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with Michael Breus, PhD, ABSM

This blog has now been retired. We appreciate all of the insights that Dr. Breus has provided to the WebMD community.


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Wednesday, April 5, 2006

Violent Behavior while Asleep?

A recent commenter asks:

“As a mental health counselor in Fl., I have a client who during her sleepwalking does destructive things such as: turning on the burners on the stove, kicking in a louvered door, throwing a pitcher of iced tea on the floor. It is my understanding it is rather unusual that sleepwalkers do such harmful activities. Are there other reports of this?”

My answer:

First of all it is great that you are asking questions about sleep, much less sleepwalking in your patients. And yes you are certainly correct, most sleepwalkers rarely do any violent behaviors.

That being said there are several factors I would consider for this type of patient. First, I would want them to have a sleep study to determine whether or not they are actually sleep walking or if they have a situation called REM behavior disorder.

The difference is that in REM behavior disorder people usually are acting out their dreams (which can be violent). To distinguish between the two there are several symptoms to be aware of:

  1. Is this behavior happening in the later 1/3 of the evening ( where REM is more likely to occur); and,
  2. Does the behavior correspond to their dreams?

Either way a sleep study is needed for several reasons. Sleepwalking can be kicked off by any number of other sleep disorders (Apnea, insomnia, sleep deprivation, Narcolepsy, etc.) . There is now an entire body of literature looking at sleep-related violence.

The good news is that these behaviors are often treated with medication (Klonipin and some tricyclic anti-depressants) . Many of those with REM behavior disorder are thought to eventually develop Parkinson’s, and if caught early the treatments are more effective.

Related Topics: The Risky Toll of Sleep Loss, Sleepy Teens

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Posted by: Michael Breus, PhD, ABSM at 2:47 pm

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