title: Increased deep sleep in a medication-free, detoxified female offender with schizophrenia, alcoholism and a history of attempted homicide: case report.
abstract: BACKGROUND
  Psychiatric sleep research has attempted to identify diagnostically sensitive and specific sleep patterns associated with particular disorders. Both schizophrenia and alcoholism are typically characterized by a severe sleep disturbance associated with decreased amounts of slow wave sleep, the physiologically significant, refreshing part of the sleep. Antisocial behaviour with severe aggression, on the contrary, has been reported to associate with increased deep sleep reflecting either specific brain pathology or a delay in the normal development of sleep patterns. The authors are not aware of previous sleep studies in patients with both schizophrenia and antisocial personality disorder.
  
  
  METHODS
  The aim of the present case-study was to characterize the sleep architecture of a violent, medication-free and detoxified female offender with schizophrenia, alcoholism and features of antisocial personality disorder using polysomnography. The controls consisted of three healthy, age-matched women with no history of physical violence. The offender's sleep architecture was otherwise very typical for patients with schizophrenia and/or alcoholism, but an extremely high amount of deep sleep was observed in her sleep recording.
  
  
  CONCLUSIONS
  The finding strengthens the view that severe aggression is related to an abnormal sleep pattern with increased deep sleep. The authors were able to observe this phenomenon in an antisocially behaving, violent female offender with schizophrenia and alcohol dependence, the latter disorders previously reported to be associated with low levels of slow wave sleep. New studies are, however, needed to confirm and explain this preliminary finding.
authors.affiliation: Institute of Biomedicine, Department of Physiology, University of Helsinki, Helsinki, Finland. nina.lindberg@pp3.inet.fi
authors.forename: Nina
authors.initials: N
authors.lastname: Lindberg
authors.forename: Pekka
authors.initials: P
authors.lastname: Tani
authors.forename: Pirjo
authors.initials: P
authors.lastname: Takala
authors.forename: Eila
authors.initials: E
authors.lastname: Sailas
authors.forename: Hanna
authors.initials: H
authors.lastname: Putkonen
authors.forename: Markku
authors.initials: M
authors.lastname: Eronen
authors.forename: Matti
authors.initials: M
authors.lastname: Virkkunen
mesh_terms: D000328:Adult; D000374:Aggression / Q000523:psychology; D000437:Alcoholism / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D000987:Antisocial Personality Disorder / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D015897:Comorbidity; D005260:Female; D005387:Finland / Q000453:epidemiology; D005555:Forensic Psychiatry; D006708:Homicide; D006801:Humans; D017286:Polysomnography; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D012890:Sleep / Q000502:physiology; D012893:Sleep Wake Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D014754:Violence / Q000523:psychology*