ArticleBMC psychiatry2025
Strangulation during the night: diagnosis of sleep-associated violence.
Article in BMC psychiatry, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
Abstract
backgroundViolent behaviors during sleep may be caused by various mental health and sleep disorders that require thorough investigation. A diagnosis could have significant implications in forensic medicine.
methodsWe present the case of a 60-year-old truck driver with no history of sleep or mental health disorders, violent behavior during sleep or wakefulness, or marital discord. He developed insomnia after retiring. He was prescribed 0.25 mg of alprazolam at bedtime. Four days later, he woke up at 5:30 a.m. with his hands wrapped around his wife’s neck. He had severely strangled and choked her. She survived. The judge requested expertise in psychiatry and sleep medicine. The perpetrator was interviewed and underwent video-polysomnography with and without alprazolam.
resultsThe perpetrator had no identified psychiatric disorder. Video-polysomnography revealed no parasomnia, such as arousal disorder or rapid eye movement (REM) sleep behavior disorder, and no epilepsy. However, it did show severe obstructive sleep apnea (OSA), with apneas in REM sleep lasting 100 s. The OSA worsened after alprazolam administration. This event was diagnosed as sudden confusional arousal induced by apnea and exacerbated by severe hypoxemia and benzodiazepine use, which can lead to aggressive behavior. Charges against the perpetrator were dropped. He experienced no further behavioral episodes while undergoing treatment for OSA and after alprazolam withdrawal, and he now lives happily with his wife.
conclusionThis case illustrates the challenges of diagnosing violent nocturnal behaviors. In this case, it was only chance that prevented a tragic fatal outcome and made it possible to distinguish attempted murder from involuntary behavior. CLINICAL TRIAL NUMBER: Not applicable.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.