Potentially Lethal Behaviors Associated With Rapid Eye Movement Sleep Behavior Disorder: Review of the Literature and Forensic Implications

:  Rapid eye movement (REM) sleep behavior disorder (RBD) is characterized by loss of the muscle atonia of REM sleep, with release of complex and violent behaviors that are often attempted dream‐enactments. This study reviewed the literature on RBD with regard to potentially lethal behavior. A total...

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Bibliographic Details
Published in:Journal of forensic sciences 2009-11, Vol.54 (6), p.1475-1484
Main Authors: Schenck, Carlos H., Lee, Samuel Adams, Bornemann, Michel A. Cramer, Mahowald, Mark W.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Behavior
Correlation analysis
Domestic Violence - psychology
dreams/dream-enactment/oneirism
Eye movements
Female
Forensic Psychiatry
forensic science
Forensic sciences
forensic sleep medicine/parasomnia pseudo-suicide
geriatric medicine
Humans
Male
Middle Aged
Nervous System Diseases - complications
neurologic disorders
Neurological disorders
parasomnia
polysomnography
rapid eye movement sleep behavior disorder
REM Sleep Behavior Disorder - complications
REM Sleep Behavior Disorder - psychology
Self-Injurious Behavior - psychology
Sleep disorders
sleep related injury/sleep violence
Violence
Wounds and Injuries - etiology
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Summary::  Rapid eye movement (REM) sleep behavior disorder (RBD) is characterized by loss of the muscle atonia of REM sleep, with release of complex and violent behaviors that are often attempted dream‐enactments. This study reviewed the literature on RBD with regard to potentially lethal behavior. A total of 39–41 clinical cases of RBD associated with potentially lethal behaviors to self and/or others were found, involving a child and adults of all age groups, that manifested as choking/headlock (n = 22–24), defenestration/near‐defenestration (n = 7), and diving from bed (n = 10). A total of 80.8% (n = 21) were males; 19.2% (n = 5) were females; mean age was 65.6 ± (SD) 13.8 years (range: 27–81 years, and a child). (Gender/age data were not listed in the remaining cases.) An etiologic association of RBD with a neurologic disorder (or with pharmacotherapy of psychiatric disorders, n = 4) was present in 21–23 patients. Thus, RBD carries well‐documented, potential forensic consequences during RBD episodes that could possibly have been misinterpreted as suicidal or homicidal behavior.
ISSN:0022-1198
1556-4029
DOI:10.1111/j.1556-4029.2009.01163.x