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Is Sleepwalking Bad?

New Hampshire Man Shoots Himself While Sleep Walking

August 1, 2013:  Police in New Hampshire say a man who shot himself in the leg this week may have been sleepwalking.  The victim, whose name is not being released because he is not facing any charges, was hospitalized in Concord Tuesday with a gunshot wound to the knee.  His wife, who reported the incident to police, told officers that he appeared to be in a state of sleep at the time and was awakened by the gunshot.  Source:  Associated Press

A rather rude awakening, I’d say.  But it’s certainly not the first time.  On October 29th 2010, Sanford Rothman in Boulder, CO had a clear wakeup call early in the morning. It wasn't an alarm. It was also a self-inflicted gunshot wound to his left knee obtained while sleep walking. 

Sleep Disorders

Sleep disorders are common and are collectively called parasomnias. Quite simply, a parasomnia is an abnormal behavior that occurs during sleep.  Parasomnia sleep disorders may cause abnormal movements, behaviors, emotions, and perceptions. Most people talk in their sleep, others eat while sleeping, while others are prone to sleepwalking.   These behaviors are, at times, amusing and may even be comical.  However, other parasomnias involve criminal activity including sexual assault or even homicide.  People acting out a parasomnia have no conscious control of their actions.

What is Sleepwalking?

Sleepwalking, medically known as somnambulism, is a behavior disorder that originates during deep sleep and results in walking or performing other complex behaviors that are initiated during a slow-wave sleep. This disorder is frequently associated with sleep deprivation. Most people have sleepwalked on at least one occasion. Sleepwalking is relatively common in young children. In the elderly, sleepwalking may be a symptom of an organic brain syndrome, such as dementia. Sleepwalking usually poses no serious health threat to those who experience it, although the risk of injury or aggression is a priority concern. Actually, a sleepwalker is not truly asleep, but is in a dissociated arousal state. A sleepwalker typically remains in this state throughout the entire sleepwalking episode. The individual may be difficult to awaken, and will probably not remember the sleepwalking incident at all.

The normal sleep cycle involves several distinct stages including; drowsiness, rapid eye movement (REM) and deep sleep. During a night, there will be several cycles of non-REM and REM sleep. Vivid dreaming occurs during REM sleep. Sleep walking most often occurs during deep, non-REM, sleep early in the night. It can also occur during REM sleep near morning. It rarely occurs during napping.

Sleepwalking episodes usually last from one to five minutes, but they may last as long as one hour. During the episode the individual may appear to be awake, but usually has a blank expression; their eyes open in a glassy stare. Sleepwalking usually involves more than just walking during sleep, it is a series of complicated actions that are carried out while sleeping. A sleepwalker can talk (frequently incoherently), cook and eat food, use the phone, have sexual relations, move furniture, wash clothes, feed the pets, bathe and dress. He or she is also capable of taking a gun from the dresser, removing knives from kitchen drawers, using power tools, driving, physically or verbally attacking others. Many sleepwalkers have the unique experience of waking up during their travels.

Sleepwalkers

Sleepwalking can occur at any age, but it is most frequently seen in children aged 6 to 12. It also occurs in adolescents, adults, or in the elderly. 30% of American adults have sleepwalked at least once in their life.  Approximately 4% have sleepwalked once or more in the past year.  Sleepwalking has a genetic tendency; it runs in families. Males are more likely to sleepwalk than females.

Causes

The most common triggers for sleepwalking include; stress, depression, sleep deprivation, sedative agents (including alcohol), fever, obstructive sleep apnea, abnormal heart rates, nighttime seizures, nighttime asthma, a gastro-esophageal reflux disorder, hormonal imbalances, menstruation, and pregnancy. Medications that have been shown to precipitate sleep walking include; benzodiazepines, anti-seizure medications, stimulants, antihistamines, and anti-arrhythmic drugs. Psychiatric components include posttraumatic stress disorder and panic attacks.

Sleepwalking and Violence

Sleepwalkers are indeed capable of violence. This violence is most prominent in male sleepwalkers, who account for almost 95% of all somnambulism violent cases. Additionally, sleepwalkers have a heightened pain threshold, which may further increase the likelihood of violence. Behaviors during adult sleepwalking are often quick, impulsive, inappropriate, and goal-oriented.

Can Sleepwalking Be a Murder Defense?

According to the experts, the answer is; "Yes, it is possible." Sleepwalking appears to be the most frequent sleep disorder invoked as defense against murder. This defense has been successful at times. The defensive argument is that the defendant was not in his normal state of mind when he committed homicide. The legal stance is that any harmful actions committed in this state of sleep walking cannot be blamed on the perpetrator. The question is should an individual be punished for a crime against a loved one, in which he had no memory of the act, had no motive for the death, made no attempt to cover his crime, and was extremely remorseful? Add the additional facts that the individual has a history of substantiated childhood parasomnias, was not under the influence of drugs or alcohol, and had no previous history of violence.   Although EEG and brain imaging has been used to improve making a differential diagnosis of sleepwalking violence, there is no reliable test to prove the same. Any prosecutor could have a difficult time convincing a jury, beyond a reasonable doubt, that this man was guilty of anything. Verdicts in these cases have been anything but consistent or predictable. Some sleepwalkers have been found guilty of homicide; others have been set totally free.

5 Essential Safety Tips for the Sleepwalker and Their Families

It has been established that approximately 25% of sleepwalkers harm themselves during their night walks.  Remember, safety is the most important factor for sleep walkers.

  1. Secure all firearms, other potential weapons, and power tools.
  2. Hide all sharp and dangerous subjects from the sleepwalker’s room
  3. Make sure that a sleepwalker sleeps on the ground floor.
  4. Lock windows and doors
  5. Additionally, a little bell on doors and windows

One common misconception is that a sleepwalker should not be awakened. While it may be difficult to wake sleepwalkers, it is not dangerous to do so. Although some sleepwalkers may become aggressive when awakened, most of the time they are simply confused, disoriented, scared, or embarrassed upon awakening. Leading the sleepwalker back to bed, and waking him or her if necessary, is the safest option. Waking a sleepwalker should be done as gently as possible to avoid aggressive responses. It is common for the person to be confused or disoriented for a short time after being awakened.

Sleepwalking Treatment

Sleepwalking is common in children and is usually outgrown over time. However, it can occasionally persist into adulthood, or may even begin in adulthood. In most cases, no treatment is necessary because sleepwalking rarely indicates any serious underlying medical or psychiatric problem. However, if an individual is having frequent episodes, injuring himself or herself, or showing violent behavior, medical and/or psychiatric treatment is advised.

Professional Treatment

When sleepwalkers exhibit violent behaviors drug therapy is indicated. Sedative-hypnotics, benzodiazepines, and antidepressants have been helpful in reducing the incidence of sleepwalking in some people. Traditionally Klonopin and Elavil are the drugs of choice.

Additional long-term therapies include relaxation techniques, mental imagery, and anticipatory awakenings (waking the individual for approximately 15-20 minutes before the usual time of sleepwalking event, and then keeping him awake through the time during which the episodes usually occur). Treatment for sleepwalking in adults may include hypnosis.

Sleepwalking is currently being evaluated psychologically, socially, and legally, related to an individual's responsibility for criminal activities committed during a reported sleepwalking incident. If you are a law enforcement officer, you may have already encountered a sleepwalker. If you haven't, chances are pretty high that you will. He may be the little old man, walking down the middle of the street, dressed in pajamas, who is truly clueless. Or the suspicious person at an ATM machine, making futile attempts to make a deposit or withdrawal. Then again, it could be an individual you stop for a routine traffic investigation who is covered in blood. The appropriate investigation and intervention into these types of cases is obviously required.

Disclaimer:  If this article has put you to sleep, I wish you only pleasant dreams. However, if you are still awake, you may want to make sure you are really awake.

 

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