Gibberish, urine, and utter chaos: What happens when you sleepwalk - Emmanuel During

譯者: Lilian Chiu 審譯者: Helen Chang

Mumbling fantastical gibberish; devouring blocks of cheese in the nude;

含糊咕噥著古怪的亂語；

赤裸身體狼吞虎嚥掉整塊乳酪；

peeing in places that aren’t toilets; and jumping out of windows.

在廁所以外的地方小便；

以及跳出窗戶。

These are all things people have reportedly done while sleepwalking,

這些都是據說人們 在夢遊時會做出的事，

a behavior that’s mostly benign but can be dangerous in rare cases.

夢遊這個行為多半是良性的，

但在極少數的情況下會有危險。

It's estimated that around 18% of people sleepwalk at least once in their lives.

據估計，有大約 18% 的人

一生中至少會夢遊一次。

So, what exactly is sleepwalking?

那麼，夢遊到底是什麼？

First, we have to understand just how many of our daily activities

首先，我們必須要了解 有多少日常活動

do not require our active attention.

無需我們主動的注意力。

Your prefrontal cortex is your brain's conscious,

前額葉皮質是大腦中負責

控制有意識、刻意做決策的中心。

deliberate, decision-making control hub.

You might decide to get up and walk using your prefrontal cortex,

你可能是用你的前額葉皮質 來決定你要起床行走，

but the intricate coordination of sensory inputs and muscles

但後續感官輸入資訊 和肌肉的複雜協調

that follows does not require any attention.

則完全不需要你的注意力。

Instead, it’s mostly executed by a network of specialized nerve cells

這部分的執行反而主要是靠 一種專門神經細胞網路，

along the lower part of the brain and spinal cord,

分佈在大腦的下半部及脊髓上，

sometimes called “central pattern generators.”

這個網路有時被稱為 「中樞模式發生器」。

These areas govern automatic movements and basic actions related to survival.

這些區域負責管理與生存 相關的自動動作和基本行動。

People with a REM sleep behavior disorder may enact their dreams

患有快速動眼期睡眠行為失的人調

有可能會在快速動眼睡眠期 上演他們的夢境，

while they’re in REM sleep,

usually keeping their eyes closed.

通常此時雙眼是閉著的。

However, this is a separate condition.

然而，這是不同的狀況。

Sleepwalking arises from a very different stage of sleep—

夢遊發生在非常不同的睡眠階段——

the deepest stage of non-REM sleep, which is called “slow-wave sleep.”

非快速動眼睡眠期中最深的階段，

稱為「慢波睡眠」。

In this state, the cortex, including the prefrontal cortex,

在慢波睡眠時，皮質， 包括前額葉皮質，

is essentially turned off.

基本上是關機的。

When someone is roused from this stage,

在慢波睡眠的人被叫醒時，

they’ll usually appear groggy before either dozing off again

通常會顯得昏昏沉沉，

然後才會再打起瞌睡或完全清醒。

or becoming fully conscious.

For that moment, though, they’re in an intermediate state

不過，在那一刻， 他們處在一種中間狀態，

straddling sleep and wakefulness.

跨在睡眠和清醒之間。

A sleepwalking episode is, essentially, an extreme, prolonged version of this.

本質上，夢遊發作就是

這個狀況的極端、持久版本。

When sleepwalking, the prefrontal cortex remains inactive,

夢遊時，前額葉皮質仍然沒有活動，

so the person doesn’t possess executive, deliberate control over their actions.

所以當事人無法刻意 控制執行自身的行動。

But other parts of their brain are active.

但其大腦的其他部分卻在活動。

And, as we know, the body is capable of a lot

且，如我們所知，

不用用到前額葉皮質，

without involving the prefrontal cortex.

身體就已經能做很多事了。

Sleepwalkers avoid obstacles, walk, and speak—

夢遊的人會避開障礙、 會走路、會說話——

though it's often nonsense.

雖然通常都是沒意義的。

Most sleepwalkers can do basic things,

大部分夢遊的人能做基本的事，

operating in a peaceful, unemotional, dreamless state.

在一種平和、沒有情緒、 不做夢的狀態運作。

In rare cases, sleepwalkers perform more complex tasks like cooking and driving.

在極少數情況中，

夢遊的人會進行出更複雜的 任務，如烹飪和開車。

They're occasionally guided by physical urges,

他們偶爾是受到生理上的 衝動所引導，如想吃，

like eating or pursuing sexual activities.

或追求性活動。

And some episodes involve the brain’s fight or flight system,

有些夢遊的發作和大腦的 「戰或逃」系統有關，

during which the person might suddenly perceive an imminent danger,

在過程中，夢遊的人可能會 突然感受到迫在眉睫的危險，

and vocalize, cry, or even jolt out of bed and run away.

因而發出聲音、大叫，

或甚至從床上跳起來並跑走。

These episodes, called “sleep terrors,”

這種夢遊發作稱為「夜驚」，

are more common in young children and usually result naturally.

在小孩身上比較常見，

且通常會自然消失。

Indeed, sleepwalking is generally more common in children,

的確，孩童比較常夢遊，

perhaps because the brain areas that control the transition

有可能是因為孩童大腦中負責 控制睡眠與清醒狀態轉換的區域

between sleep and wakefulness are still developing.

還在發展中。

But the exact mechanisms that cause sleepwalking remain unclear.

但我們仍然不清楚 造成夢遊的確切機制。

Many cases appear to run in families, while others are more mysterious.

許多案例顯然是家庭遺傳， 其他的則更神秘。

Anything that could lead to partial awakening

凡是會導致部分清醒的因素，

is thought to increase the likelihood.

都被認為會增加夢遊的可能性。

This includes factors that promote deeper slow-wave sleep—

包括會促進更深層 慢波睡眠的因素——

like sedatives, hot sleep environments, and operating on too little sleep—

如鎮靜劑、熱的睡眠環境， 及在睡眠不足時做事——

or things that disrupt sleep— like stress and other sleep disorders,

或者會打斷睡眠的因素——

如壓力及其他睡眠失調，

such as sleep apnea and restless leg syndrome.

比如睡眠呼吸中止及不寧腿症候群。

Doctors will usually evaluate these factors and promote habits

醫生通常會評估這些因素， 並建議有助於健康睡眠的習慣，

that aid in healthy sleep, such as exercise, stress management,

比如運動、壓力管理，

and a consistent and sufficient sleep schedule.

以及定時且充足的睡眠時程。

They’ll also often recommend safety measures,

他們通常也會推薦安全措施，

like hiding dangerous items, installing door alarms and securing windows.

比如把危險的物品藏起來、

在門上安裝警報，以及關緊窗戶。

If this doesn't help, they'll consider certain medications.

如果這個方式行不通， 他們會考量用某些藥物。

But many of the available treatments for sleepwalking

但許多可取得的夢遊治療方式

haven’t yet been rigorously studied,

尚未通過嚴謹的研究，

so how they work and how effective they are is not entirely clear.

所以它們的運作機制和效益 尚未完全明朗。

So, what should you do if you encounter a sleepwalker?

所以，遇到夢遊的人時該怎麼做？

A common misconception is that rousing a sleepwalker causes irreparable harm.

一般人常誤以為

叫醒夢遊的人會造成 不可挽回的傷害。

Fortunately, this is not true.

好在，事實並非如此。

However, trying to forcefully wake them can cause confusion and distress.

然而，試圖強制叫醒他們

有可能造成困惑及苦惱。

The best practice seems to be to gently guide them back to bed;

最佳的做法似乎是溫柔地 引導他們回到床上，

and, if they resist, to simply ensure they’re safe until the episode resolves.

如果他們反抗，

那就只要在夢遊結束之前 確保他們的安全就好。