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Potentially Lethal Behaviors Associated With Rapid Eye Movement Sleep Behavior Disorder: Review of the Literature and Forensic Implications
Author(s) -
Schenck Carlos H.,
Lee Samuel Adams,
Bornemann Michel A. Cramer,
Mahowald Mark W.
Publication year - 2009
Publication title -
journal of forensic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.715
H-Index - 96
eISSN - 1556-4029
pISSN - 0022-1198
DOI - 10.1111/j.1556-4029.2009.01163.x
Subject(s) - choking , rapid eye movement sleep , psychiatry , pediatrics , nightmare , rem sleep behavior disorder , parasomnia , psychology , poison control , medicine , dream , injury prevention , sleep disorder , clinical psychology , polysomnography , insomnia , medical emergency , electroencephalography , neuroscience , anatomy
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.