06/15/2010 05:12 am ET | Updated Nov 17, 2011

Sleep Violence. Rare, But Real

If you think you've got it bad because your bed partner snores, think again.

In an engrossing editorial about sleep violence, a man chronicles what it's like to commit violent acts in his sleep (granted, his didn't go much further than punching the headboard or acting like a defensive lineman). But sleep violence can be serious. And it's not something to joke about. It entails a spectrum of disorders, including:

  • Night terrors: momentary, frightening hallucinations, resulting in panic and confusion. Night terrors are common among children. Most children grow out of them, though some can progress to more violent forms of this behavior in adolescence.
  • R.E.M. Sleep Behavior Disorder (R.B.D.): this is characterized by vivid dreams that portray threatening persons or objects. Mild instances result in restlessness and abnormal twitching in bed; more serious are occasions when people, in acting out their dreams, attempt to fight back against their imaginary foe, thereby raising the risk of serious injury.

For centuries, high-profile cases have involved sleep violence. If you strangle your wife to death in your sleep, should you be held 100 percent accountable? This has been a tricky subject for legal scholars.

Are there any risk factors? Certainly.  Most patients with R.B.D. are males over 50 years of age.

Interestingly, scientists have discovered that people with R.B.D. develop lesions on a small portion of their brain stem that ordinarily inhibits physical movement during R.E.M. sleep. So while most people are "paralyzed" during sleep, people with R.B.D. are not, and can sleepwalk and do things with their bodies that you'd normally equate with being wide awake and fully conscious.

Other risk factors include:

The good news is we have a collection of drugs at our disposal to help people with serious R.B.D., which people in previous centuries did not (though they would lock people up and force them to sleep alone). Therapy can also work for some people.

The phenomenon has been the subject of a television movie.  After Kenneth Parks, an unemployed Canadian, murdered his mother-in-law in 1987, Hilary Swank filled the role of playing his wife in "The Sleepwalker Killing" (1997). Having no motive for the crime and a history of sleepwalking, Parks was acquitted by an Ontario jury. In another case in Scottsdale AZ, the man was found guilty.

If you or someone you know is prone to violent acts in their sleep, they should immediately see a sleep specialist to get help - this is a treatable disorder.

Sweet Dreams,

Michael J. Breus, PhD

The Sleep Doctor™

This article on sleep violence is also available at Dr. Breus's official blog, The Insomnia Blog: by Sleep Doctor Michael Breus, PhD.