Violence in sleep

Sleep-related violence occurs in 2% of the adult population and can result from various conditions, including parasomnias (such as arousal disorders and rapid eye movement behavior disorder), epilepsy (in particular nocturnal frontal lobe epilepsy) and psychiatric diseases (including delirium, dissociative states and factitious disorders). Its occurrence is probably favored by hypoactivity or dysfunction of the prefrontal cerebral areas, and selective activation of pathways involved in complex emotional and motor behavior. The present review outlines the different sleep disorders associated with violence, and aims to provide information on diagnosis, therapy and forensic issues. It also discusses current physiopathological models, establishing a link between sleep-related violence and violence observed in other settings.