Violent sleep: Not so rare as you think!
Mary Ntafouli, Panagiotis Bargiotas
Sleep-Wake-Epilepsy Center, University Hospital Bern
Violence during sleep isn’t common, but it’s also not extremely rare. Violent Behavior Sleep was reported by 1.7% of worldwide general population [1]. Disorders of arousal (i.e., sleepwalking, confusional arousals and sleep terrors) have sometimes been associated with violent behaviors against other individuals, as well rapid eye movement (REM) Sleep Behavioral Disorder. According to the literature, violent behavior occurs in slightly different ways in those disorders [2, 3].
Parasomnias
Sleepwalking and REM Sleep Behavioral Disorder (RBD) are the most common disorders that manifest violent behavior. It can be mostly occurred at REM stage of sleep cycle, specifically as a symptom of REM Behavioral Disorder (RBD). RBD is a type of parasomnia that the body doesn’t fall into the normal paralysis that accompanies REM sleep. So, dreams are started to acting out. In the case of sleepwalking, the violence occurs only after the sleepwalking episode has been triggered and is underway [2].
Treatment
Build a safe environment: closed doors and windows, sleeping on the first level, removal of furniture with sharp edges and use of mattress or pads on the floor near the bed [4].
These patients can be physical danger to themselves and their bed partners, further diagnosis and treatment in a certified sleep laboratory is advisable.
- Ohayon, M.M. and C.H. Schenck, Violent behavior during sleep: prevalence, comorbidity and consequences. Sleep Med, 2010. 11(9): p. 941-6.
- Pressman, M.R., Disorders of arousal from sleep and violent behavior: the role of physical contact and proximity. Sleep, 2007. 30(8): p. 1039-47.
- Bargiotas, P., et al., Demographic, Clinical and Polysomnographic Characteristics of Childhood- and Adult-Onset Sleepwalking in Adults. Eur Neurol, 2017. 78(5-6): p. 307-311.
- Eisensehr, I., et al., Reduced striatal dopamine transporters in idiopathic rapid eye movement sleep behaviour disorder. Comparison with Parkinson’s disease and controls. Brain, 2000. 123 ( Pt 6): p. 1155-60.