Sleep-Related Violence and Sexual Behavior in Sleep: A Systematic Review of Medical-Legal Case Reports

Abstract

SRV and SBS medical-legal cases did not show apparent differences, except for the severity of the charges and the victim characteristics. An international multidisciplinary consensus for the forensic evaluation of SRV and SBS should be developed as an urgent priority.

Calls for an International Consensus on Sleep-Related Violence and Sexual Behavior in Sleep Are Premature

“…1 While we agree with the conclusion that the uniform reporting of forensic sleep cases could facilitate analysis of such cases, there are severe limitations with this method. As an alternative, we would advocate more systematic research on the behaviors typically seen during disorders of arousal and other parasomnias.…”

An International Consensus on the Forensic Assessment of Sleep-Related Violence and Sexual Behavior in Sleep: If Not Now, When?

“…W e read with interest the letter by Dr. Rumbold and colleagues 1 with their comments about our systematic review of medical-legal case reports of sleep-related violence and sexual behavior in sleep recently published in the Journal of Clinical Sleep Medicine. 2 We are pleased to note that these authors share the core recommendation from our study, i.e., the need for a uniform reporting of forensic sleep cases. In order to provide more data, we further analyzed all the retrieved case reports (N = 36), fi nding out that the information least provided was that regarding the forensic evaluation (provided only in 58% of reports), followed by the description of defendant characteristics (60%), circumstantial factors of the alleged event (68%), description of victim characteristics (72%), and the legal issues (81%).…”

Sleep‐related motor and behavioral disorders: Recent advances and new entities

“…Injury can occur (either to the individual or bed partner). NREM parasomnias have been used as a defense in cases of sleep‐related violence or sexual behavior …”

“…Somnambulism (sleepwalking) typically arises from stage N3. Behaviors range from simple acts (eg, gesturing, pointing, walking around the bedroom) to more complex behaviors (eg, running away from imaginary threats, getting dressed, cooking, and even 49 Population and twin studies indicate that genetic factors are important in the etiology of sleepwalking. 50,51 In predisposed individuals, sleepwalking is believed to be precipitated by factors that increase pressure for deep sleep (eg, sleep deprivation, intense exercise in the evening, fever) and/or factors that cause sleep fragmentation (eg, arousing stimuli, stress).…”