Sexsomnia = sex sleep
Anyone hearing about sexsomnia, sometimes referred to as “sleep sex,” might be forgiven for thinking it sounds amusing. It's anything but, however. This is a highly disturbing, distressing disorder destroying the toughest relationships, and at times, family bonds.
Although acknowledged earlier, the term “sexsomnia” only became the disorder's accepted description when a case study was published in 2003, by Colin Shapiro, a University of Toronto researcher.
In 2007, the problem gained greater traction when Sleep journal published a piece by researchers M.W. Mahowald, I. Arnulf, and C.H. Schenck, in which they detailed the full range of sexual, sleep-related behaviors.
Since then, sexsomnia has become widely investigated and gradually accepted as a sleep condition rather than an excuse given by rapists.
The implications for legal cases involving sexual attack have been significant; sexsomnia has frequently been alleged, and sometimes proven, as a defense in sexually motivated assaults. In some cases, perpetrators have been acquitted.
When a diagnosis is given, it is usually referred to as non-rapid eye movement (NREM) parasomnia. NREM relates to the specific sleep phase in which it occurs, while parasomnias are sleep disorders showing abnormal behaviors, dreams, and sensations.
In NREM, the person is caught between their sleeping and waking cycles when suddenly roused from deep sleep. This facilitates brain activity of the type they should only display in waking hours, thus leading more readily to “conscious-type” behaviors being committed unconsciously.
How does sexsomnia show itself?
In sexsomnia, the sleeping person tries to engage in sex with anyone close at hand. This might be a partner, a family member, or a stranger.
Since the attack is unconscious, considerable force, which would be unusual for the individual when having sex awake, may be used, resulting in serious injuries to the victim.
These typically arise from the use of forcible restraint, excessive body weight, or unusual sexual practices.
In some cases, sexsomnia can cause sleep masturbation, which can also be upsetting for sufferers' partners. This can lead to romantic partners believing they do not sexually satisfy the sufferer, while in reality, there's no correlation between sleep masturbation and sexual fulfillment.
One of the biggest issues for sexsomniacs is that during an “attack” on someone, the sexsomnia sufferer appears relatively normal, awake and conversant. This makes it unlikely the sufferer will be believed when they say they know nothing about what they did.
What's the effect of sexsomnia?
For the sufferer and their loved ones, this parasomnia is devastating. The individual has no idea when their parasomnia will strike, and remains unaware of what they do when it happens. This is the same as being unaware if they turn over or throw away their pillows in the night. Sufferers' partners often sleep in nightly fear of attack, while the sufferer himself feels unrested and exhausted the following day.
It's clear, too, that sexsomniacs only find out about incidents via those who are involved or harmed. This leads to discord, relationship rifts, and eventually, to the sufferer's deep feelings of distress and shame.
They will often avoid social interaction with those who have been “attacked” for some time afterward. The sufferer feels responsible for something they're powerless to control, and the person or persons attacked may also apportion blame, disbelieving it could happen without the sufferer's knowledge.
Sexsomnia attacks are rare, even among diagnosed sufferers, but the level of fear victims and perpetrators experience during attack phases means that even if these occur only once every six months, they are still intolerable. Of course, there's also the effect that the sufferer's partner also cannot sleep due to their fear.
In dire situations, sexsomniacs are charged with assault and rape, so face serious, life-changing consequences. Once they're aware of their parasomnia, many sufferers avoid dating and forming new relationships, for fear of what could happen. The sexsomniac must always consider what will happen when he tells his new partner about the problem.
The stress of living with sexsomnia and feeling powerless can lead to depression, anxiety, and social phobia. There also can be a devastating effect on emotional and physical intimacy for sufferers and their partners.
Are sufferers otherwise normal?
Sufferers show otherwise normal behavior when awake, holding down responsible jobs and being sociable individuals with average sex lives and sexual preferences. The problem manifests only during sleep.
While sleeping, sexsomniacs commonly suffer from other disturbed rest patterns due to their “awake-asleep” symptomology allowing them to do things most people only do in waking hours. This includes sleeptalking and sleepwalking; indeed, sleepwalking explains why sexsomniacs periodically end up in another person's bed yet truthfully know nothing about it until the next morning.
Does sexsomnia only affect men?
Sexomnia is far more common in men, or perhaps the statistics merely indicate that male sexual assault is more likely to be reported and logged as it's often penetrative and more aggressive. A female cannot assault a man in quite the same way and is unlikely to cause injuries whereas male sexsomniacs often cause physical harm.
Female sexsomniacs tend to masturbate in their sleep more than they involve someone else. Currently, statistics show that around 11% of males and 4% of females have diagnoses of sexsomnia.
What triggers sexsomnia?
The usual causes are elevated stress levels and lack of normalized rest. Some foods, as well as colorants and additives, may contribute to restless sleep and make the symptoms more likely. Like many other sleep disorders, sexsomnia is exacerbated by taking alcohol and recreational drugs.
Many sexsomniacs suffer no (or fewer) episodes when there's nobody else in the bed, but if there is a bed partner, the mere presence of another person can act as a trigger.
Staying overnight in a strange place can also lead to disrupted sleep-wake patterns and make it more likely an attack will occur.
What's the solution to sexsomnia?
The obvious solution for many sufferers, although traumatic and far from ideal, is to never share a bed with anyone. In some households, the sufferer's bedroom door must be locked by someone else when they sleep because it's assumed they'll simply migrate to another room if given the chance.
To diagnose sexsomnia, a sufferer needs to be referred to a sleep clinic, where patterns of rest will be monitored and possibly videoed over a protracted period.
Clonazepam, a benzodiazepine prescribed more commonly to treat panic attacks and seizures, is sometimes prescribed for sexsomnia and proves moderately effective. Whatever treatments are administered, there's no doubt that living with sexsomnia causes intense distress and fear for the sufferer; they will always worry that it may recur.
Since sufferers themselves are unaware of their sleep-based actions, their partners need to be the instigators of investigations and diagnoses. Partners must urge sufferers to seek help; the earlier this is done, the more likely a sexsomniac receives effective treatment enabling a more fulfilling–and safer–intimate relationship.
Learn more about Sexsomnia from Psychiatry Advisor.