Roger Broughton

Yes OSA is common in children especially where the adenoids

Yes, there are treatment options. It would be helpful to know the age of your daughter. Most childhood sleepwalkers grow out of the condition well before adulthood. A few questions which would orient the best way treat your daughter.

First, there are very few dangers in childhood. Just reassure yourself about this and also tell your daughter so she does not worry unnecessarily.

Sleepwalking arises typically in the first third of the night's sleep during an arousal in the deepest stages of what is often called slow wave sleep (SWS - the brain waves are of high amplitude and slow). It may be triggered by ambient noises such as a door slamming shut. So make sure her bedroom is quiet and dark. It is very important that she is not chronically sleep deprived for whatever reason, because sleep deprivation causes an increase in the amount and intensity of SWS and in sleep depth in general (it is harder to awaken persons in this situation).

If your daughter is of an anxious personality, stress-reduction programs by a psychologist may be effective, as in certain instances is hypnosis. In a few cases, there is a very high frequency of sleepwalking in the extended family indicating a strong genetic predisposition. In these persons, chemotherapy is almost always needed.

Finally, and only as a last resort in young children, medication can be useful. If all else has failed, you should ask your family doctor to do a trial for 3 or 4 weeks on one of the benzodiazepines, which decrease SWS and have a half life in the blood which is about that of the nightly sleep need of your daughter. This depends mainly on her age and is probably around 9 hours. The drugs which have proven most effective are either clonazepam and lorazepam, taken about 20 min before the time of habitual sleep onset. In a good proportion of instances, a few weeks of such treatment stops the sleepwalking episodes completely. If these drugs do not help, then one would try so-called tricyclic medication which diminishes the intensity and amount of Rapid Eye Movement sleep and the arousals at the end of each period of sustained SWS are mainly due to the onset of a REM sleep period. Tricyclic medication, when effective, appears to be due to reducing the intensity of arousals due to the onset of REM sleep.

In very rare cases, sleepwalking must be differentiated from what is called REM sleep behavior disorder and/or frontal lobe epilepsy. Sorting this out requires referring your daughter to a Sleep Disorder Center, preferably one in a pediatric hospital. Make sure that the center is university-affiliated and accredited by the American Association of Sleep Medicine or, in Canada, the Canadian Sleep Society.

Good luck and best wishes,

Roger Broughton, MD, PhD, FRCP(C), FAASM

Yes. This common, especially in the elderly whose memory is beginning to fade. If this is the case, refer your dad to a neuropsychologist for determining the nature and seriousness of his memory in wakefulness.

Best wishes,

Roger Broughton, MD

Yes there are. The best is for her to get lots of regular exercise. Exercise facilitates sleep and deepens sleep. It is very important for her to keep regular hours of going to sleep and of awakening. Each of these can have a great impact on facilitating and improving sleep.

Best wishes,

Roger Broughton, MD, PhD, FRCP(C)

Some have insomnia if he or she regularly has problems of falling asleep or has their night sleep fragmented by frequent awakenings AND is very sleepy or fatigued during the daytime. Insomnia is not a final diagnosis. The are very many causes and these are the real diagnoses: insomnia is simply the result of these causes.

Roger J. Broughton, MD, PhD, FRCP(C)

Yes, yoga can help, as can any technique to increase relaxation.

Roger Broughton, MD

Yes, loud inspiratory snoring is a common symptom of obstructive sleep apnea (OSA) which can have major effects on general health - accidents due to sleepiness, high blood pressure, heart attacks, stroke. It is particularly likely to be OSA if you want your husband sleeping and he stops breathing for several seconds before snoring.

You should have your husband referred by your family doctor for diagnosis and treatment in a Sleep Medicine Center. There is at least one in any city. Check on internet or in the yellow pages of your phone book. Do not delay having him assessed.

Best wishes and good luck,

Roger Broughton MD, PhD, FRCPC

If the apneas are obstructive and your mother is overweight, then she should lose weight into the normal range for her age. If this does not help her drowsiness, she should be referred by her family doctor to a Sleep Medicine center. If her number of apneas/hypopneas is above the normal range and if her sleep is highly fragmented, she will no doubt have a trial on CPAP. She should avoid sleeping pills and alcohol, and also exercise regularly.

The best way to improve the quality of night sleep and avoid a feeling of hangover it to take daily exercise which increases your heart rate for at least 30 min, but not in the evening when it can disrupt sleep. All medication or herbal therapy which help getting to sleep can produce hangover effects. I am 81 years old and have been active in sleep medicine since 1962 and my recommendation is based upon personal experience and on patient care.


Good luck,
Roger Broughton MD, PhD, FRCPC,

It is almost a certainty that your daughter has Sleep Terrors. If so, usually a very small dose of clonazepam will suppress them after one or two nights. If this does not arrest the attacks, show this message to your pediatrician. Have him/her check your daughter for narrowing of the upper airway (at her age most likely enlarged tonsils or/and adenoids).

As I wish to have an idea as to how often I am right and how often I am wrong, I need to have this feedback!

Best wishes and good luck,
Dr. Roger

Roger Broughton MDCM,PhD,
FRCP(C), FAASM