ABSTRACT

Many different medical conditions and external causes can cause the syndrome of medicolegal automatism. The two main types of sleep disorders likely to cause medicolegal automatism are parasomnias and sleep apnoea/hypopnoea syndromes. They cause lack of capacity in completely different ways. Whether sleep-disordered breathing leading to parasomnia is an insane cause of automatism or not is an open question. There have been no precedents set on whether or not OSAHS is an insane cause of automatism. It is an internal cause, but it is probably not a disease of the mind. The solution for diabetics was the designation of those causes of medicolegal automatism not due to a disease of the mind as non-insane automatism. This means all external causes, and some internal causes that are not diseases of the mind. Therefore Tarleton's insulinoma or the effects of diabetes itself (which would cause hyperglycaemia) are causes of insane automatism.