What Is Sexsomnia? – Sleep Center

If you have ever acted out sexually while sleeping, you’re not alone. Here is a closer look into the rare and largely unknown sleep disorder know as sexsomnia.

By Wyatt MyersMedically Reviewed by Lindsey Marcellin, MD, MPH

Reviewed: June 6, 2013

Medically Reviewed

Most people are familiar with sleepwalking, in which a person in deep sleep will get up and begin walking around the house. Another condition that occurs during the same phase of the sleep cycle is sexsomnia, in which the sleeping individual acts out sexually. Unlike sleepwalking, sexsomnia is largely unknown and misunderstood.

The condition recently made headlines because of a study at the Toronto Western Hospital in Canada. Results from questionnaires filled out by 832 sleep center patients revealed that 62 participants, or 7.6 percent, experienced sexsomnias — 11 percent of the men and 4 percent of the women. The researchers expected the percentage of those with sexsomnia to be lower in the general population, and these results made them realize that the condition might be more common than previously believed.

What Is Sexsomnia?

Like sleepwalking, sexsomnia is known as a parasomnia, an abnormal activity that occurs during a specific kind of sleep. But unlike other forms of parasomnia, the condition is sexually aggressive in nature.

“Sleep sex or sexsomnia is a form of non-rapid eye movement (NREM) parasomnia, similar to sleepwalking, that causes people to engage in sexual acts such as masturbation, fondling, intercourse, and sometimes rape while they are asleep,” says Robert Oexman, DC, director of the Sleep to Live Institute in Joplin, Mo. “This is similar to sleepwalking in that it occurs during NREM sleep, but medically it is a separate condition.”

Since the sexsomniac is experiencing a deep sleep phenomenon, he usually won’t even remember it the following day. “Most cases involve no recall and even a denial that the event occurred,” says Russell Rosenberg, PhD, vice chairman of the National Sleep Foundation in Atlanta.

What Causes Sexsomnia?

Many parasomnias, including sexsomnia, are poorly understood. As a result, experts aren’t exactly sure what causes them. However, there are clearly some risk factors that make sexsomnia more likely to occur in some people than in others.

“Many of these types of behaviors during sleep occur secondary to other sleep disorders such as sleep deprivation or obstructive sleep apnea,” says Raman Malhotra, MD, co-director of the Saint Louis University Sleep Disorders Center. “Certain medications can induce these types of behaviors. There also seems to be a genetic component to NREM sleep parasomnias, usually running through families.” Drug and alcohol abuse are other risk factors for sexsomnia, adds Rosenberg.

According to the data from the Toronto Western Hospital, men are more likely to experience sleep sex than women, though both can be affected. Rosenberg also believes sexsomnia might be more common than people realize. “There is shame involved with the disorder, so I believe that it is underreported in the general population,” he says.

How Sexsomniacs Can Be Helped

Currently, there are no FDA-approved drugs for the treatment of sexsomnia, but doctors have had success using some common sedatives and antidepressants off-label for treating the condition. “If we try these medications, we will closely monitor the patient for a few months to make sure they are working,” says Rosenberg.

Another important approach to treating sexsomnia is creating a safe environment for those affected by the condition. This might include sleeping in a separate bedroom, locking doors, or even putting alarms on doors to wake people up and make them aware of what is happening. “It is important that safety measures be put in place immediately in order to keep both the patient and anyone else in the house secure,” says Dr. Malhotra.

Finally, if an underlying sleep disorder or drug and alcohol abuse might be causing the sexsomnia, it’s important to treat those conditions, too. “Making sure patients are getting adequate amounts of sleep, avoiding certain medications, or treating any underlying sleep disorders such as restless legs syndrome or sleep apnea may be the only treatment necessary to make the behaviors disappear,” says Malhotra.

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What is sexsomnia?

Key Points

Sexsomnia is recognised as a rare sleep disorder in which a person engages in sexual activity during their sleep. In general they’ll have no recollection of events during the act or when they wake up.

In this article, we’ve explored both the legal and medical sides of sexsomnia and we’ve covered the following areas:

• what is sexsomnia: we look at what sleep science can tell us about this rare disorder
• the causes of sexsomnia and how it can affect the individual and those around them
• sexsomnia and the law: examples of cases and the difficulties it presents in legal cases
• how sexsomnia can be successfully treated by lifestyle changes and addressing underlying health conditions.

Introduction

Sexsomnia (often misspelled as ‘sexomnia’ and sometimes also known as ‘sleepsex’) is a rare sleep disorder which mostly affects men. It’s thought to account for around 7% of referrals to sleep disorders clinic, but the actual value is probably higher as some people may be embarrassed to seek help and others may not realise they have the problem.

Sexsomniacs engage in the following sexual activities while they’re asleep¹:

• sexual vocalisations
• masturbation
• fondling
• intercourse/attempted intercourse.

Sexsomnia is considered a parasomnia, which means a sleep disorder related to abnormal movements.

There are many common parasomnias, and you’ve probably heard of ones such as sleepwalking, sleep paralysis and bedwetting (to name but a few).

Several parasomnias occur during our rapid eye movement (REM) sleep, a good example being sleep paralysis. REM sleep is generally considered to be when most of our dreams occur but sexsomnia occurs during non-REM sleep and isn’t related to dreaming.

As with other parasomnias, sexsomniacs do not remember the acts that they perform while they are asleep.

Although abnormal sexual behaviour during sleep was first described in 1989, the term ‘sexsomnia’ wasn’t coined until 2003 when 11 patients exhibiting sexual behaviours during sleep were described.²

Causes of sexsomnia

Sexsomnia can co-occur alongside other sleep disorders such as sleepwalking, sleep apnoea, night terrors and bedwetting. It may be triggered by:

• depression, stress and anxiety
• previous sleep deprivation
• poor sleep hygiene
• excessive consumption of alcohol or drugs
• use of sleeping tablets.

Treatments that improve the quality of sleep may help to reduce the incidence of events.

When your sleep improves, it can also reduce levels of stress, anxiety and depression. If you’re having trouble sleeping and you feel like it’s having an effect on your mental and physical wellbeing, Sleepstation’s CBTi programme can help.

The implications of sleepsex

Sexsomnia, by its very nature, can have a profound impact on both the person with the condition and their partners. As people with sexsomnia tend to have no recollection of the events, it can be scary and confusing to learn that they have been carrying out behaviours outside of their conscious control.

For the bed partner, a range of feelings can be expected emcompassing everything from fear to enjoyment. In 2000, groundbreaking work was published recording stories and experiences of people who had experienced ‘sleepsex’.³

In a loving relationship, it may be understood as ‘just one of those things that happens’ as the account below suggests:

Sleepsex is great. My husband initiates it while we’re sleeping and then we wake up in the middle of making love. Often it’s better when he’s asleep because we’re completely relaxed and uninhibited.

However, given the nature of the behaviour, it may be hard for the bed partner to understand the fact that this behaviour is not deliberate:

During his sleepsex episodes, he becomes very aggressive and violent and then claims he does not remember anything… I had to call 911 last night because of a violent assault.

In extreme cases, sexsomnia has led to accusations of sexual assault — including rape — although the condition has been used successfully as a legal defence in some such cases.

A diagnosis of sexsomnia can often leave a person feeling shame, guilt or depression. For both the person experiencing sexsomnia and their partner, it’s crucial to speak to a sleep specialist and often consulting with a therapist may be recommended to help both parties with the diagnosis.

Sexsomnia and the law

A review of 90 cases of sexsomnia in the literature from nine different countries (including the United States and United Kingdom) found that 82% of the offenders were male.⁴ In 97-98% of cases those charged presented amnesia as a defence.

In about a third of the incidents reviewed there were also reports of aggression and violence. Ultimately, 14% of the cases resulted in legal proceedings.

Sexsomnia is now formally recognised as a psychiatric disorder and has been included in the standard diagnostic manual DSM-5⁵ ― essentially the bible of psychiatric disorders.

However, difficulty in clearly defining such behaviours and the possibility of falsely claiming sexsomnia as a defence can cause difficulties for a judge and jury.⁶⁷⁸

Luedecke: a study in sexsomnia

A number of the early legal cases concerning sexsomnia as a defence occurred in Canada — the most important of which was R v Luedecke.⁹ This case involved a defendant who had attended a party in Toronto in 2003 during which he consumed a large amount of alcohol and some magic mushrooms. Apparently:

• he had been awake for 22 hours before he fell asleep at about 4am
• he woke to find he was in the middle of nonconsensual sex and the woman was screaming
• the woman said Luedecke looked ‘completely incoherent’
• Luedecke said he was ‘completely dazed and in shock’.

When he learned later that day that police were looking for someone in connection with a sexual assault, Luedecke contacted the police and gave a voluntary statement.

The judge accepted that Luedecke’s conduct was triggered by the external factors outlined by a sleep expert. According to the defence, excessive sleep deprivation, alcohol, genetic predisposition factors and stress all contributed to circumstances beyond their client’s control.

The judge was satisfied that the defence of sane automatism (i.e. the accused was not responsible for his actions because he didn’t have conscious control of those actions) was correct and acquitted Luedecke.

The difficulty of proving sexsomnia in a legal setting

In a legal setting, a defence of sexsomnia is often difficult to establish, as the diagnostic tests needed to diagnose sleepsex are not generally taken into consideration.

Polysomnography is not routinely performed as part of a medicolegal evaluation in part as this diagnostic tool is not associated with the crux of the legal focus upon mens rea with the criminal allegation.¹⁰

To put this in layman’s terms, recording sleep behaviour (polysomnography) cannot offer evidence that the accused knew the act they committed was wrong (mens rea is Latin for guilty mind). So while there may be evidence of behaviours that would support the possibility of sexsomnia:

there is absolutely no after-the-fact polysomnograph finding that could possibly have any relevance as to whether the accused was sleepwalking at the time of the event in question.

What this means is that if you record someone’s sleep and discover that it’s normal then it doesn’t mean that it has always been normal — the accused person may have been experiencing sexsomnia in the past even if there’s no evidence for it in the present.

A good example can be seen in the case of State v. Scott⁸, where overnight sleep recording did not demonstrate unusual sexual behaviours in sleep. In this case, the court accepted an expert’s opinion that Scott exhibited ‘sexual behaviours in sleep parasomnia’ based on the defendant’s sleep history — as well as supporting evidence from family and sleep partners.

Even though the defendant’s sleep recording was normal — and might suggest the likelihood of a deliberate sexual assault — more importance was placed on the historical evidence. It was that evidence which exonerated Scott.

How is sexsomnia diagnosed?

Diagnosing sexsomnia usually relies on completing a sleep study, to try to capture the behaviour as it happens, or having accounts from a partner which, if detailed enough, can be sufficient for a doctor to determine if the behaviour is truly sleepsex.

When a sleep study is undertaken to diagnose sexsomnia, a person will usually spend several nights sleeping at a sleep clinic. During the sleep study, several measurements are taken while you sleep, including:

• brainwave activity
• heart rate and respiration rate
• leg and eye movements.

These can be used to identify or rule out other sleep disorders and ultimately accurately diagnose sexsomnia. If an episode of sexsomnia doesn’t occur during the sleep study then your doctor may recommend undertaking a second study.

Sexsomnia treatment approaches

Sexsomnia is treatable. As sexsomnia can be caused by other underlying sleep disorders, such as obstructive sleep apnoea, treating the primary cause should also help to resolve the sexsomnia.

Reducing intake of alcohol and addressing substance abuse in those with sexsomnia can be beneficial. Taking steps to reduce levels of stress, anxiety and depression can also have a positive effect on sexsomnia. Improving sleep hygiene can reduce symptoms.

Identifying measures to improve the overall sleep of someone with sexsomnia should help to reduce their sleep-sex symptoms.

As mentioned earlier, in some instances, talking therapies may be advised to help with processing any negative emotions that a person may be experiencing after receiving a diagnosis of sexsomnia.

If you think you may be experiencing sexsomnia, it’s important that you speak to your healthcare provider about it. Whether your worries are justified or not, leaving them unaddressed could interfere with your sleep and could lead to developing other sleep disorders, such as insomnia.

If you’re looking for sleep advice or want to learn more about how to sleep well, we have a wealth of information available in our articles section, ranging from sleep tips to the science behind everything sleep-related.

And if you’re worried about your sleep or a sleep problem then we can help. Sleepstation’s CBTi progamme is both clinically proven and highly effective, so if you want quality, long-lasting improvements to your sleep, based on decades of sound science, register for Sleepstation today.

Summary

• Sexsomnia is a relatively rare sleep disorder in which the person initiates sexual behaviour while asleep.
• Numerous causes and triggers of sexsomnia have been identified.
• Judicial systems around the world deal with the legal implications of sexsomnia differently.
• Sexsomnia can be treated by addressing any underlying sleep problems and triggers.

References

• Andersen ML, Poyares D, Alves RS, Skomro R, Tufik S. Sexsomnia: abnormal sexual behaviour during sleep. Brain Research Reviews 2007;56:271–282.

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• Shapiro CM, Trajanovic NN, Fedoroff JP. Sexsomnia—a new parasomnia? The Canadian Journal of Psychiatry 2003;48:311–317.

  ↑

• Mangan M. Sleepsex: Uncovered. Xlibris Corporation; 2001.

  ↑

• Schenck CH. Update on sexsomnia, sleep-related sexual seizures, and forensic implications. NeuroQuantology 2015;13.

  ↑

• American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5 (R)). 5th ed. Arlington, TX: American Psychiatric Association Publishing; 2013.

  ↑

• Davis C. Sexsomnia–excusable or just insane? Criminal Law Journal 2015;39:21–39.

  ↑

• Organ A, Fedoroff JP. Sexsomnia: sleep sex research and its legal implications. Curr Psychiatry Rep 2015;17:34.

  ↑

• Mohebbi A, Holoyda BJ, Newman WJ. Sexsomnia as a defense in repeated sex crimes. J Am Acad Psychiatry Law 2018;46:78–85.

  ↑

• R. v. Luedecke, 2005 ONCJ 294 (CanLII) Available from: www.canlii.org/en/on/oncj/doc/2005/2005oncj294/2005oncj294.html

  ↑

• Cramer Bornemann MA. Sexsomnia: A medicolegal case-based approach in analyzing potential sleep-related abnormal sexual behaviors. Parasomnias, New York, NY: Springer New York; 2013, p. 431–61.

  ↑

Berlinale 2023. “Past Lives” by Celine Son A touching film about the unlived love of two old friends. With Theo Yu, who played Tsoi in Serebrennikov’s Summer

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At the Berlin Film Festival, the debut film by American director Celine Son “Past Lives” was shown – a film about old friends who fell in love with each other in childhood and met in New York as adults. Film critic Anton Dolin tells why everyone can recognize themselves in the characters of the film, which the audience of the Berlinale received very warmly.

You can tell a story of unhappy, tragic, troubled love in a play or film. Or maybe a love that ended well. But how to tell about love that could only happen?

This emotional experience, hardly conveyed by dramatic means, is almost more universal: probably everyone dreamed of a romance with someone or imagined such a relationship. New York debutante Celine Son managed to make a movie about this. In her quite innovative idea is the small but distinct sensationalism of Past Lives, shown at the Berlinale after the premiere at the American Sundance and garnering rave reviews.

The first scene of the film: the camera slowly zooms in on three young people sitting next to each other at the counter in a New York bar. The viewer examines them together with the cameraman and unknown off-screen observers (we hear only their voices), trying to guess what unites these three. Two, a woman and a man, of Asian appearance, the third is a white American, a bearded intellectual, immersed in thought, to whom the girl turned her back. Two out of three are probably a couple, but who? And who is the third to them? Family friend, buddy, hired guide?

A wonderful introduction to the topic – the inability to fully understand and recognize another person, even when he is at arm’s length. And not only someone else’s, but even close. Celine Son keeps a chaste distance in relation to her three heroes, but still she knows more about one of them than about the remaining two. A confident woman named Nora (Greta Lee from The Morning Show Season 2) is a self-portrait of the director.

Nora – playwright. As a child, she and her parents moved from her native Seoul to Toronto, and as an adult, she moved to New York, where she got married – exactly the same fate lived Son herself. American – Arthur, her husband, also a writer (played by John Magaro, an artist of Woody Allen and Kelly Reichardt), with whom she now lives in the prestigious West Village. The third hero is Hye San (Teo Yu, remembered for his role as Tsoi in Summer), an engineer from Korea who first came to the United States. In childhood, she and Nora – then her name was Na Yan, but even she herself forgot that name – were in love with each other. And when they were 12, they broke up. Since then, we have only seen each other on Skype, and then not for long.

Past Lives only pretends to be a drama about a love triangle. Firstly, there is no material for drama here – all its participants are too delicate people who wish each other well. The maximum level of intimacy between Nora and Hye San is a friendly hug, perhaps lasting for a few barely noticeable moments. Secondly, the heroine definitely made a choice, there is no ambiguity in it.

The trick of “Past Lives” is that, despite the seeming simplicity of the three-act narrative – 12 years pass between actions – they deal with what is not shown, not said, left in the zone of the possible, but not happened. That is, with the invisible. On the surface, there are banalities, like a tourist ferry ride to Staten Island and back, past the Statue of Liberty. In depth is the question of what this notorious freedom is. Can it, in principle, exist if a person is given only one life, in which there is no place for any “what if”?

The name refers to the Buddhist idea of ​​reincarnation, and the untranslatable Korean concept of “inyon” plays an important role – the inseparable connection of two people throughout life. The roots of Son’s film debut are in Asian half-tone cinema: “In the Mood for Love” by Wong Kar-wai, “Right Now, Not After” and other tragicomedies by Hong Sang-soo, “Accident and Guess” by Ryusuke Hamaguchi.

Equally important, however, is how closely the Dream is connected to modern US intellectual culture and today’s perceptions of American independent cinema. This is reminiscent of the unobtrusively ironic soundtrack by Daniel Rossen and Christopher Behr from the excellent alternative band Grizzly Bear, and the deliberately sparse pictorial solution that perfectly conveys the everyday poetry of the big city (cameraman Chabière Kirchner filmed “Voice of Change” for Steve McQueen). The director is known as a theatrical playwright prone to experimentation, in particular, during the pandemic, she staged Chekhov’s “The Seagull” with the help of The Sims 4 game. Past Lives was produced by the fashion studio A24 (“Reincarnation”, “Lady Bird”, “Everything is everywhere and at once”).

This movie is about paradoxes not only of love, but also of emigration. Adults make decisions for children, and they come up with justifications for such a radical step. The girl’s parents, her mother, an artist, and her father, a film director, wanted to leave for Canada, and then Nora told her classmates that she wanted to receive the Nobel Prize in Literature, but in Korea this did not shine for her. Ultimately, a spontaneously set goal leads her to a profession. Her irrational self-confidence and Hye Sang’s equally conscious desire to live a simple life are directly linked to the geographic trajectories of fate – leave to succeed, or stay to fit in.

In some cases, a plot based on a phantom love story is a direct metaphor for emigration. Nora and Arthur speak English, Hye San is unable to understand them; in the same way, Arthur cannot catch what his wife is talking about with a childhood friend. Love is also a language that only two people always share. At the same time, “Past Lives” is the ABC of separation, which even in the era of the Internet becomes a test for any feelings and relationships, and not only tears them, but also paradoxically prolongs them. Finally, both emigration and love are processes of a slow, imperceptible to you, but inevitable transformation of something alien into native. And vice versa.

In one of the last scenes of the movie, Nora and Hye Sang are standing outside waiting for a taxi. The insignificant, barely a meter, distance between them seems insurmountable. In the same way, our ghosts are always in front of us at arm’s length: lovers, friends, loved ones, homeland. And the lives that we might have wanted to live, but did not work out.

Anton Dolin

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Why do chickens dream: interpretation of dreams about chickens

A dream about a chicken is difficult to perceive as something dangerous. These touching, gentle and fluffy creatures seem so touching and defenseless. However, it is worth remembering that, like any chicks, chickens are a symbol of lack of independence, a kind of infantilism. In general, it is based on these feelings that such a dream should be interpreted. In more detail about the details of the vision, I will tell you about popular dream books, to which we draw your attention.

Chickens in Miller’s dream book

According to this dream tradition of interpretation, troubles and cares are promised by a dreaming brood of chickens. And really, just imagine if a dozen fluffy yellow lumps were in your hands in reality, how much time and effort you would have to spend to care for them. However, these worries are more likely to benefit you, they will not be in vain. If in a dream you saw slightly grown chickens, this suggests that what you are doing right now will allow you to succeed, but for this you will have to seriously try, spend a lot of time and effort.

But a dream dinner, during which you taste chicken meat, should be considered rather an unfavorable dream. Know that such a vision warns you that your reputation has been shaken because of your selfishness, and there will be no stability in love and career affairs in the near future.

Chickens in Tsvetkov’s dream book

The interpreter is clear in his predictions. In his opinion, small and noisy chickens dream of uninvited guests in your house.

But a hen with chickens, according to this tradition of interpreting dreams, incurs financial losses. At the same time, they can be associated with spending on relatives and people close to you.

Chickens in Vanga’s dream book

The fortuneteller believes that these yellow-mouthed chicks portend good luck in financial matters, independence in money. If the chicks dream of a woman who has long dreamed of replenishment in the family, she should actively engage in the fulfillment of her dream, the period for this is now the most favorable.

Chickens in Freud’s dream book

If you had to feed chickens, then soon you will have to spend the night with a person who does not have the proper experience in this area. Your sexual experience will teach him everything in this area, you will give him the opportunity to gain emancipation, the ability to relax. Well, that’s a bold challenge.

In a dream, chickens are very small, just hatched – pay attention to your health, go to the doctor, get tested, check the organs that have been bothering you for a long time.

Chickens in Longo’s dream book

The white magician believes that a person who subconsciously strongly wants to start a family can see a hatched chicken in a dream. If the chick drinks in your dream, then in reality you will tend to make hasty decisions, draw the wrong conclusions and not quite accurately assess the situation.
Modern dream book about chickens: you will be disappointed
It is interesting, but not all interpreters are ready to see only positive omens in such a sweet dream. According to the authors of this book, a dream about chickens may indicate that a lot of routine, not always interesting work awaits you in life, you will need to spend time on it, but the reward for what you do will be disappointing.

Chickens in the Islamic dream book

For the stronger sex, such a dream is directly related to their fair halves and family values. Interpreters say that the number of chickens in a dream is the number of sons that will be born to a man. If in a dream you see how a chicken hatches eggs, this is a sure sign that you will soon hear about the pregnancy of your soulmate. If you weren’t ready for this, you just have time to come to your senses to meet this news with joy, as it should be.

In general, such a dream portends financial well-being and new acquisitions. Photo: pixabay.com

Chickens in the Esoteric Dream Book

Interpreters urge you not to dismiss this dream in any way. After all, the little chickens that surrounded you in a dream warn that you are wasting your life on completely unnecessary, stupid things, fussing too much, attaching too much importance to trifles. And at this time, really good opportunities pass by, grandiose projects, participation in which could bring you a lot of money and status. Take advice and try to understand what is really important in your life. The right priorities can work wonders.

Chickens in Azar’s dream book

In this book, special attention is paid to what you do with chickens yourself. In general, such a dream portends financial well-being and new acquisitions. But for an accurate interpretation, it is worth remembering the details of the dream. So, if you feed chickens in a dream, minor troubles await you. They will not bring much harm, but will irritate and spoil the nerves. If you see how a chicken hatched in a dream, expect good luck in an important matter for you. Does your dream include a chicken that has bred a lot of fluffy yellowmouths? Rejoice at the good sign, because it says that the support of an influential person will appear in your life.

I dreamed of a hen with chickens: basic interpretations

In most books, such a dream is considered a good sign. A mother hen with a brood of babies symbolizes harmony in the house, family comfort, complete mutual understanding with relatives. On the other hand, the same dream may indicate that not everything is safe in your work environment, the more noisy the chickens behave in their sleep, the stronger the squabbles between colleagues. For the dreamer, this is advice: focus on your work affairs, do not get into intrigues, let your zeal and diligence speak for you, otherwise there is a high probability of losing a warm place.

If in a dream dead or sick chickens have accumulated around a laying hen, this is a signal that in real life you are losing profit, you are on the verge of a complete failure of the business, you do not see the right path for you. Let this dream be an occasion to look around more closely in search of valuable opportunities.

What to do if you dreamed of dead chickens

Of course, this plot is not the most pleasant, but there is no particular tragedy in it either.