Seeing someone walk, shout, appear frightened, move forcefully, or seem unable to wake fully can be unsettling. The most helpful response depends on the type of episode, but the immediate priorities are to remain calm, reduce the risk of injury, and avoid escalating confusion or fear.
These suggestions provide general education. A healthcare professional can offer advice tailored to the specific condition and the person’s circumstances.
If an episode is happening
Stay calm
Speak quietly and move slowly. Remember that the person may not be fully awake or able to understand what is happening.
Avoid interpreting limited or unusual responses as deliberate behaviour.
Check for immediate danger
Look for hazards such as:
- Stairs
- Open windows or exterior doors
- Sharp or breakable objects
- Furniture in the person’s path
- Forceful movements near another person
- A risk of falling from the bed
- Activities involving heat, water, tools, or appliances
If there is immediate danger, focus on moving the person or the hazard to a safer position when this can be done safely.
Use a calm, simple approach
Use the person’s name and short instructions such as:
- “You’re safe.”
- “Let’s go back to bed.”
- “Come this way.”
- “I’m here with you.”
Long explanations or repeated questioning may not be helpful while the person is still partly asleep.
Give the person space
Do not crowd the person unnecessarily. Some people may become more confused or agitated if they feel blocked, grabbed, or surrounded.
Helping Someone Who Is Sleepwalking
A sleepwalker may have their eyes open and may perform familiar behaviours without full awareness.
What to do
- Remain calm.
- Clear nearby hazards when possible.
- Approach slowly and from a visible direction.
- Speak in a quiet, reassuring voice.
- Gently guide the person away from danger.
- Encourage them to return to bed.
- Stay nearby until the immediate risk has passed.
- Check afterward for injuries.
What not to do
Avoid:
- Shouting
- Shaking the person
- Slapping or startling them
- Arguing with them
- Asking complicated questions
- Physically restraining them unless necessary to prevent immediate harm
- Assuming they can make safe decisions because their eyes are open
- Making fun of the episode afterward
Should I wake a sleepwalker?
It may not be necessary to wake the person if they can be calmly guided back to bed.
However, the idea that a sleepwalker must never be awakened is too absolute. Waking may be necessary if the person cannot otherwise be moved away from immediate danger.
If waking is necessary:
- Keep your voice calm.
- Say the person’s name.
- Explain briefly that they are safe.
- Avoid sudden shouting or shaking.
- Allow time for confusion to clear.
- Reassure rather than confront them.
The person may initially be frightened, disoriented, or agitated.
Based primarily on: Irfan et al. (2021); Mayo Clinic (2017); Zergham (2023); Kazi (2022).
Helping Someone During A Sleep Terror
During a sleep terror, the person may scream, appear intensely frightened, and be difficult to comfort even though they are not fully awake.
What to do
- Stay calm.
- Remain nearby.
- Protect the person from falling or striking nearby objects.
- Reduce noise and stimulation.
- Speak softly if speaking appears helpful.
- Allow the episode to settle without forcing interaction.
- Guide the person back toward a safe sleeping position if possible.
What not to do
Avoid:
- Shouting
- Shaking the person
- Demanding that they explain what happened
- Trying to force them fully awake
- Holding them down unless this is necessary to prevent immediate injury
- Assuming that they are responding to a remembered dream
Attempts to abruptly stop a sleep terror may increase confusion or agitation.
After the episode, the person may have little or no memory of what occurred.
Based primarily on: Irfan et al. (2021); Ntafouli et al.
Helping Someone During A Confusional Arousal
A person experiencing a confusional arousal may sit up, stare, speak unclearly, respond unusually, or appear disoriented.
What to do
- Give the person time to become fully awake or return to sleep.
- Use short, calm statements.
- Keep the surroundings quiet.
- Remove immediate hazards.
- Avoid asking several questions at once.
- Do not expect a clear or logical conversation.
If the person becomes agitated, step back while continuing to monitor safety.
Based primarily on: Irfan et al. (2021).
Helping Someone After A Nightmare
A person awakening from a nightmare is generally awake and may remember the dream clearly.
What to do
- Listen without dismissing the experience.
- Remind the person that they are awake and safe.
- Allow time for them to settle.
- Offer a light, water, or quiet company if wanted.
- Ask what kind of support would feel helpful.
- Avoid pressuring them to describe the dream.
- Encourage professional support when nightmares are repeated, trauma-related, or causing fear of sleep.
For a child, use simple reassurance appropriate to their age. Repeated nightmares can affect the sleep and functioning of both the child and the family.
Based primarily on: Stefani and Högl (2021).
Helping Someone With Possible REM Sleep Behaviour Disorder
REM sleep behaviour disorder can include forceful dream-enacting movements and may create a risk of injury.
During an episode
- Protect yourself first.
- Move away from kicking, punching, or grabbing.
- Avoid forcefully restraining the person unless needed to prevent immediate harm.
- Remove dangerous objects when this can be done safely.
- Use the person’s name and a calm voice from a safe distance.
- Check both the person and bed partner for injury afterward.
Repeated dream enactment should be medically assessed rather than managed only through home safety measures.
Between episodes
Until professional advice is obtained, consider:
- Removing sharp, heavy, or breakable objects from beside the bed
- Moving furniture away from the bed
- Protecting the area beside the bed
- Reducing the risk of falling from the bed
- Securing weapons or other dangerous objects outside the sleeping area
- Discussing temporary separate sleeping arrangements if a bed partner is being injured or placed at risk
Separate sleeping should be presented as a possible temporary safety measure, not as punishment or blame.
Keep a description of:
- Movements and vocalizations
- Dream recall
- Injuries
- Episode timing
- Medication changes
- Observations from a bed partner
Based primarily on: Dauvilliers et al. (2018); Jung (2016); Pacheco (2023); Roguski et al. (2020).
What Can I Do During Sleep Paralysis?
Sleep paralysis can feel frightening because awareness has returned while voluntary movement remains temporarily limited.
During an episode, try to:
- Remind yourself that the episode is temporary.
- Focus on slow, calm breathing.
- Direct your attention toward a familiar sound or object.
- Try making a small movement, such as moving a finger or toe.
- Remind yourself that vivid sensations or perceptions can occur during the sleep–wake transition.
- Allow movement to return rather than struggling forcefully.
These approaches may help some people, but they are not guaranteed to stop every episode.
How can another person help?
If you recognize that someone may be experiencing sleep paralysis:
- Speak calmly.
- Use their name.
- Remind them that they are safe.
- Avoid startling them.
- Allow them time to regain movement and speech.
Afterward, ask what type of support they would prefer during any future episode.
Reducing possible triggers
The supplied articles identify sleep deprivation and irregular sleep schedules as possible predisposing factors. It may therefore be helpful to:
- Protect adequate sleep time.
- Keep sleep and wake times reasonably consistent.
- Plan for sleep disruption during travel or schedule changes.
- Discuss repeated episodes with a healthcare professional.
Based primarily on: Sharpless (2016); Stefani and Högl (2021); Cleveland Clinic (2021).
What Can I Do About Sleep Talking?
Sleep talking may not require an intervention when it is occasional and not causing distress or disruption.
Possible steps include:
- Protecting adequate sleep time
- Discussing whether stress or sleep disruption may be contributing
- Reducing avoidable nighttime disturbances
- Using earplugs or white noise for a partner or roommate when appropriate
- Avoiding recordings or sharing sleep speech without the person’s knowledge and consent
- Seeking advice when vocalizations are accompanied by forceful movement, leaving the bed, intense distress, or other concerning symptoms
Do not treat sleep speech as an intentional disclosure or a reliable statement of the person’s waking thoughts.
Based primarily on: Cleveland Clinic (2021); Miller (2023); Suni (2023).
What Can I Do About Sleep-Related Bruxism?
If you suspect sleep-related grinding or clenching:
- Arrange a dental assessment when there is tooth wear, pain, sensitivity, or damage.
- Note whether a partner hears grinding sounds.
- Record morning jaw discomfort, headaches, or muscle fatigue.
- Discuss medication and health history with the appropriate professional.
- Avoid assuming that a store-bought dental device will address the cause.
- Ask a dentist whether a professionally assessed oral appliance may help protect the teeth.
The supplied review discusses sleep-habit counselling, relaxation techniques, and reducing nighttime alcohol, caffeine, and tobacco exposure. However, it also emphasizes that evidence for many bruxism interventions remains limited.
Occlusal splints may help protect teeth and reduce grinding sounds, but they may not permanently eliminate the underlying jaw-muscle activity.
Based primarily on: Guaita and Högl (2016); Suni (2023); Ucar et al. (2022).
Supporting A Child
When a child experiences a nighttime episode:
- Remain calm and reassuring.
- Focus on safety rather than punishment or correction.
- Keep a consistent bedtime routine where possible.
- Protect adequate sleep time.
- Remove bedroom and hallway hazards.
- Avoid a top bunk when nighttime wandering is a concern.
- Secure stairs, windows, and exterior doors as appropriate.
- Explain the experience in simple, non-frightening language.
- Avoid discussing the episode in a way that embarrasses the child.
- Record how often it happens and what the episode looks like.
- Seek professional advice when episodes are dangerous, frequent, worsening, or affecting the child or family.
Avoid telling the child that the behaviour was their fault. A child may have no memory or control over the event.
Supporting A Partner Or Roommate
Parasomnias can affect everyone sharing the sleeping environment.
Helpful steps include:
- Discussing the episodes during the daytime
- Agreeing on a simple safety plan
- Asking how the person would prefer to be supported
- Keeping exits and pathways safe
- Recording observations accurately and respectfully
- Protecting everyone’s privacy
- Avoiding blame, teasing, or filming without consent
- Seeking professional advice when either person is being injured or losing substantial sleep
A roommate or partner can provide valuable observations, but they are not responsible for diagnosing or treating the condition.
Bedroom Safety Checklist
Consider whether the following measures apply to the person’s symptoms:
Around the bed
- Clear clutter and electrical cords.
- Move sharp-edged furniture away.
- Remove glass, heavy objects, or breakable lamps.
- Place commonly needed items within safe reach.
- Consider floor protection when there is a risk of falling.
- Avoid sleeping in a top bunk when wandering or falling is possible.
Doors, windows, and stairs
- Check that windows are secure.
- Consider alarms or other appropriate safeguards for exterior doors.
- Keep stairways clear.
- Use gates or barriers when appropriate for the person’s age and needs.
- Avoid locking arrangements that could prevent emergency exit.
Dangerous objects
- Store weapons securely outside the sleeping area.
- Secure sharp tools and other dangerous objects.
- Reduce access to appliances when complex nighttime behaviour is occurring.
- Keep car keys in a secure location if nighttime wandering is a concern.
For bed partners
- Keep a clear path to move away safely.
- Avoid sleeping immediately beside sharp furniture.
- Discuss temporary separate sleeping arrangements if forceful movements are causing injury.
- Seek professional assessment rather than relying on environmental changes alone.
Safety measures should be proportionate to the observed behaviour and should not unnecessarily restrict or stigmatize the person.
Keeping A Sleep & Episode Diary
A diary may help identify patterns and prepare for an appointment.
Record:
- Date
- Approximate time of the episode
- What happened
- How long it appeared to last
- Whether the person left the bed
- Whether they responded
- Whether they were confused or frightened
- Dream recall
- Memory the following day
- Injuries or near misses
- Bedtime and wake time
- Recent sleep loss
- Stress, illness, travel, or schedule changes
- Medication or substance changes
- Breathing problems or other sleep symptoms
- Observations from a witness
The diary can support clinical assessment, but it cannot establish a diagnosis.
