Doctor: You see her eyes are open.
Gent: Ay, but their sense are shut.
Doctor: What is it she does now? Look how she rubs her hands.
Gent: It is an accustom'd action with her, to seem thus washing her hands. I have known her continue in this a quarter of an hour.
Lady Macbeth: Yet here's a spot.
Doctor: Hark, she speaks. I will set down what comes from her, to satisfy my remembrance the more strongly.
Lady M.: Out, damn'd spot! out, I say!
SLEEPWALKING has mystified the world throughout history, carrying with it many myths. Shakespeare, for one, showed his fascination by expressing Lady Macbeth's angst through troubled sleep.
"Psychiatric literature is full of statements about the psycho-dynamic symbolism of sleepwalking," says Dr. William H. Reid of the Nebraska Psychiatric Institute and an authority on sleepwalking. "Before we knew what we now know, we thought sleepwalking happened during a dream."
The sleepwalker begins his/her meanderings during the deepest level of the five stages of sleep, whereas most dreaming occurs during the first stage, REM (rapid eye movement). The reason you don't sleepwalk and dream simultaneously, says Reid, is that the body's voluntary muscles are "paralyzed" during the REM stage. When a sleepwalker remembers a dream upon awakening, it is probably because of the short REM that accompanies waking up.
Although experts stress that sleepwalking is usually a harmless condition, Dr. Wallace Mendelson, codirector of the National Capital Sleep Center at Bethesda's Suburban Hospital, tells about a famous case in which a woman got up during her sleep and murdered her daughter with a kitchen knife. Her defense at the trial was sleepwalking.
She had recently been put on sleeping pills. Were they the culprit?
"We can speculate, but nobody ever knows," says Mendelson. Sleepwalking, he adds, "is an extremely rare side effect of pills."
Another famous case of somnambulistic homicide took place in France, the details and circumstances sounding more like an Agatha Christie novel than real life.
Robert Ledru, a prominent detective, was vacationing at Le Havre in the north of France when local authorities asked him to aid in the investigation of a businessman who had been killed while bathing on a local beach.
Ledru discovered footprints made by a person wearing socks and missing a toe from the right foot. Ledru, who had awakened one morning to find wet socks in his hotel room--and was missing a toe on the same foot as the killer--became alarmed. Ballistics proved that Ledru's pistol was the same weapon used in the murder.
"I have the killer and the evidence," Ledru notified police, "but I lack the motive. It was I who killed Andre Monet."
And still another case, although not involving a murder, was nonetheless upsetting--for good reason--to the patient.
As Mendelson tells it, the chief complaint of a young male sleepwalker was that "no woman would go to bed with him twice." Distraught, he went to a sleep lab to have his behavior monitored.
"The doctor said he would get undressed, jump up onto the dresser and start beating his chest. He was having a nocturnal seizure: His nervous system was just getting fired up."
Surprisingly, that case (along with most others) is not, says Mendelson, necessarily indicative of a troubled psyche. Sleepwalking, generally, is considered more a physiological.
Sleepwalking among children, however, could be a sign of emotional stress, says Mendelson. And sleepwalkers tend to suffer from a higher incidence of other abnormal sleep behavior (parasomnia)--bedwetting, teeth-gnashing, head-banging--and "night terrors" (pavor nocturnus), when a person wakes up terrified, often screaming, but has no recollection of a dream.
Dr. J. Christian Gillin, former chief of the sleep laboratory at the National Institute of Mental Health and now at the University of California at San Diego, has found in his extensive research on the subject that most sleepwalkers are children, more often males, between the ages of 7 and 12. Fifteen percent of all boys, he says, have at least one sleepwalking incident in their childhood years.
"Little children," says Reid, "don't have completely matured nervous systems."
To back up his belief in a link between stress and children's sleepwalking, he relates one case in which a widow found her daughter wandering into her room, asking if "mommy was still there." The little girl's fear that her mother might die, as her father had, triggered the sleepwalking. The predisposition for nocturnal wandering, he adds, has to be there first.
Sleepwalking, says Reid, is not uncommon among families experiencing marital strife. To reassure parents, he emphasizes that kids usually outgrow it. "A fair number of kids will walk into their school years, but not often."
Most of his patients have been under 40. "So as one gets older, one does it less, but we have no scientific data to prove it."
Virtually all of Reid's adult patients were sleepwalkers as children, and he believes that there is a genetic component. Well over half of his patients have had at least one relative with a history of sleepwalking, and he once treated a parent and child together.
Gillin is less sure about a hereditary basis. "I don't think we really know," says Gillin. "It may run in families, but it's one of those things we don't understand." If an adult starts sleepwalking, says Reid, "It's important that it be checked out. It could be a form of epilepsy or a result of drugs such as sleeping pills."
Or even of joining the military, which affects some people more dramatically than others. "Stress is in the eye of the beholder," says Reid. "You can be discharged for sleepwalking. They don't want you walking around and falling into someone's foxhole."
Of the Army recruits Reid has treated, only about half wanted discharges. The others were treated with hypnosis, with varying success.
The typical picture of sleepwalkers--plodding along in a zombie-like stupor, arms raised out front--is a myth. Reid tells of noctural nomads driving their cars, turning over furniture or even raiding the refrigerator.
"The sleepwalking doesn't bother me, doctor," complained one patient, "but I'm gaining weight. I eat while I sleepwalk."
This is not uncommon, says Reid. Many patients find dirty dishes in their sink the next morning and they can't remember getting up in the middle of the night.