Sleepwalking Care Staff Guide: Night-Time Safety and Support

Sleepwalking means getting up and moving around while asleep. The NHS says it does not usually need treatment, but it is important to keep the person safe. Most people think of sleepwalking as a childhood issue, yet it can affect adults too, and in a care setting a person who walks at night can be at risk of falls, injury or leaving the building. Night staff in particular need to know how to respond calmly and safely.

This guide summarises NHS advice on sleepwalking and applies it to care settings. It does not replace assessment by a GP or sleep clinic.

What does sleepwalking look like?

The NHS explains that a sleepwalker typically has open eyes and a blank-looking face and cannot respond normally to their surroundings. Episodes usually happen early in the night, last a few minutes and are not remembered afterwards. The NHS says sleepwalking is most common in children and in people with family members who also sleepwalk.

Possible causes and triggers

The exact cause is unknown, but the NHS links sleepwalking to:

• not getting enough sleep
• sleep apnoea or restless legs syndrome
• being unwell with a high temperature
• certain medicines, such as sleeping pills
• stress
• alcohol

In care settings, night-time walking can also have other causes. Confusion, delirium, dementia and other sleep disorders can all lead to night-time wandering or unusual behaviour in sleep. Our guides to REM sleep behaviour disorder and to wandering and exit-seeking in dementia explain how these differ. Because the cause matters, new or worsening night-time walking should be reported rather than assumed to be harmless sleepwalking.

What to do if someone is sleepwalking

The NHS advises gently guiding the person back to bed. If you must wake them, do so gently, because waking them suddenly can leave them confused, scared, angry or upset. In practice:

• Stay calm, speak softly and avoid shouting or grabbing.
• Make sure the person is not at immediate risk, for example on stairs or near a door.
• Guide them gently towards their bed or room rather than trying to hold them still.
• Stay with them until they are settled, and record what happened and how long it lasted.
• If they are injured or unwell, get medical help in line with your procedures.

Making the environment safer

The NHS recommends keeping floors clear of tripping hazards, keeping doors and windows closed, locking away sharp objects such as knives and tools, and fitting door alarms if there is a risk of leaving the house. Translated to a care home, that means checking that corridors and rooms are free of clutter, that doors to unsafe areas are secured, that sharp objects and chemicals are stored safely, and that suitable alarms or sensors are in place with the person's consent and in line with legal safeguards. Any measure that restricts movement must be proportionate and lawful, so involve the senior team and follow the Mental Capacity Act where relevant.

Helping people sleep well

Because poor sleep is a trigger, good sleep habits help. The NHS suggests relaxing before bed, avoiding daytime naps, keeping consistent bed and wake times, avoiding caffeine and alcohol in the evening, and managing stress. Our guide to insomnia, sleep disorders and Z-drugs explains how to support sleep without relying on medicines.

The NHS also recommends keeping a sleep diary noting episodes, bedtime, sleep quality, caffeine or alcohol intake and tiredness or stress. Staff can help residents by recording episodes factually, which gives clinicians useful information.

When to seek medical advice

The NHS advises seeing a GP if sleepwalking disrupts sleep, if there is concern about accidents or injuries, or if there are other symptoms such as feeling very tired during the day or breathing that stops and starts during sleep. The GP may refer the person to a sleep clinic if sleepwalking risks accidents, severely affects sleep, or may be linked to a condition such as sleep apnoea.

Treatment

The NHS says treatment is usually not needed. If sleepwalking is linked to another condition or a medicine, treating the condition or changing the medicine should help. The NHS warns against stopping medicines without speaking to a GP first. Sleep clinic options include psychological therapies such as cognitive behavioural therapy or hypnotherapy and, if other approaches have not worked, medicines such as clonazepam or antidepressants. These are specialist decisions.

Training and professional development

Night-time care calls for particular skills, from calm communication to risk assessment. Record your learning in a CPD log, reflect on real incidents in supervision and explore our CPD resources for care staff to extend your knowledge.

Frequently asked questions

Is it dangerous to wake a sleepwalker?

The NHS says you can wake them gently if you need to, but sudden waking can leave them confused, scared or upset. Guiding them back to bed is usually best.

Can medicines cause sleepwalking?

The NHS lists certain medicines, such as sleeping pills, as a possible trigger. Do not stop a medicine without advice from a GP.

Is night-time wandering in an older person always sleepwalking?

No. It can have other causes, so report new or worsening episodes to a senior colleague or clinician.

This article draws on the NHS sleepwalking page (last reviewed April 2025).