Sleepwalking Workup

Updated: Mar 11, 2019
  • Author: Syed M S Ahmed, MD; Chief Editor: Selim R Benbadis, MD  more...
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Approach Considerations

No specific laboratory studies are indicated in the workup of routine parasomnias. No imaging studies are required.

Polysomnography (PSG), with or without multiple sleep latency testing, should be reserved for the few cases in which the diagnosis is still unclear after a careful history and physical examination. The abnormal behavior during slow-wave sleep (SWS) is generally diagnostic. Sleep deprivation can be used as a tool to induce somnambulistic episodes in the sleep laboratory.

Microarousals and sleep state disorganization are observed frequently and often noted on electroencephalography (EEG) alone, if the study is performed during nocturnal sleep. Hypersynchronous slow delta-wave activity has been observed in the sleep EEG of sleepwalkers; however, controversy remains regarding these findings on PSG.