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14 - Forensic sleep medicine issues: violent parasomnias

from SECTION 3 - SLEEP IN SPECIALTY AREAS

Published online by Cambridge University Press:  08 August 2009

By
Michel A. Cramer Bornemann ,
Mark W. Mahowald  and
Carlos H. Schenck
Edited by
Harold R. Smith ,
Cynthia L. Comella  and
Birgit Högl
Michel A. Cramer Bornemann
Affiliation:
University of Minnesota Medical School
Mark W. Mahowald
Affiliation:
University of Minnesota Medical School
Carlos H. Schenck
Affiliation:
University of Minnesota Medical School
Harold R. Smith
Affiliation:
University of California, Irvine
Cynthia L. Comella
Affiliation:
Rush University Medical Center, Chicago
Birgit Högl
Affiliation:
Inssbruck Medical University
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Summary

Actus non facit reum nisi mens sit rea – the deed does not make a man guilty unless his mind is guilty

Edward Coke (1552–1634)

Introduction

Increasingly, parasomnias are invoked as an explanation for a wide variety of illegal and/or violent behaviors ostensibly arising from the sleep period, with the hope that if such behavior is deemed sleep-related, it may serve to exonerate the perpetrator. In such cases, sleep medicine practitioners are asked to render opinions regarding legal issues pertaining to violent or injurious behaviors purported to have arisen from sleep. Such acts, if having arisen from sleep without conscious awareness, would constitute an “automatism.” Recent advances in the understanding of wake/sleep behaviors and consciousness have made it apparent that some complex behaviors, occasionally violent or injurious with forensic science implications, are exquisitely state-dependent, meaning that they arise exclusively, or predominantly, from the sleep period. They may therefore be without conscious awareness, and therefore possibly without culpability.

It is likely that violence arising from the sleep period is more frequent than previously assumed. One recent survey found that 2% of the adult population report violent behaviors arising from the sleep period.

Case example

AJT was a white male in early adulthood who was the son of a wealthy shoe manufacturer with a factory near Weymouth, Massachusetts. Despite being married with two young daughters, AJT was known to frequently engage in “debauchery” and had been known to squander his affluence in “revelries associated with his aberrant actions.

Keywords

arousalneurologic conditionsnocturnal seizuresparasomniasviolent sleep-related behaviorsREM sleep behavior disorderpsychogenic dissociative disorderspsychiatric conditions
Type
Chapter
Information
Sleep Medicine , pp. 240 - 255
Publisher: Cambridge University Press
Print publication year: 2008

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