By Russel Turk

It’s night-time, but all is not quiet. While some people sleep peacefully in their beds, others are engaging in random acts of violence. To stop them these people could be restrained, perhaps even arrested – or they could simply be woken up.

Experts have conducted research into some of the stranger things we get up to in our sleep, and their conclusions show that tossing and turning can sometimes reach risky proportions.

Violent behavior is very common in sleep, says Dr Peter Fenwick, a consultant neuro-psychiatrist at London University. “Nearly 90 per cent of the patients who come to you [in a sleep clinic] will have had some sort of violence in their sleep,” he says. And men are more susceptible to the problem than women.

So just how bad can it get? Dr Fenwick says kicking and hitting out with hands and arms is the most common type of violence, occurring on a nightly basis. But in some cases the violence can be much more serious. Some of his patients, for example, have placed their hands around a person’s neck.

And violent sleep activity can sometimes turn sexual. US scientists have coined the term “sleep sex” to describe the phenomenon where people commit sexual acts on themselves or their partners during sleep. One woman studied by researchers from Stanford University reported being sexually assaulted by her sleeping husband at least once every 15 days for 12 years.

Although cases of sleepwalking can be a source of great amusement when the sufferer ends up in an uncompromising position, not everyone is able to wake up and see the funny side.

Not, for instance, the person who wanders out onto a busy road and suffers serious injury, or the person who ends up naked on his balcony, as one of Dr Fenwick’s patients did, and is then convicted of indecent exposure. He says, “As a sleepwalker, never, never go to bed without your pajamas on.”

Violence is more likely to occur during sleepwalking, and what are known as sleep terrors, says Dr Fenwick. Sleep terrors are when people act out things that happen in their dreams. You may imagine you’re doing a wonderful rugby tackle, says Dr Fenwick, but in reality you’re violently colliding with your wardrobe. Similarly, in an effort to escape something in a dream, people can instead leap down a set of stairs or even out of a window.

Sleep terrors happen when people respond to dream imagery. Normally, REM (rapid eye movement) sleep is accompanied by paralysis, which stops us from acting out our dreams. But in some people this paralysis does not occur, a condition known as REM sleep behavior disorder.

However, Professor Chris Idzikowski, director of the Sleep Advisory Service in London, says it would be wrong to think that cases of violence during sleep are always so dramatic.

Nevertheless, if a restless sleeper or someone who suffers from nocturnal epileptic attacks shares a bed with someone, he says there is always the possibility that their moving limbs will strike the partner violently.

So how can people deal with this problem? In his Sleepwalking Thesis written in 1815, John Polidori, author of “The Vampire”, urged sleepwalkers to issue their servants with whips and surround the bed with baths of ice-cold water. Fortunately, more scientific methods are available today.

Drugs from the same family as valium are used to treat REM sleep behavior disorder, helping to keep the patient calm, while paroxetine is used for sleepwalkers. Various anti-epileptic drugs or even beta-blockers, which minimize anxiety, can also be prescribed.

But Prof Idzikowski says patients need better treatments. “When it is really severe then using medicine to try and control it becomes a sensible option but when it’s something that is happening three or four times a year, it is less appropriate to be on drugs all the time,” he says.

Dr Fenwick also believes that society’s increasing reliance on medication could be exacerbating the condition. “We are becoming a society that takes more and more drugs and there is little doubt that some drugs are related to sleepwalking and sleep violence,” he says.

“Make sure your room is safe and try not to get too sleep deprived,” is Dr Fenwick’s advice to those susceptible to mild acts of violence in their sleep. In the more extreme cases he says the person should go and see a sleep specialist. And if that doesn’t work? Make sure you wear pajamas and surround the bed with cold water…

Further Information:
The British Sleep Foundation
Tel: 020 7345 3317
www.britishsleepfoundation.org.uk

© Health Media Ltd 2002
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