Sleep-walking, or sleepwalking – a special condition of nervous system at which the sleeping person has a disinhibition of the motive centers in the absence of control of consciousness over them. It is shown by the automated actions made by the person in a dream. During an episode of a snokhozhdeniye of the patient gets out of a bed and the lasagna, balancings begins to make various movements from simple walking to difficult motive acts on type, showing miracles of dexterity and force. Diagnostics is based on the description of behavior of the patient and data of EEG. In most cases drug treatment is not required, but antidepressants, anti-psychotics depending on complexity of a case can be applied.
The sleep-walking, or snokhozhdeniye is a special state at which the person unconsciously makes during sleep the difficult movements in full compliance with the scenario of a dream which he sees at this moment. The disease concerns to group of frustration of a dream which in medical literature call parasomniya. The sleeping person enduring a sleep-walking episode is called the sleep-walker.
The people far from medicine, quite often call a disease of sleepwalking. Historically developed delusion is the cornerstone of it that displays of a disease are caused by energy of moonlight. Statistically, about 15% of the population of the globe at least once in life endured a snokhozhdeniye episode. This state equally often occurs among men and women. The largest number of cases of a sleep-walking are the share of children's age (4 — 8 years).
The sleep-walking always appears in a phase of a slow dream, in the first half of night and is connected with emergence in a brain of sudden flashes of electric activity. Scientists still could not explain true mechanisms of emergence of a snokhozhdeniye. However there is a hypothesis which to some extent explains development of this phenomenon. During sleep at the healthy person in a brain braking processes begin to prevail. Normal they cover all sites at the same time. At a sleep-walking separate neurons show non-standard electric activity owing to what a part of structures of a brain rastormazhivatsya. That is not the "full", but "partial" dream turns out. At the same time the parts of the nervous system responsible for consciousness remain "sleeping", and the centers which are responsible for the movement, coordination and subcrustal educations begin independent life.
Example of the fact that the "partial" dream is possible is ability of the sentry to fill up in a standing position. At the same time the brain is in a condition of a dream, and the centers which are responsible for balance maintenance stay in an active state. Other example is mother swinging the uneasy child in a cradle. She is capable to fall asleep, but the hand will continue to perform her the movements. In the described examples such "partial" falling asleep was defined by a psychological spirit, that is the cerebral cortex purposefully makes the program of behavior of the lowest nervous structures. In a case awakening of certain areas of a brain happens to a snokhozhdeniye without control from bark and is caused by abnormal electric activity of separate nervous cages.
At adults the sleep-walking can be observed at various neurologic diseases: hysterical neurosis, neurosis of persuasive states, Parkinson's disease, syndrome of chronic fatigue, etc. Provocative factors which promote development of episodes of a snokhozhdeniye are: a strong nervous shock, including positive character, a long stress for day, a chronic sleep debt (for example, owing to an insomniya). Loud noise during sleep, sudden flash of light, bright lighting in the room sleeping, including in a full moon can start the mechanism of partial "awakening". For this reason people since ancient times connected a sleep-walking with the full moon as its light in the absence of electricity was one of the main provokers of "abnormal" behavior.
People are inclined to carry a sleep-walking to mystical phenomena, surrounding it with aura of prejudices and myths. Actually, the snokhozhdeniye is result of misoperation of a brain at which processes of braking and excitement are during sleep out of balance.
Though the sleep-walking is also called a snokhozhdeniye, at it the most various complexes of movements from simple sitting in a bed, prior to playing a piano can meet. Usually the episode of a snokhozhdeniye begins with the fact that the patient sits down in beds, at the same time his eyes are open, eyeballs are most often not mobile. In the majority after several minutes of sleep-walkers goes back to bed and continues to sleep. In difficult cases the sleeping person is roused and begins the movements on the house. It can be just aimless circulation, at the same time his face has the absent expression, hands powerlessly hang bodies on each side, the case is slightly inclined forward, steps small. And sometimes sleep-walkers it is capable to make difficult complexes of actions, for example, to put on, open a door or a window, to get out on a roof, to go on building eaves, to play the piano, to search for the book on the book shelf.
However for all cases of a snokhozhdeniye - from the simplest to the most difficult - there are common characteristic features which are present always and are diagnostic signs. Treat them: lack of clear consciousness during a snokhozhdeniye episode; open eyes; lack of emotions; total absence of memories of perfect actions after awakening; end of an attack of a snokhozhdeniye deep sleep.
Lack of clear consciousness. In spite of the fact that during a snokhozhdeniye of people it is capable to show such miracles of dexterity of which it is never capable in a condition of wakefulness, all its actions have automatic character and are not controlled by consciousness. Therefore the sleep-walker cannot come into contact with the person who stopped it, does not react to questions, does not realize danger, can do harm to herself or surrounding depending on the scenario of a dream.
Open eyes. At the person in an episode of a snokhozhdeniye of an eye are always open. It is used for diagnostics of a true sleep-walking and attempts of its simulation. The look concentrated, but "empty", can be directed afar. In attempt to become opposite to a face of the sleep-walker his look will be directed through standing.
Lack of emotions. As at a snokhozhdeniye control of consciousness over process of the movement is turned off, and manifestations of emotions will also not be. The human face always released "senseless", it does not express fear, even at commission of obviously dangerous actions.
Amnesia. After the sleep-walker woke up, he remembers nothing from what occurred at night. If to tell it about the incident, he does not trust, perceiving everything as attempt of a draw.
Termination. All episodes of a snokhozhdeniye come to the end absolutely equally: the sleep-walker comes back to the bed or lays down in any other place and continues the dream. The same is observed in compulsory attempts to force it to return to go to bed if it manages to achieve, then the dream of the person proceeds, without having broken. To wake the person during a snokhozhdeniye episode, it is necessary to put a lot of effort. As he does not understand the speech turned to it and does not react to other ways to come into contact, the only effective ways are "to shake" it or to hurt (to prick or strongly to pinch).
At such compulsory awakening the sleep-walker does not understand a long time where she is, is disoriented in time, looks embarrassed, is alarmed. At it the attack of fear during which it is capable to do harm to itself(himself) and people around can develop.
Diagnostics of a sleep-walking
Basis for diagnostics of an episode of a snokhozhdeniye is the clinical picture with all richness of its manifestations which is observed by either the patient's relatives, or the doctor. In the diagnostic plan how often there are episodes is important that precedes them.
The neurologist has to ask as much as possible in details witnesses of a snokhozhdeniye on features of behavior of the patient at this moment, expression of his face, the response to attempts to come to it into contact, a state after natural awakening. At the most sick it becomes clear whether he remembers that he made at night.
As the snokhozhdeniye can develop as it is absolutely spontaneous at full health, well display of diseases of nervous system, carrying out additional methods of a research is obligatory. They include full neurologic and psychiatric inspection, computer (brain KT) or magnetic and resonant (brain MRT) a tomography according to indications, EEG (electroencephalography). According to indications to the patient consultation of the somnologist and a research of a night dream can be held with a sleep-walking.
Except an idiopathic (spontaneous) sleep-walking which is manifestation of immaturity of a brain at children, and also is inherent in persons with a neurotic warehouse of character, episodes of a snokhozhdeniye can appear at the following diseases: temporal epilepsy, tumors of a brain, schizophrenia, senile dementia.
Helps to differentiate a true sleep-walking from night attacks at temporal epilepsy the electroencephalogram and a polisomnografiya. On features of the registered brain potentials judge existence or lack of the center of a pathological impulsation which is characteristic of epilepsy. At identification of symptoms of epilepsy of the patient direct to consultation to an epileptolog.
Treatment of a sleep-walking
Treatment of a sleep-walking rather difficult and ambiguous question. In domestic neurology the following tactics in therapy of parasomniya is accepted: if snokhozhdeniye episodes at children occur seldom (several times a month), have simple character (are limited to sitting in a bed, attempts to put on clothes), last on time no more than several minutes, do not pose a threat for life and health of the patient then preferable the waiting technique without use of medicines is.
In these cases are limited to the preventive measures directed to prevention of development of episodes of a snokhozhdeniye or their interruption right at the beginning. So, the wet towel put about a bed in most cases is a simple, but effective way to awaken the patient while he got up. The irritant in the form of temperature influence on a foot causes bystry rastormazhivayushchy influence on a cerebral cortex and the child wakes up. Besides, salt or grass bathtubs with extract of a lavender, needles belong to the ways contributing to normalization of a psychoemotional background before going to bed; "an evening ritual" when withdrawal to a dream is followed by a standard set of the actions repeating day by day (for example, bathing reading of the fairy tale wish good night).
At the long and often repeating snokhozhdeniye episodes which include difficult actions and are followed by danger to life and health of the patient, application of medicinal therapy becomes obligatory. Treat medicines which are used at a sleep-walking: antidepressants, antipsychotic, sedative. The choice of concrete medicine depends on the neurologic and mental status of the patient.
Treatment of the sleep-walking which developed against the background of diseases of nervous system first of all is connected with elimination of primary factor. For example, removal of a tumor at oncological diseases of a brain, purpose of antiepileptic medicines at temporal epilepsy, correction senile weak-mindedness at advanced age.
Forecast and prevention of a sleep-walking
The forecast at a sleep-walking depends on whether it is true or this display of other diseases of nervous system. Snokhozhdeniye which is caused by immaturity of a brain at children has a favorable current and passes spontaneously in youthful age. The sleep-walking at adults which developed against the background of a tumor of a brain, a mental disease or epilepsy completely depends on weight of the main pathology. Emergence of episodes of a snokhozhdeniye at senile age can speak about the developing weak-mindedness and has adverse character.
Prevention of a sleep-walking at children consists in creation of the quiet psychological atmosphere in a family, school collective. Positive impact on prevention of emergence of any forms of parasomniya is exerted by restriction of viewing of telecasts before going to bed, prevention of access for children to the movies and programs containing violence scenes, cruelty, intimate life. A preventive measure which allows to prevent development of episodes of a snokhozhdeniye is early diagnosis of diseases of nervous system and mentality.