-disorders/sexsomnia-a-new-dsm-5-diagnosis/article/379644
  8. Sleep talking: Causes. (n.d.). Retrieved from https://www.sleepfoundation.org/sleep-disorders-problems/sleep-talking/causes
  9. Sleep talking: What is it? (n.d.). Retrieved from https://www.sleep.org/articles/sleep-talking
  10. Sleepwalking. (n.d.). Retrieved from https://www.sleepfoundation.org/sleep-disorders-problems/abnormal-sleep-behaviors/sleepwalking

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