Sleep talking may signal stress, illness or obstructive sleep apnoea

Sleep talking is usually harmless, but its sudden appearance in an adult could point to an underlying medical or psychological condition, according to ENT consultant and sleep surgeon Dr Kehinde Jezinnah Duncan.

Duncan described sleep talking as one of several parasomnias, a group of sleep disorders that also includes sleepwalking and night terrors. She said anxiety, daytime stress, fever, insufficient rest, alcohol or other substance use, family history and obstructive sleep apnoea may contribute to the behaviour.

People may speak while dreaming without knowing what they have said. Their comments are generally brief reactions to events within a dream rather than coherent disclosures of secrets or detailed personal information.

Sleep occurs in different cycles, including rapid eye movement, or REM, sleep and non-REM sleep. REM sleep is associated with dreaming and rapid eye movement. Although talking can happen during any sleep stage, Duncan said it commonly occurs during REM sleep. Deep sleep is important for the body's recovery and helps prevent daytime tiredness.

Long-standing sleep talking without other symptoms is not normally considered alarming. However, an adult aged 18 or older who suddenly begins doing it should be assessed, particularly when the episodes include screaming, night terrors, loud snoring or gasping for air.

A medical review may examine medications, alcohol and substance use, family history, recent stressors and possible psychological concerns. An ENT examination can also identify enlarged tonsils or blockage within the nose or throat. Treatment depends on the cause and may involve reducing stress, addressing an illness, obtaining psychological care or treating sleep apnoea with a breathing machine or surgery.

Duncan warned that untreated obstructive sleep apnoea may be associated with hypertension, diabetes, heart attack, stroke and prostate problems. The condition prevents normal oxygen levels and interferes with deep sleep.

Children can also talk in their sleep and develop obstructive sleep apnoea. Duncan said their smaller nasal passages and throats make them more susceptible to snoring and airway obstruction. She also linked some childhood bedwetting to sleep apnoea, explaining that the disorder may stimulate a hormone that affects the bladder.

Sleepwalking is another disorder that may be connected to illness, genetics, stress, nervousness or inadequate rest. A person may leave bed, walk around and have no memory of the episode the following day.