A person’s day is in the transition process of wakefulness-slow-wave sleep-rapid-wave sleep. Sleepwalking disorder [sleepwalking disorder] is a disorder of waking during sleep. The brainstem upward projection system is closely related to wakefulness and sleep states. Among them, the brainstem reticular superior activation system plays an extremely important role in the maintenance of the waking state. The superior projection system is divided into specific and non-specific superior projection systems. The specific upward projection system consists of various conduction tracts that travel up the brainstem, terminate in specific nuclei in the thalamus, change neurons and then project via the internal capsule to cortical sensory areas, producing specific sensations and having an arousing effect on the cortex. The nonspecific superior projection system consists of the brainstem reticular formation. The brainstem reticular formation reaches the thalamus via synaptic contacts and then makes diffuse projections to the cerebral cortex, maintaining and influencing the excitatory state of the cerebral cortex. It provides the basis for arousal in the cerebral cortex. There are four types of arousal maintained by the nonspecific upstream activation system: 1) cortical arousal response with EEG desynchronization; 2) emotional arousal response with projections to the limbic system via the reticular formation; 3) autonomic arousal response with connections to the hypothalamus via the reticular formation; 4) spinal arousal response with increased muscle tone via the reticular spinal tract. Sleep walking disorder is the result of a disorder in which the cortical arousal response and the spinal arousal response are not coordinated during stages 3 and 4 of sleep. During the NREM stage in the first 1/3 of sleep, patients appear to get up and walk around, gaze dully, make stereotyped and purposeless movements, even go to the street, drive a car and wander, and can answer questions with others, but the answer is not what they want. The patient is able to avoid obstacles. The duration varies, sometimes up to several days. Forced awakening can lead to confusion and even violent aggression, which is mostly or completely forgotten afterwards. There are many causes of sleep walking disorder. Stressful emotional tension is the most common. Fever, overexertion, and coffee consumption are also causative factors. Many antipsychotic medications such as thioridazine, chloral hydrate, lithium carbonate, fluphenazine, endorphin, and venlafaxine can exacerbate or cause sleep walking disorder to occur. Certain disorders that predispose to sleep arousal, such as obstructive sleep apnea syndrome, periodic limb movement disorder, and other disorders that severely disrupt sleep during the NREM phase are also associated with sleep walking episodes. In a few patients, the onset is associated with the menstrual cycle and the pregnancy period. Some patients have a genetic family history. The differentiation between sleep walking disorder and epileptic automatism is that sleep walking disorder must occur in NREM stages 3 and 4, and the EEG shows a mixture of sleep waves (delta waves) and wake waves (alpha waves). Although incomplete awakening occurs in NREM stage, it is not accompanied by walking behavior, then it is a vague awakening of consciousness. If awakening in the middle of sleep and fear occurs, it is called sleep terrors. Some patients with dementia often have nocturnal walking out of bed due to dysregulation of arousal and sleep rhythm, but their intellectual impairment is different from that of sleep walking syndrome. Patients with nocturnal feeding syndrome also walk around in their sleep, but the patient is fully conscious. Etiological treatment is crucial for sleep walking syndrome. Sleep walking syndrome is due to the fact that spinal arousal has been initiated, but cortical arousal is still inhibited. Studies have shown that the function of the noradrenal system in the head of the blue spot nucleus, the brainstem reticular formation and the acetylcholine system in the cortex are related to the maintenance of cortical arousal, so antidepressants such as reboxetine, amitriptyline and promethazine are effective in the treatment of sleep walking syndrome.