First AD

Second AD

Patients who have REM Behavior Disorder are in REM sleep when the violence occurs. It occurs because the usual REM sleep atonia is lost intermittently, which allows the patient to essentially act out the content of the dream.

However, it is important to remember that the action remains within the dream world. While dreaming, the patients are not conscious of being in bed with a spouse sleeping nearby. Rather, their actions are those of the dream character.

The accountant who is dreaming he is repelling pirates with a cutlass might accidentally punch his wife. It is unlikely that his wife was part of the dream scenario or that the punch was intentionally directed at her.

Forensically, both sleepwalking and RBD might result in violence without intention, planning, or culpability.

," by Mark R. Pressman, PhD, on which this quiz was based.

Sleep Disorders

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A quiz on complex sleep-related behaviors.

Mini Quiz: Sleep and Violence

Mark R. Pressman, PhD