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14 - Forensic sleep medicine issues: violent parasomnias


Published online by Cambridge University Press:  08 August 2009

Michel A. Cramer Bornemann
University of Minnesota Medical School
Mark W. Mahowald
University of Minnesota Medical School
Carlos H. Schenck
University of Minnesota Medical School
Harold R. Smith
University of California, Irvine
Cynthia L. Comella
Rush University Medical Center, Chicago
Birgit Högl
Inssbruck Medical University
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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)


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.

Sleep Medicine , pp. 240 - 255
Publisher: Cambridge University Press
Print publication year: 2008

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