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Medically reviewed guide · Last updated: 1 September 2026 · Reading time: approx. 10 min
Sleepwalking: A Harmless Childhood Phase or a Warning Sign in Adults?
At a glance
Sleepwalking is a disorder of arousal from deep sleepthe brain only partly wakes up, the body acts, and consciousness stays asleep. It typically happens in the first third of the night, and in the morning there is usually no memory of it at all.
In children it is common and usually harmless.It often runs in families and is, as a rule, outgrown by puberty. What matters most is a safe environment.
In adults it is worth looking at the triggerslack of sleep, stress, fever, irregular sleeping times, sleep apnoea or restless legs can set off episodes.
Medicines as triggers are well documentedthe sleeping pills zolpidem and zopiclone (Z-drugs) can trigger complex behaviours during sleep — up to and including eating, making phone calls or driving with no memory of it. Quetiapine and montelukast also list sleepwalking in their summaries of product characteristics.
Get it checked immediatelyinjuries, leaving the home or driving while asleep, violence towards a bed partner, acting out dreams for the first time after the age of 50, and episodes with twitching, tongue biting or wetting. After a fall with a head injury or with loss of consciousness: call 112 (emergency number in Germany).
Night-time behaviours compared
Form
Timing
Typical picture
Memory in the morning
First step
Sleepwalking
First third of the night
Sitting up, walking around, glassy stare, hard to wake
None
Make the surroundings safe, avoid triggers
Night terrors (pavor nocturnus)
First third of the night
Sudden screaming, panic, sweating, cannot be calmed; mainly toddlers
None
Do not wake the child, stay close; usually harmless
REM sleep behaviour disorder
Second half of the night
Hitting, kicking, shouting — dreams are "acted out"; mostly men over 50
Often remembers the dream
Have it assessed by a neurologist
Nightmare
Usually the second half of the night
Waking up frightened, immediately oriented afterwards
Vivid memory
Check triggers and medicines
Epileptic seizure at night
At any time, often several times a night
Brief, always following the same course, possibly twitching, tongue biting, wetting
None or fragmentary
Record a video, have it assessed by a neurologist
Caused by sleeping pills
After taking the medicine
Complex behaviours such as eating, making phone calls, driving
None
Talk to your practice promptly
Table scrolls to the right
Up and about at night since the new sleeping pill?
Time taken, dose and night-time episodes documented side by side — free of charge in the brite app.
Sleepwalking belongs to the parasomnias (unwanted behaviours or experiences during sleep). It is not insomnia — if your main problem is falling asleep or staying asleep, you will find the right explanation under sleep disorders. This article is about what lies behind walking around, crying out or lashing out at night.
Sleepwalking in children: a question of maturity
In childhood, deep sleep is particularly pronounced, and the brain does not yet always switch cleanly between sleeping and waking. The result is a partial arousal: the child sits up, walks around the room with eyes open, mumbles, perhaps moves something — and barely responds when spoken to. Episodes usually last a few minutes, and in the morning there is no memory of them at all. Sleepwalking often runs in families and is outgrown by puberty in most children.
Closely related are night terrors (pavor nocturnus), especially in toddlers: shortly after falling asleep, the child starts up with a scream, seems panic-stricken, sweats, the heart races — and yet cannot be comforted, because the child is not really awake. However frightening this is for parents, the child does not remember it, and as a rule there is no lasting harm. Common aggravating factors are overtiredness, a shifted sleep rhythm, fever and excitement.
Sleepwalking in adults: look for the triggers
In adults, sleepwalking is less common. Often it already existed in childhood and returns under certain conditions. Typical triggers are lack of sleep followed by "catch-up sleep", stress, shift work, travel across time zones, fever, a full bladder or noise. Alcohol is considered a possible aggravating factor, especially in combination with sleeping pills. Some adults eat in their sleep (sleep-related eating disorder) — noticeable from empty packaging or crumbs in the morning, with no memory of it.
When another sleep disorder breaks up deep sleep
Anything that repeatedly interrupts deep sleep can set off sleepwalking. Above all, this includes sleep apnoea: pauses in breathing lead to many brief arousals, often combined with loud snoring. Restless legs syndrome, with leg movements at night, can also play a role. When the underlying condition is treated, the episodes quite often disappear along with it.
REM sleep behaviour disorder: when dreams are acted out
In dream sleep (REM sleep) the muscles are normally slack — a safeguard so that we do not carry out our dreams with our bodies. In REM sleep behaviour disorder this block is missing: people affected hit out, kick, shout or fall out of bed, usually in the second half of the night, and can often describe the dream if they are woken. It frequently affects men over 50. This matters medically because the disorder sometimes appears years before Parkinson's disease or a related disease of the nervous system. That is no reason to panic, but it is a clear reason for a neurological assessment and regular check-ups.
Seizures at night, low blood sugar and confusion
Some forms of epilepsy show themselves almost exclusively during sleep. They can look like sleepwalking, but they are brief, always very similar and often happen several times a night — a video on your phone helps the practice enormously here. In people taking insulin or sulfonylureas, low blood sugar at night can lead to confusion, wandering around and sweating. And in older people with early dementia, or during an infection, confusion at night is something different from sleepwalking — it should be assessed by a doctor promptly.
Self-tests: first clues at home
You cannot observe your own sleepwalking — this is where family members come in. The following observations do not replace a diagnosis, but they make the conversation at the practice much more productive.
The time: episodes in the first two or three hours after falling asleep fit deep sleep and therefore sleepwalking or night terrors. Restlessness in the early hours of the morning points more towards dream sleep.
The morning question: if the person remembers nothing, that fits sleepwalking. If they can recount a dream that matches the behaviour, that points more towards REM sleep behaviour disorder or a nightmare.
The phone video: a short recording of an episode is often more valuable to sleep medicine than any description. Pay attention to the duration, the sequence and whether the movements are the same every time.
The sleep diary: for two to four weeks, note down bedtime, how long you slept, stress, fever, alcohol and every episode. This makes patterns such as "always after short nights" visible.
The partner's view: loud snoring with pauses in breathing, twitching legs or daytime sleepiness point to a sleep disorder that can drive sleepwalking.
The medication check: in the weeks before the first episodes, was a sleeping pill, an antidepressant, an asthma medicine or an antipsychotic added, or was the dose increased? Was it combined with alcohol?
Warning signs: when not to wait
Injuries during sleep, falls on the stairs or attempts to go through windows or balcony doors
Leaving the home, cooking or driving while asleep
Violence towards a bed partner or towards yourself
Acting out dreams for the first time in middle or later life
Episodes with rhythmic twitching, tongue biting or wetting, or several times a night always following the same course
Sleepwalking for the first time in adulthood with no recognisable trigger, or a marked increase in episodes
Wandering around at night with sweating and confusion in people taking blood sugar lowering medicines
Emergency: call 112 immediately After a fall with a head injury, with loss of consciousness, with a seizure lasting longer than five minutes, or if someone can barely be woken or is breathing slowly after sleeping pills and alcohol, call 112 (emergency number in Germany). If you suspect an overdose, the steps in the guide Medication overdose: what to do will help.
Driving while asleep is a stop signal Anyone who has eaten, made phone calls or even driven at night while taking a sleeping pill, without remembering it, should speak to the prescribing practice the very next day. According to the summary of product characteristics, complex sleep behaviours like these are a reason to seriously consider stopping the medicine. Until then: no driving, no alcohol, no other sedating medicines.
The treatment pathway: step by step
Most people who sleepwalk do not need medication. The focus is on safety and on eliminating triggers.
Safety first. Secure windows and balcony doors, lock the front door and put the key out of reach, fit a gate to the stairs, clear away sharp objects. Children are better off not sleeping in the top bunk. A bell on the bedroom door wakes family members in time.
Guide back gently instead of waking. Do not hold on to a sleepwalking person or wake them abruptly — they are then often confused and may react defensively. Speak calmly and slowly walk them back to bed.
Stabilise sleep. Get enough sleep at regular times, at weekends too. Lack of sleep is the most important trigger you can influence. Avoid alcohol in the evening and go to the toilet before going to bed.
Children: have it assessed by a paediatrician. Usually information and a safe environment are enough. If episodes occur every night at the same time, scheduled waking shortly before the usual time is sometimes recommended; the evidence for this is limited.
Sleep medicine when there are warning signs. With injuries, a first occurrence in adulthood, suspected seizures or dream enactment, the next step is an examination in a sleep laboratory with video (video polysomnography). It distinguishes between the forms and reveals sleep apnoea or leg movements.
Targeted treatment. Sleep apnoea, for example, is treated with a breathing mask, a triggering medicine is switched, and stress is addressed with psychotherapy. Medicines against sleepwalking itself are only considered in exceptional cases. Which treatment is right is always decided by the practice treating you.
The medication angle: when the pill keeps working through the night
Sleepwalking is one of the symptoms for which medicines are overlooked particularly often — because nobody suspects a sleeping pill that is supposed to be improving sleep.
Z-drugs: zolpidem and zopiclone
Zolpidem and zopiclone can trigger complex sleep behaviours: walking around, eating, making phone calls, cooking or driving — without the person remembering any of it in the morning. The US Food and Drug Administration (FDA) therefore introduced its strictest warning level for this group of active substances in 2019; the German summaries of product characteristics also warn about it explicitly. The risk rises with alcohol, with other sedating medicines, with a higher dose than prescribed, and if a full night's sleep does not follow after taking the medicine. Z-drugs are intended for short-term use; after longer regular use, stopping them should be medically supervised, because otherwise the insomnia can come back even more strongly.
Other active substances with a known link
The antipsychotic quetiapine, which is often also used at a low dose as a sleep aid, lists sleepwalking and related events as a rare side effect in its summary of product characteristics. With the asthma and allergy medicine montelukast, neuropsychiatric side effects are known, including nightmares and sleepwalking — particularly relevant in children. Sleepwalking has also been described with sodium oxybate, which is used in narcolepsy.
Antidepressants, beta blockers and dream sleep
Many antidepressants, such as SSRIs, venlafaxine or tricyclic active substances, alter dream sleep. They can trigger REM sleep behaviour disorder or make a previously unnoticed one visible. Fat-soluble beta blockers such as propranolol are known for causing vivid dreams and nightmares. That is no reason to stop an effective treatment on your own initiative — but it is a reason to raise the timing.
Over-the-counter sleeping pills: only for a short time
Over-the-counter sleep aids containing diphenhydramine or doxylamine often still leave you groggy the next morning and, together with alcohol, increase the sedation. According to the package leaflet, they should not be taken for longer than two weeks without medical advice. What actually helps with sleep problems is summarised in the guide Sleeping pills: what helps, and alternatives to sedatives in the guide Alternatives to sedatives.
Do not stop anything on your own — but always raise it Stopping benzodiazepines and Z-drugs abruptly after taking them for a long time can cause restlessness, insomnia and, in extreme cases, seizures. Antidepressants and antipsychotics also need a planned exit. Note down since when you have been taking the medicine, at what dose and when the episodes began, and discuss this promptly with your practice.
Sleeping pill at 10 pm — episode at midnight?
Dosing times and night-time events in your record show the pattern that is missing at the appointment.
Sleep enough and regularly — fixed bedtimes and no chronically short nights. Catch-up sleep after sleep deprivation is especially rich in deep sleep and therefore a typical trigger.
Wind down in the evening — avoid stress, arguments and exciting media shortly before going to sleep. For children, a calm, consistent bedtime routine helps.
Do not combine alcohol and sleeping pills — the mixture significantly increases the risk of complex sleep behaviours. More on this in the guide Medications and alcohol.
Take sleeping pills only as prescribed — directly before going to bed, at the prescribed dose and only if a full night's sleep is possible afterwards.
Take snoring and restless legs seriously — having sleep apnoea or restless legs syndrome treated often removes what is driving the sleepwalking.
Sleeping pills only as prescribed — with a reminder
A fixed time for taking them, no accidental double dose, interactions in view.
Waking them is not dangerous, but it is often unhelpful: the person is then confused and may get a fright or react defensively. It is better to speak calmly and gently walk them back to bed. You should only wake them if there is immediate danger.
As a rule, no. Sleepwalking is common in children, often runs in families and is usually outgrown by puberty. The real risk is injury, so windows, doors and stairs should be secured. With injuries, very frequent episodes or unusual movement patterns, an assessment by a paediatrician makes sense.
Common triggers are lack of sleep, stress, irregular sleeping times, fever, alcohol and untreated sleep apnoea. Medicines are also a possibility, especially the sleeping pills zolpidem and zopiclone. If sleepwalking appears for the first time in adulthood, it should be assessed by a doctor, in a sleep laboratory if necessary.
Yes. Zolpidem and zopiclone can trigger complex sleep behaviours such as walking around, eating or even driving with no memory of it, especially together with alcohol or at too high a dose. If that happens, speak to the prescribing practice promptly; according to the summary of product characteristics, stopping the medicine should then be seriously considered. Until then, no alcohol and no driving.
Both arise from deep sleep in the first third of the night, and there is no memory of them in the morning. In sleepwalking, quiet walking around is the main feature; in night terrors, it is sudden screaming with panic, sweating and a racing heart. In children, both are usually harmless.
An examination in a sleep laboratory makes sense with injuries or dangerous behaviour, a first occurrence in adulthood, dreams being acted out, suspected seizures at night or signs of sleep apnoea. The referral is usually made via your GP practice or a neurology practice.
U.S. Food and Drug Administration (FDA): Drug Safety Communication on complex sleep behaviours with eszopiclone, zaleplon and zolpidem (2019). Accessed 2026.
Summaries of product characteristics for the active substances mentioned (including zolpidem, zopiclone, quetiapine, montelukast). Accessed 2026.
Gesundheitsinformation.de (IQWiG): Sleep disorders — German source. Accessed 2026.
This article is for general information and does not replace medical advice, diagnosis or treatment. The observations described are a guide and not a diagnosis. In the case of injuries during sleep, seizures, loss of consciousness, or if someone can barely be woken after sleeping pills and alcohol, please contact a doctor or the emergency services without delay.
