Self-Reported Precipitating and Priming Factors for Somnambulism in Adult Sleepwalkers

Several studies have explored how factors that deepen sleep (e.g., sleep deprivation) and factors that fragment sleep (e.g., environmental stimuli) facilitate the occurrence of somnambulistic episodes experienced by sleepwalkers in the sleep laboratory. Little is known, however, about the broader range of variables that sleepwalkers perceive as contributing to their episodes in their home environment. We examined self-reported precipitating and priming factors for sleepwalking in a large cohort of 188 adults diagnosed with primary somnambulism using a comprehensive questionnaire. The most frequently endorsed precipitating or priming factors for sleepwalking episodes were psychological stress (95%), bad dreams and nightmares (78%), and sleep deprivation (60%). Factors such as irregular sleep schedules, intense movies, and new sleep environments were also relatively common. In contrast, substance use (e.g., alcohol, caffeine) and physical ailments (e.g., fever, pain) were cited less frequently. We found few significant differences in reported factors based on biological sex, age of onset, or family history, although women were more likely to associate noisy environments and the use of hypnotics with their episodes. These findings emphasise the critical role of stress in sleepwalking and suggest that stress management and sleep hygiene should be incorporated into treatment strategies. Furthermore, our study underscores the growing recognition of dream-like mentation as an integral component of sleepwalking in adults. Future research should focus on refining our understanding of the role of psychosocial stressors and their possible neurobiological mechanisms underlying adult somnambulism.