Sleep forensic case reports

Abstract

Sleep assessment in suspected sleep related violence (SRV) and sleep-related abnormal sexual behaviour (SRASB) cases is mandatory. When such behaviours are suspected or purported to have caused a criminal offence (i.e. assault, attempted murder, murder, sexual assaults) sleep experts asked to provide report/testimony relied on previous forensic cases as a valuable source of information. We aimed at analyzing reported forensic cases of SRV and SRASB to investigate if they provided information about a minimal set of medical-legal key elements. Systematic review was performed searching MEDLINE and PSYCHINFO databases from January 1980 through December 2012. One expert in legal medicine and two experts in sleep medicine reviewed all reports to assess whether they provided information about 15 key elements grouped in four categories: (1) legal issues (charge, defense, verdict); (2) defendant and victim characteristics (sex, age, relationship); (3) circumstantial factors (timing of the event, proximity, psychophysical condition of the defendant at the time of the event); and (4) forensic evaluation (clinical sleep assessment, polysomnography (PSG), PSG findings, other medical evaluations). Out of 624 retrieved references we included 35 reports (19 SRV and 16 SRASB), ranging from single case reports to case series up to summaries of legal cases. The number of provided key elements ranged from 4 to 14. The most frequently reported were the defendant’s sex and the relation with the victim (97%), while the less frequent were PSG (37%) and PSG findings (29%). In average, legal issues were provided in 84% of reports, defendant and victim characteristics in 74%, circumstantial factors in 77%, and forensic evaluation in 47%. Criminal trials involving SRV and SRASB are rare. In this light, exhaustive reporting is essential. This is the first attempt to analyze the information provided by published SRV/SRASB forensic cases. We disclosed that a minimal set of medical-legal key elements was never provided. While information about legal issue is frequently provided, the lack of key elements concerning defendant and victim characteristics, circumstantial factors and especially forensic evaluation weakens the forensic relevance and the scientific interest of many reports. Improving the quality of reports of forensic cases of SRV/SRABS would provide essential information for sleep medicine experts called for forensic evaluation and a homogeneous body of data for scientific research.