E2 Medical Disclaimer

I thought it was a joke the first time I read the word. Like sexalicious or sextastic. Then, I found out that sexsomnia was real. Not just because google confirmed it (and google is the arbiter of reality these days), but because I suddenly remembered that I had been a party to it. Many times, in fact. I had simply forgotten it, like gossamer lube from a libidinous dream. But I tease.

What is it?

Sexsomnia is sleepsex. Like sleepwalking, but, you know, sex. It is also called SBS, for Sexual Behavior during Sleep. It is one of several parasomnias that include the more familiar somnambulism, sleep eating, and sleep apnea. It is not as common as sleep violence.

The afflicted find themselves waking up in the middle of sexual activity. In benign forms the activity is harmless, such as masturbation when alone or in some sexual act with a bed partner. In extreme cases the behavior can be embarrassing or dangerous, such as the protracted shouting of sexual noises, engaging in violent masturbation (more common in men, who can awake with bruises), or in the worst cases sexual assault of a bed partner. Subjects are often more dominant in their behaviors than they are when doing the same things when awake. Subjects report complete amnesia of the events.

Some sufferers of the harmful variety also reported some common precipitating factors: alcohol abuse, polysubstance abuse, sleep deprivation, or psychophysiological stress. There's also evidence that it runs in families.

From a first person perspective I can say that being awakened by a benign sexsomnulist (sexsomniac?) can be at first wonderfully surprising. You think that you're dreaming a sexy dream, but then come out of it. Darn. It was just a dream. But wait, it not a dream at all! Hey-hey! It's only when you realize that your bed buddy isn't quite aware of what they're doing that it loses much of its sexiness. (Not all.) It is when your sleeping partner "loses interest" now that you're aroused and awake that it can become annoying. Especially if they get grumpy when you try to awake them. Especially if it occurs repeatedly. Especially.

It has been only recently identified by the psychological community. The earliest paper that I could find citing the problem was as recent as 1996. It is not yet recognized in the most widely used classification of such things, the American Academy of Sleep Medicine's International Classification of Sleep Disorders. Still, the topic is reaching the layperson, as evidenced by Cosmopolitan magazine's 2002 article "Her Boyfriend Did a Shocking Thing in His Sleep. Could Yours?"

The topic only took 9 years to reach the courts. Canadian defense lawyers cited sexomnia in defense of their client, a Toronto man accused of sexually assaulting a woman sleeping on his couch after they had met at a party. She reported that, "During the entire altercation, when someone touches you, you can feel their body heat. He had no body heat. His arms were very limp." He was acquitted of the charges. Women's rights activists were very upset at the court's ruling, fearing that this added another excuse by which men could justify sexual assault.

What causes it?

Well, I'd like to think sex appeal, thank you very much. But that's just me "suffering" from the benign type. Sleep scientists say it is a problem with the arousal mechanism, which means the biological processes by which an individual is roused from deep sleep to wakefulness. But in the harmful kind, it may signal a deeper problem.

Sleep researchers at Stanford University did a study on harmful-sexomnia sufferers and ascribed much of it (not all) to feelings of guilt, shame, and depression about sex while awake. It is notable that none were diagnosed with dissociative disorders. (The authors of the Stanford study suspect that some sufferers in the world will be diagnosed as such.) Sufferers also displayed some other stuff I don't yet understand: sleep-disordered breathing, stage 3 to 4 non-rapid eye movement sleep parasomnias, and REM sleep behavior disorder, all of which, are apparently concurrent with morning amnesia. Because of the general taboo of the subject and the sufferers' feelings in particular, partners often tolerated harmful varieties of the behavior for many months before seeking help.

What cures it?

If you know of someone who has the harmful variety, they should seek counseling, which helped most patients in the study. A low-level step you can take in the meantime is simply to sleep apart from each other to avoid the physical contact that may partially initiate the arousal mechanism. Also, if you notice a correlation with any precipitating factors (see above), avoid those things. In extreme cases, treatment of psychiatric disorders are needed, including prescriptions of Clonazepam (trade name: Klonopin) or other antiepileptic or antidepressant drugs. These were the minority.

To learn more, head to http://www.sleepsex.org/ and read up. You can share your stories and if you're suffering from the harmful kind read up on steps you can take. This is important, as sufferers may be at risk, like the Toronto guy, of being accused of sexual assault. If you'd rather read, one book has been published to date, with the perhaps-inapprioriately double-entendred title Sleepsex: Uncovered.

my bed
(this last contains an excellent set of references.)