- Adult-onset idiopathic sleep terrors may cause violent nocturnal behaviour, including attempted strangulation of a bed partner.
- Polysomnography documented an event during N3 (slow-wave) sleep with autonomic hyperactivation and complex motor behaviour.
- No psychiatric disorder, substance use, stressors or sleep deprivation identified; mild asymptomatic obstructive sleep apnoea found, prompting comprehensive evaluation and prompt intervention.
BMJ Case Rep. 2026 Jul 22;19(7):e271826. doi: 10.1136/bcr-2025-271826.
ABSTRACT
We report a case of a man in his 40s presenting with idiopathic adult-onset sleep terrors manifesting as nocturnal violent behaviour, including a concerning episode of attempted strangulation of his bed partner. Polysomnography documented an event during N3 sleep (slow-wave, deep non-rapid eye movement) with autonomic hyperactivation and complex motor behaviour. A detailed psychiatric evaluation did not reveal any diagnosable anxiety, mood or other psychiatric disorder, and there was no history of substance use, recent psychosocial stressors or sleep deprivation. Notably, there were no precipitating factors, though mild obstructive sleep apnoea without associated symptoms was detected. This case underscores the risk of violent behaviour in adult sleep terrors and emphasises the need for comprehensive evaluation and prompt intervention.
PMID:42486659 | DOI:10.1136/bcr-2025-271826
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