Sleep-Related Violence: What Every Clinician Should Know
Sleep-Related Violence: What Every Clinician Should Know
In October 2003, Jules Lowe of Manchester, England, attacked and killed his 82-year-old father while asleep. He was later acquitted and found not guilty by reason of insanity following expert testimony from a sleep disorders specialist. Though the media reported this as the first case in which a parasomnia was successfully used as a defense for murder, the reality is that sleep disorders have been used as a defense for violent acts for centuries.
Schenck and colleagues reported a 67-year-old man with recurrent dream-enacting behavior who physically assaulted his wife on numerous occasions. The man stated, "I felt bad when I would abuse my wife, but I did it in my sleep so there was nothing I could do about it." One report described a man who resorted to tying himself into bed while his wife slept in another room to prevent harming her, and another man had to live in a separate house from his wife to prevent injuring her during the night.
These examples represent a fraction of the cases of sleep-related violence reported in both the medical and legal literature. While most individuals are either not charged or acquitted because of a lack of recollection, intent, or control over their actions, others have resulted in criminal charges of assault or rape or have led to divorce. Though these stories are fascinating to the professional medical community and lay public alike, they clearly have the potential to be very dangerous, and the clinician must have a familiarity of the various etiologies and potential precipitating factors for these sleep disorders.
Introduction
In October 2003, Jules Lowe of Manchester, England, attacked and killed his 82-year-old father while asleep. He was later acquitted and found not guilty by reason of insanity following expert testimony from a sleep disorders specialist. Though the media reported this as the first case in which a parasomnia was successfully used as a defense for murder, the reality is that sleep disorders have been used as a defense for violent acts for centuries.
Schenck and colleagues reported a 67-year-old man with recurrent dream-enacting behavior who physically assaulted his wife on numerous occasions. The man stated, "I felt bad when I would abuse my wife, but I did it in my sleep so there was nothing I could do about it." One report described a man who resorted to tying himself into bed while his wife slept in another room to prevent harming her, and another man had to live in a separate house from his wife to prevent injuring her during the night.
These examples represent a fraction of the cases of sleep-related violence reported in both the medical and legal literature. While most individuals are either not charged or acquitted because of a lack of recollection, intent, or control over their actions, others have resulted in criminal charges of assault or rape or have led to divorce. Though these stories are fascinating to the professional medical community and lay public alike, they clearly have the potential to be very dangerous, and the clinician must have a familiarity of the various etiologies and potential precipitating factors for these sleep disorders.