Walking in Sleep - Talking in Sleep - Laughing and Crying in Sleep - Eneuresis.

Using the term in a broad sense, somnambulism is applied to any movement which occurs in sleep. There is, probably, no sleep which is not accompanied by movements of some kind. One who notes the facial expression of the sleeper will usually be able to observe various changes of expression, indicative of the pleasurable or painful content of the dream. While these finer movements may be included under the term somnambulism, they are to be considered as more or less natural. Gross movements, as talking in sleep, laughing and crying in sleep, sleep-walking, etc., are more representative of what is usually called somnambulism. To most people somnambulism means walking in sleep, and it is to this that we will give most attention.

Walking In Sleep

With walking in sleep most people are familiar, if not through personal experience then from their reading. An excellent description may be found in Macbeth (Act V, Scene I). In the most common type of sleep-walking the individual acts without speaking. More rarely the sleep-walker acts and speaks. In a rarer form, which is to be regarded as more related to hypnosis than natural sleep disturbances, the individual may both speak and act, at the same time retaining the ability to see and hear.

The sleep-walker is of course, acting a dream, and what is performed will, therefore, depend upon the nature of the dream. If the dream depicts a scene indoors, naturally the person will not venture outside the house during the attack. Often the sleep-walker is found upon the street, clad in night garments, as in a case known to the writer. This individual had gone to bed wondering if he had locked the door of his shop; he was stopped close to his shop by a policeman. During the sleep-walking the individual's eyes may be open or shut. Even if open, actual sight is abeyant, though impressions may be made on the retinae which may modify the course of the attack to some extent. The movements of the sleep-walker are so precise and certain as to lead the observer to believe that sight is employed. However, what the individual sees is the material of his dream; if be does not meet with accident this is a matter of good fortune.

When-the sleep-walker talks he converses with the dream-characters. Generally there will be no attention paid to what observers say unless the latter are able to assume the parts of the dream persons. Sometimes a conversation may be carried on with an observer. When talking occurs the individual may seem to exceed himself, but this is due to the vividness of the dream and the absence of doubts, distractions, etc., of waking life. Talking in a foreign language and other superior abilities may be displayed, but when we recall that the dream has the power to awaken all past experiences such should cause no surprise.

In certain persons the sleep-walking attacks vary very little. Every word, gesture, and other act occur at exactly the same time with each performance, just like a drama on the stage. Should the attack be terminated abruptly the dream-drama will, with the next attack, begin at the point where it was broken off. This point is illustrated by a case of Charcot's. His patient was a newspaper man, who during somnambulistic attacks believed he was a novelist. After he had written two or three pages these were taken away from him and the attack terminated. In the next attack he began writing at the point where he had left off.

Following the sleep-walking there is no memory of what occurred during it, and the individual is not chagrined at anything that may have happened. He is filled with wonder and seems to question the acts attributed to him. By special psychological methods it is possible to learn the nature of the dream. Sometimes the effect of telling the individual the nature of his dream performances is to have him become somnambulistic immediately.

The performances of the sleep-walker vary. They may be simple or complicated. Sometimes individuals finish work that has been left incompleted on going to bed; others have stereotyped actions, as going to a certain pond and swimming. Not all the performances attributed to walking in sleep, or somnambulism in general, should be credited. Sometimes a person will awaken from sleep, perform some work, and return to sleep; in the morning he believes that the work must have been done in sleep since he is unable to remember that he awakened.

Janet1 has recorded many interesting cases of somnambulism, among them the case of Irene, aged 20, who had watched for 60 nights by her mother who was dying of tuberculosis:

"After the mother's death she tried to revive the corpse, to call the health back again; then, as she had the limbs upright, the body fell to the floor, and it took infinite exertion to lift it again into the bed. You may picture to yourself all that frightful scene. Some time after the funeral, curious and impressive symptoms began. It was one of the most splendid cases of somnambulism I ever saw. The crises last for hours and they show a splendid dramatic performance, for no actors could rehearse these lugubrious scenes with such perfection. The young girl has the singular habit of acting again all the events that took place at her mother's death, without forgetting the least detail. Sometimes she only speaks, relating all that happened with great volubility, putting questions and answers in turn, or asking questions only, and seeming to listen for the answer; sometimes she only sees the sight, looking with frightened face and staring on the various scenes, and acting according to what she sees. At other times, she combines all hallucinations, words and acts, and seems to play a very singular drama. When, in her drama, death has taken place, she carries on the same idea, and makes everything ready for her suicide. She discusses it aloud, seems to speak with her mother, to receive advice from her, she fancies she will try to be run over by a locomotive. That detail is also a recollection of a real event in her life. She fancies she is on the way, and stretches herself out on the floor of the room, waiting for death, with mingled dread and impatience. She poses and wears on her face expressions really worthy of admiration, which remain fixed during several minutes. The train arrives before her staring eyes, she utters a terrible shriek, and falls back motionless as if she were dead. She soon gets up and begins acting over again one of the preceding scenes. In fact, one of the characteristics of these somnambulisms is that they repeat themselves indefinitely. Not only the different attacks are always exactly alike, repeating the same movements, expressions, and words, but in the course of the same attack, when it has lasted a certain time, the same scene may be repeated again exactly in the same way five or ten times. At last, the agitation seems to wear out, the dream grows less clear, and, gradually or suddenly, according to the cases, the patient comes back to her normal consciousness, takes up her ordinary business, quite undisturbed by what has happened."

1 Major Symptoms of Hysteria, 1907, pp. 28 et seq., by Pierre Janet. The Macmillan Co.

As a rule the acts of a sleep-walker are harmless and in accord with his experiences or inner nature. Somewhere I have read of a clergyman, a most upright character by day, who by night was a thief; and of another individual who resembled Mr. Hyde, made famous by Stevenson. We may attribute these cases to very powerful dreams, or to strong impulses which the individual was able to repress by day. As has been stated, there are different sides to every one's nature, and this being true it is not to be wondered at if we are, at times, different persons in dreams.

The most important, from a medical viewpoint, are attacks which occur frequently, and especially those that do not vary in their nature. Sleep-walking is, of course, an abnormal state, and if for no other reason than the grave accidents to which it renders one liable, deserves medical attention. Further, it indicates, in many cases at least, that there is lodged in the mind some past experience, some hope, fear, or wish that is so powerful as to be able to gain control of the body during sleep, and to use the body for its own purposes. Since the idea is so powerful, it cannot but be in need of removal. The nature of the idea is a matter for the psychologist to determine. Occasionally, benefit is obtained by tying the person's hands to the bed; arousing the person a half-hour or so before the expected attack, when attacks occur at definite times; and by forcibly suggesting at bed time that the sleep-walking will disappear.

Talking In Sleep

Talking in sleep occurs most frequently in children and is not of itself-of great importance or significance. The dreams of children are, as a rule, very vivid, and the inhibitory centres of the brain are not well-developed ; this will, in part at least, explain why children tend to talk in sleep more than adults. In connection with talking in sleep it is interesting to note that it is possible to enter into conversation with some sleeping persons, and, if they are mentally troubled, to implant ideas that may be of value in correcting their faulty ideas. Usually, however, noises of any kind sufficient to attract attention in the waking state will awaken the sleeper.

Laughing And Crying In Sleep

Laughing in sleep occurs at times and is of no serious import. It of course, indicates something pleasurable in the dream. Dreams are often witty and even in dreams we are able to appreciate the witticisms. Crying in sleep, on the other hand, indicates some sorrowful dream. If it occurs once or twice it may not be noteworthy, but if it occurs often the individual had better consult some competent physician-psychologist so that the nature of the dream thoughts which are oppressing the mind may be discovered and removed.