Benzodiazepine receptor agonists (BzRAs) are a commonly prescribed class of medication used in the treatment of insomnia. These medications have been previously associated with various complex sleep behaviors. We report the case of a man admitted with a self-inflicted gunshot wound to the head potentially resulting from complex sleep behavior associated with the use of a BzRA. Mr. D, was a 49-year-old man with no prior psychiatric history was admitted to St. Joseph's Hospital and Medical Center (a major tertiary care hospital and level 1 trauma center in Phoenix, AZ) with an apparently self-inflicted gunshot wound to the head. It was determined via physical examination and imaging studies that the injury was due to a .22 caliber bullet that had been fired left-to-right through both orbits resulting in destruction of his right eye and significant damage to the left eye, leaving him totally blind and resulting in multiple intracranial sequelae including a right anterior temporal intraparencyhmal hemorrhage, a cerebellar sub-dural hematoma, and scattered subarachnoid hemorrhage. After extubation on the 15th hospital day, Psychiatry was consulted in the setting of an apparent suicide attempt.
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