Somnabulism: Emergency Department Admissions Due to Sleepwalking-Related Trauma

INTRODUCTION Somnambulism is a state of dissociated consciousness, in which the affected person is partially asleep and partially awake. There is a pervasive public opinion that sleepwalkers are protected from hurting themselves. There have been few scientific reports of trauma associated with somnambulism and there are no published investigations on the epidemiology or trauma patterns associated with somnambulism. METHODS All emergency department admissions to Inselspital, Bern, Switzerland, from January 1, 2000 until August 11, 2015 were included when the patient had suffered a trauma associated with somnambulism. Demographic data (age, gender, nationality) and medical data (mechanism of injury, final diagnosis, hospital admission, mortality and medication on admission) were included. RESULTS Of a total of 650,000 screened emergency department admissions, 11 were associated with trauma and sleepwalking. Two patients (18.2%) had a history of known NREM parasomnias. The leading cause of admission was falls. Four patients required hospital admission for orthopaedic injuries needing further diagnostic testing and treatment (36.4%). These included two patients with multiple injuries (18.2%). None of the admitted patients died. CONCLUSION Although sleepwalking is benign in the majority of cases and most of the few injured patients did not require hospitalisation, major injuries are possible. When patients present with falls of unknown origin, the possibility should be evaluated that they were caused by somnambulism.