Parasomnias are abnormal states of behavior and experience in which basic instincts are inappropriately unleashed during sleep. These instinctual behaviors can be appetitive, such as feeding (sleep related eating disorder), and sex (sexsomnia, sleepsex), and can also involve locomotion, exploration, intense fear, aggression, and violence. When the dice are rolled during sleep for parasomniacs, whose brains are asleep but who are interacting with the environment, bad things often happen, including injuries and the frequent disruption of the bed partner’s sleep.
Parasomnias represent extreme states of mixed sleep-wakefulness. Brain research has shown that when the brain is globally asleep, there are still parts of the brain that are awake. With parasomnias, release of behavior is not accompanied by proper judgment. Sleep behavior is non-culpable behavior, in the eyes of the law.
An example of extreme sleepwalking is provided by the famous case of Kenneth James Parks that made Canadian legal history. That case illustrates how a perfect storm of sleepwalking risk factors can converge with terrible consequences. On the night of May 24, 1987, the 24 year old Parks had a prolonged sleepwalking episode that resulted in the murder of his mother-in-law Barbara Woods, and the near-murder of his father-in-law Donald Woods. He was acquitted on the basis of sleepwalking after a dramatic jury trial that began in Toronto nearly a year later. I reviewed the 1,737-page court transcript, and agree with the verdict. (I published this analysis in my book Paradox Lost.) During my talk at the sleep symposium on June 3, I will describe the amazing and horrible series of events that took place after midnight, beginning with Ken Parks driving 23 km (14 miles) to the home of his in-laws (and their two teenage daughters—who were terrified by the loud, animal-like grunting outside their bedroom doors that night, before Parks turned around, went down the stairs, and left the house).
In the process of stabbing Barbara Woods to death, Parks severed multiple tendons on both his hands—but he did not feel pain nor did the police observe him to be in pain later that night despite these deep, extensive injuries. This is a striking example of “dissociative analgesia” common in sleepwalking, and is indicative of a very sleepy brain that does not easily feel pain. This observation by the police provided strong evidence in the trial supporting the Sleepwalking Defense. Also, Parks was always known to be a deep sleeper, and he had had at least one life-threatening episode of sleepwalking, when at age 11 his feet were going out a 6th floor window when his grandmother found him and pulled him in. There was a very strong family sleep history, with 20 parasomnias affecting 10 first and second degree relatives, across 4 categories of parasomnias.
Besides the personal and family history of parasomnias, on May 24, 1987 there were several extreme “state factors” (conditions of the moment) that pushed him strongly towards sleepwalking: major sleep deprivation (48 hours), physical stress (playing rugby on a hot, humid afternoon when overweight and very out-of-shape), and emotional stress (from gambling addiction). On account of all these risk factors and the evidence presented in court, I fully agree with the verdict of innocence. Also, there was no motivation for murder. When Parks first met his future wife Karen, she was a teenage runaway, and he convinced her to return home. His in-laws remained deeply appreciative of this advice he gave to their daughter, and they felt very close to Ken. Barabara Woods referred to Ken Parks as a “gentle giant.”
Sleep related eating disorder features binge-eating of high caloric foods (fats, carbohydrates) during partial awakenings from sleep. SRED is considered to be a “final common pathway disorder”, meaning that a variety of other sleep problems (sleepwalking, restless legs syndrome, sleep apnea, certain sleeping medications) can induce SRED. The video I will show of the “pinky lady” illustrates the intriguing phenomenon of “sleep state dependent behavior,” since for this 42 year old woman, with each bite of a brownie, she puts her pinky at the entrance to her mouth, and seems to nibble at her pinky and do other little things. She would never eat that way, using her pinky, while awake. This pinky activity was a good indicator that her brain and mind were still involved with sleep, and promoting peculiar eating-related motor activity.
Finally, what is sexsomnia and what causes it? I will describe the case of a 61 year-old woman whose sexsomnia was one of a total of 5 parasomnias (RBD, sleepwalking, sleep-eating, etc.). Her case will soon be published, along with the case of a 41 year old man with sexsomnia also being part of a total of 5 parasomnias, in the journal Sleep Medicine. That scenario is one of the two major scenarios for sexsomnia: a long history of multiple parasomnias (with some often beginning in childhood); or obstructive sleep apnea (snoring and daytime sleepiness), with the apneas triggering automatic sexual behaviors and no subsequent memory. As to the details of sexsomnia that cover the gamut of sexuality in the reported cases, they will be provided during my presentation on June 3.
The Mind after Midnight: Where Do You Go When You Go to Sleep? takes place on Friday, June 3, at 8:00 PM at NYU Kimmel Center, Eisner & Lubin Auditorium.
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