Sleepwalking (somnambulism)
Last reviewed: 23.04.2024
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Sleeping, or somnambulism, is sitting, walking or other complex behavior during sleep, usually with open eyes, but without realizing what is happening. Sleeping is characteristic of the late childhood and pubertal period, observed with incomplete awakening from the III and IV stages of a slow (without BDG) sleep. The likelihood of somnambulism increases with previous deprivation and poor sleep hygiene, family cases are described. There is often murmuring in a dream, causing damage to an obstacle or on a ladder, but there are no dreams. As a rule, patients do not remember anything.
Crimes can be committed during sleep, and then the defense on the basis of automatism will be adequate. After the Burgess case (R v. Burgess (1991), the conflict began to be considered by the courts in connection with "internal factors", that is, as the automatism associated with insanity.
[Causes of conflict
Pleasure occurs in the fourth phase of slow-wave sleep, and not in the REM sleep phase (rapid eye movements), when the body is usually motionless. There may be partial excitement, in which it is possible to perform complex actions, including with the use of violence. According to Fenwick, when diagnosing a crime, especially when assessing crimes that could have been committed during a breakdown, it is necessary to consider the following factors.
The following general factors are important:
- Family history. It is known that there is a genetic component in the etiology of the disease.
- Beginning in childhood. Sleeping usually begins in childhood; although in a smaller number of cases it begins in adolescence.
- Later on, the onset of confluence is rare. However, this can happen after a head injury. If the first episode of falling is at the time of the crime, then here should be approached with a fair amount of doubt.
Next, the episode should be viewed more subjectively.
- Given that the dream occurs in the 3-4th stages of sleep, it should occur within two hours after falling asleep.
- On awakening, the face must be disoriented.
- Witnesses should note inadequate automatic behavior and disorientation upon awakening.
- Amnesia should be present, extending throughout the entire period of ascendancy.
- There may be some "trigger" factors, such as taking drugs, alcohol, excessive fatigue or stress.
- If this is a sexual offense, then sexual arousal during sleep happens only in the REM-sleep phase, that is, not during the sleep period.
- Any memories relating to the period preceding the demotion should not be like a dream.
- For crimes committed during the time of conflict, attempts at concealment are not typical.
- Similar behavior may have been noted in previous episodes of confluence.
- If the crime looks unmotivated and uncharacteristic for this person, then it supports the view of committing it during the time of the conflict.
Treatment of confluence
The treatment is aimed at protection from damage using electronic alarms for waking, low beds, and removing obstacles from the bedroom.
Persons suffering from sleepwalking are recommended to sleep with locked doors and windows and medications are prescribed. Of the medications, benzodiazepines are effective, especially clonazepam, 0.5-2 mg orally before bedtime.