Prescription Drugs That May Cause Sleepwalking

Sleepwalking (medical term: somnambulism) is a condition in which a person gets up and walks around when partially awake. It usually occurs during periods of slow-wave sleep or non-rapid eye movement (NREM) sleep, which is a stage of deep sleep. Sleepwalking is more common in children aged 4 to 12, and most people outgrow it by the time they are teenagers. However, some adults can experience sleepwalking; therefore, if the onset of sleepwalking is during adulthood, it is more than likely caused by other underlying conditions or medication side effects. Please continue reading to find out which medications can trigger sleepwalking.

What causes complex sleep behaviors like sleepwalking?

Common causes of sleepwalking include stress and anxiety, sleep deprivation, fever, alcohol consumption, medical conditions that affect sleep quality such as comorbid obstructive sleep apnea, disruptions to the usual sleep schedule due to travel, or sleep interruptions from a sudden noise or touch causing abrupt awakening from a deep sleep. In addition, twenty-nine drugs have been identified that can cause a sleep disorder, such as sleepwalking.

What are the symptoms of sleep disorders like sleepwalking?

People can do one or more of the following behaviors when sleepwalking occurs:

Get out of bed and walk around
Sit up in bed with eyes open
Not respond to others or be dazed, disoriented, or confused
Sleep-related eating or preparing food
Get dressed and leave the house
Sleep-driving
Unusual behaviors such as urinating in the hallway
Engage in sexual activity without being aware
Make phone calls
Move furniture
Get injured from jumping out of a window or falling down a flight of stairs
Have night terrors while sleep walking
Not remember episodes of sleep walking in the morning
Have trouble functioning during the daytime due to disrupted sleep

Why have I suddenly started sleepwalking?

As mentioned above, there are many causes of sleepwalking. Genetics also play a major role in sleepwalking; this health condition runs in the family. So if you have a parent who sleepwalks, there is a high chance that you will also sleepwalk; the risk increases even more if both parents have this sleep disorder.

A sleep specialist or expert in sleep medicine can get to the bottom of why you may have suddenly started sleepwalking. They can use suitable screening tools such as a sleep EEG (study of brain waves) to make a diagnosis.

If your sleepwalking is a medication side effect, your healthcare provider can identify drugs that may be possible culprits. If a condition such as obstructive sleep apnea is causing sleep disturbance, continuous positive airway pressure (CPAP) may help.

What medications can cause sleepwalking?

Zolpidem (Ambien)

Zolpidem is the most commonly implicated medication in parasomnias like sleepwalking, sleep-driving, and sleep-related eating. It belongs to a group of drugs called sedative-hypnotics that enhance GABA activity in the brain. This is a medication prescribed to treat insomnia. Sleepwalking is a rare side effect of zolpidem. Post-marketing studies have found less than 1% of patients who take zolpidem experience sleep-related events characterized by sleepwalking, driving, eating, or sexual behavior. If you develop any abnormal sleep behaviors while on zolpidem, tell your doctor right away.

Eszopiclone (Lunesta)

This medication is a hypnotic and it is used to treat insomnia (difficulty falling asleep and staying asleep). It helps to regulate the sleep cycle by slowing activity in the brain. People taking eszopiclone (Lunesta) can experience a serious and potentially life-threatening parasomnia behavior characterized by sleepwalking, sleep-related eating, sleep-driving, or having sex while not fully awake. Tell your doctor if you or your family members notice these symptoms after taking sleeping pills.

Sodium Oxybate (Xyrem)

This medication is approved by the U.S. Food and Drug Administration (FDA) to treat cataplexy (sudden short-lived muscle weakness) and narcolepsy (excessive daytime sleepiness). Sodium-oxybate is also illegally sold as a street drug called GHB. It can cause sleep-related events such as sleepwalking. This is a serious side effect and you should call your doctor immediately or get emergency medical treatment if it occurs.

Atypical antipsychotic medication

There are case reports of atypical antipsychotic medication use causing a sleep-eating or sleepwalking episode. These medications, like quetiapine (Seroquel), are used to treat schizophrenia and bipolar disorder. In patients with these psychiatric disorders, the differential diagnosis remains challenging because the behaviors can be confused with symptoms of the underlying condition. Antipsychotic dosage reduction may help in controlling abnormal sleep behaviors. The effects of these medicines are usually temporary and sleepwalking resolves when the drug is discontinued.

Beta blocker

Beta blockers, such as propranolol, are commonly prescribed to treat high blood pressure and migraine. There are case reports of beta blockers causing sleepwalking episodes and other sleep disturbances like nightmares and insomnia.

What antidepressants cause sleepwalking?

Antidepressants enhance serotonergic activity in the brain. They also suppress REM (rapid eye movement) sleep and disturb normal sleep architecture. Certain medications used to treat depression and bipolar disorder have been linked to sleepwalking. By increasing muscle tone, SSRIs (selective-serotonin reuptake inhibitors) cause other sleep behaviors that are resemblant to sleepwalking. This results in sleep behaviors like acting out a dream causing kicking, talking, or jumping out of bed. Examples of SSRIs include:

Fluoxetine (Prozac)
Paroxetine (Paxil)
Sertraline (Zoloft)
Citalopram (Celexa)
Fluvoxamine (Luvox)

What is the treatment for medication-induced sleepwalking?

If a medication causes adverse effects such as sleepwalking, you should discuss an alternate medication option with your doctor. The important thing is to report sleepwalking to your healthcare provider without delay so they can change you to alternative treatments.

In the meantime, you and your family should create a safe sleep environment to prevent serious injuries to yourself and others during a sleepwalking episode. This includes moving furniture out of the way, taping electrical cords to walls, locking doors and windows, and placing a gate at the top of stairs to prevent falls.

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