Miya Pearson
Sexsomnia, also known as sleep sex, is a sleep disorder characterised by engaging in sexual activities during sleep. Sexsomnia is a type of parasomnia, which refers to unusual sensations and behaviours, such as sleepwalking, that people may experience or exhibit while asleep, falling asleep, or waking up. People with sexsomnia may experience sexual behaviours such as masturbation, sexual movements, sexual aggression, or initiating sex with another person. The disorder can be difficult to detect as those experiencing it may appear awake, with their eyes open, but they are in fact asleep and unaware of their behaviour. Sexsomnia can cause distress and shame for those who experience it and their partners, but treatment is possible and may include medication or lifestyle changes.
| Characteristics | Values |
|---|---|
| Other names | Sleep sex, parasomnia |
| Diagnosis | Video-polysomnography (vPSG) |
| Prevalence | Rare, 8% of people at a Canadian sleep disorder clinic showed symptoms |
| Sex | More common in men, who are almost three times more likely to have the disorder than women |
| Age | More common in adults than children |
| Symptoms | Masturbation, sexual intercourse, sexual aggression, sexual movements, self-touching, sexual motions, initiating sex with another person |
| Treatment | Medication, improving sleep hygiene, reducing stress or triggers, maintaining a healthy sleep-wake schedule |
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What You'll Learn
Sexsomnia, a sleep disorder
Sexsomnia, also known as sleep sex, is a sleep disorder characterised by engaging in sexual activities while asleep. People with sexsomnia may experience self-touching, sexual motions, or sexual intercourse with others. They often have no recollection of their sexual behaviours while asleep, and it is often their bed partner who first notices and reports the sexual behaviour. Sexsomnia can cause shame and distress for those who experience it and their partners.
Sexsomnia is classified as a parasomnia, an abnormal activity, behaviour, or experience that occurs during sleep. Parasomnias refer to unusual sensations and behaviours that people may experience or exhibit while asleep, falling asleep, or waking up. Sexsomnia often occurs alongside other parasomnias, such as sleepwalking and sleep talking. It is believed to be caused by disruptions while the brain is moving between deep sleep cycles. Sleep deprivation, stress, shift work, and alcohol consumption may also trigger sexsomnia. Obstructive sleep apnea is linked to many documented cases of sexsomnia, as it causes disruptions during deep sleep.
The exact prevalence of sexsomnia is unknown, but it is considered rare. A Canadian study found that 8% of people at a sleep disorder clinic showed symptoms of sexsomnia, with men almost three times more likely to have the disorder than women. However, this may not be representative of the general population, as people may not report their symptoms due to embarrassment or shame. Treatment for sexsomnia depends on the underlying cause but often includes medication, improving sleep hygiene, and reducing stress or triggers.
The most widely accepted diagnostic method for sexsomnia is video-polysomnography (vPSG). During vPSG, individuals are attached to physiological monitors, such as heart rate, breathing, and motion monitors, and are videotaped while they sleep. A record of sleep sex episodes may also be sufficient for a doctor to diagnose the condition. Treatment for underlying sleep disorders or behavioural issues may also help treat sexsomnia.
Sexsomnia can have legal implications, as it has been used as a criminal defence in court for alleged sexual assault and rape cases. The question of consent becomes complex, as the individual initiating or engaging in the sexual act is technically unconscious.
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Somnophilia, a paraphilia
Somnophilia, derived from the Latin "somnus" (sleep) and the Greek "-philia" (friendship), is a paraphilia in which an individual becomes sexually aroused by someone who is asleep or unconscious. It was first defined by John Money in 1986, who characterised it as a type of sexual fetishism. He described it as a "marauding-predatory type" of syndrome, where erotic arousal and orgasm are dependent on intruding upon someone who is unable to respond. Money also noted that somnophilia has a sort of stepwise logic with necrophilia and can be considered a "stealth and stealing paraphilia".
Somnophilia rises to the level of diagnosis when it causes "significant impairment", specifically when the individual engages in a sex act with a partner who has not given their consent. It is an under-researched paraphilia, and there are discrepancies in its definition and understanding. However, studies have shown that somnophilic fantasies are more common than previously thought. For example, a 2015 study found that 22.6% of men and 10.8% of women had fantasised about "sexually abusing a person who is drunk, asleep, or unconscious". Another study in 2021 reported that 9% of participants had an interest in sex with someone who is unconscious or sleeping, with 7.7% engaging in such behaviour.
The Diagnostic and Statistical Manual of Mental Disorders classified the term in 2000 under DSM-IV TR code 302.9. The Dictionary of Psychology categorised somnophilia as a predatory paraphilia, and it is often associated with biastophilia, which is a sexual interest in non-consensual sex. To explore this correlation, researchers developed the Somnophilic Interest and Proclivity Scale (SIPS), which distinguishes between consensual and non-consensual somnophilia. The scale also measures rape-related, sadistic/masochistic sexual fantasies, and the need for sexual dominance/submission.
Somnophilia should be distinguished from sexsomnia, a parasomnia disorder in which individuals exhibit sexual behaviours while asleep, often with no recollection of their actions. Sexsomnia can cause self-touching, sexual motions, or seeking sexual intimacy with others unknowingly. It often presents in individuals with pre-existing sleep disorders and is most commonly diagnosed in adolescent males. While somnophilia refers to a sexual interest in engaging in sexual activity with a sleeping person, sexsomnia refers to the act of sleep sex itself, which can have negative consequences for both the individual and their partner.
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Sleep studies and diagnosis
Sexsomnia, or sleep sex, is a sleep disorder characterised by engaging in sexual activities while asleep. It is a type of parasomnia, which refers to unusual sensations and behaviours that occur during sleep, such as sleepwalking. People with sexsomnia may exhibit a range of behaviours, including masturbation, sexual movements, sexual aggression, or initiating sex with another person. The disorder can be difficult to detect, as those experiencing it may appear awake, with their eyes open, but they are, in fact, asleep and unaware of their actions.
Sleep studies can play a crucial role in diagnosing sexsomnia and understanding its underlying causes. These studies are typically conducted at specialised medical facilities, and there are several steps that individuals can take before and during the process to aid in diagnosis.
Firstly, if a partner or loved one notices unusual sleep behaviours over a few weeks or months, it is recommended to consult a sleep specialist or a family doctor for an initial evaluation. Before the appointment, it can be helpful to ask anyone who has observed the sleep sex behaviours to document their observations in writing. Additionally, keeping a sleep journal or diary can provide valuable insights into sleep patterns and episodes. These records may be sufficient for a preliminary diagnosis, but further tests may be requested.
One such test is polysomnography, which involves monitoring various physiological parameters during sleep. This test can help differentiate between different sleep stages and identify any abnormalities or disruptions. In the case of a 40-year-old male patient with sexsomnia, polysomnography revealed that his sleep architecture included stages N1, N2, N3, and REM sleep, with an apnea-hypopnea index of 1.3 events per hour of sleep. However, polysomnography may not always detect parasomnias, as evidenced by the absence of abnormal findings in the patient mentioned above.
Another important aspect of diagnosis is understanding the patient's medical history, including any underlying sleep disorders, medical conditions, or mental health issues. For example, the 40-year-old male patient had a history of recurrent depression, and his sexsomnia episodes were impacting his relationship and sex life. Additionally, alcohol consumption was identified as a contributing factor, and he was counselled for alcohol cessation.
Treatment for sexsomnia often involves a combination of medication and lifestyle changes, depending on the underlying causes. In the case of the 40-year-old patient, abstinence from alcohol was the first step, and when that did not resolve the issue, clonazepam, a benzodiazepine, was introduced. Other medications used to treat sexsomnia include tricyclic antidepressants and selective serotonin reuptake inhibitors.
It is important to note that sexsomnia can cause shame, guilt, and distress for both the affected individuals and their partners. Therefore, seeking help from mental health professionals, such as individual or couples' therapy, can be beneficial in addressing these emotional and relational challenges.
While sexsomnia is considered a rare disorder, it is important to recognise that the stigma and embarrassment associated with it may lead to underreporting. As a result, the prevalence of sexsomnia may be higher than what is currently known.
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Treatment and medication
Sexsomnia is a sleep disorder characterised by engaging in sexual activities during sleep. The causes of sexsomnia are unclear, but it may be related to other sleep disorders and external factors like stress, substance abuse, and alcohol. Treatment for sexsomnia depends on the underlying cause, but often includes medication, improving sleep hygiene, and reducing stress or triggers.
Sexsomnia can cause distress and shame for both the person experiencing it and their partner. However, it is treatable in most cases. Treatment options include medication and lifestyle changes.
Medication
- Benzodiazepines (such as clonazepam) are commonly prescribed to treat sexsomnia.
- Anticonvulsant medications such as carbamazepines can be used to treat sexsomnia caused by seizures.
- Antidepressants and anti-seizure medications may also be prescribed.
- Other drugs that have been used with limited success include trimipramine, lamotrigine, olanzapine, clomipramine, fluoxetine, escitalopram, and duloxetine.
- Paroxetine, an SSRI, has been found to be effective in treating sexsomnia in certain cases.
Lifestyle Changes
- Reducing stress and anxiety can help manage sexsomnia.
- Identifying triggers such as alcohol consumption and recreational drug use can help prevent sexsomnia episodes.
- Getting regular sleep is important, and maintaining a consistent bedtime can help prevent episodes.
- Keeping a sleep diary or journal can help track sleep patterns and identify any triggers or patterns associated with sexsomnia episodes.
- Cognitive behavioural therapy (CBT) has been found to be effective in controlling symptoms in certain cases.
- Couples therapy may be beneficial in addressing the emotional impact of sexsomnia on relationships.
- Until effective treatments are found, creating a safe environment for both the affected individual and their loved ones is important. This may include sleeping in separate rooms and locking doors.
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Emotional and criminal consequences
Sexsomnia, or sleep sex, is a sleep disorder characterised by engaging in sexual activities while asleep. People with sexsomnia may experience sexual behaviours ranging from masturbation to sexual intercourse, and they may also exhibit sexual aggression. The disorder can cause emotional distress for both the affected individual and their partner.
Emotional Consequences
Sexsomnia can have significant emotional consequences for both the person experiencing it and their partner. Feelings of strangeness, guilt, shame, and depression are common among those with sexsomnia. In one case, a female patient with sexsomnia attempted suicide, leaving a suicide note before changing her mind and deciding not to jump into a river. Marital difficulties and stress are also prevalent, with partners of people with sexsomnia sometimes feeling inadequate or believing that their partner's behaviour is a sign of displeasure in the relationship. This can lead to a growing rift between partners and cause considerable distress for both parties.
In addition to emotional distress, sexsomnia can also have legal and criminal implications. As sexsomnia involves engaging in sexual activities without awareness or intention, it has been raised as a legal defence in court cases. The legitimacy of sexsomnia as a defence has been controversial, and it is still undetermined whether it is considered "sane" or "insane" automatism in the eyes of the law. However, it is now recognised as a legitimate sleep disorder that can be treated and managed by medical professionals.
Criminal Consequences
The legal implications of sexsomnia have been widely discussed and debated. As sexsomnia can involve individuals engaging in sexual activities without their knowledge or consent, it raises questions about consent and responsibility. If a person with sexsomnia commits a sexual act without realising it, it could potentially be argued that they are not legally responsible for their actions. This defence has been explored in court cases, with varying outcomes. In Canada, case law exists to support the use of sexsomnia as a legal defence based on automatism. However, the determination of whether it falls under "sane" or "insane" automatism remains to be established by the courts.
The impact of sexsomnia on legal and criminal proceedings can be complex and multifaceted. While it may be considered a defence in some cases, it is essential to recognise that sexsomnia is a rare disorder. It is also important to note that the presence of sexsomnia does not necessarily exempt individuals from legal consequences. The specific circumstances, evidence, and legal frameworks involved in each case will play a significant role in determining the outcome.
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Frequently asked questions
Sex sleep, or sexsomnia, is a sleep disorder characterised by engaging in sexual activities during sleep.
Sexsomnia is a type of parasomnia, which refers to unusual sensations and behaviours during sleep. Signs that someone is acting under the influence of a sexual parasomnia include unresponsiveness or minimal responsiveness to conversation or the environment. They may also be more assertive during episodes of sleep sex.
It is considered rare, but it is difficult for experts to estimate how many people experience it. One study found that 8% of people at a Canadian sleep disorder clinic showed symptoms of sexsomnia, with men almost three times more likely to have the disorder.
