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Abnormal sex acts tied to array of sleep disorders

June 1, 2007
Courtesy American Academy of Sleep Medicine
and World Science staff

Ab­nor­mal sex­u­al be­hav­iors dur­ing sleep may be more com­mon than was once thought, re­search­ers say. A new re­port pro­vides what the au­thors say is the first sys­tem­at­ic re­view and clas­sifica­t­ion of sleep-related dis­or­ders as­so­ci­at­ed with ab­nor­mal sex­u­al ac­ti­vi­ties and ex­pe­ri­ences.

Sleep-related dis­or­ders as­so­cia­ted with ab­nor­mal sex­u­al be­hav­iors & ex­pe­ri­ences
List com­piled by Carlos Schenck, M.D. et al.

I. Para­som­nias with ab­nor­mal sleep-related sex­u­al be­hav­iors (sex­u­al vo­cal­iza­tions, mas­tur­ba­tion, fondling an­oth­er per­son, sex­u­al in­ter­course with or with­out or­gasm, ag­gres­sive sex­u­al be­hav­iors):

A. Con­fu­sion­al arous­als (with or with­out ob­struc­tive sleep ap­ne­a)
B. Sleep­walk­ing
C. REM sleep be­hav­ior dis­or­der

II. Sleep-related sex­u­al seizures (sex­u­al vo­cal­iza­tions; li­bid­i­nal hy­per­a­rous­al; gen­i­tal arous­al; ic­tal [con­vul­sive] or­gasm; sex­u­al au­toma­tisms [re­flexes]; ag­gres­sive sex­u­al be­hav­iors)

III. Sleep dis­or­ders with ab­nor­mal sex­u­al be­hav­iors dur­ing wake­ful­ness and wake-sleep tran­si­tions:

A. Kleine-Levin syn­drome, a rare dis­or­der char­ac­ter­ized by re­cur­rent and un­u­su­al­ly long episodes of hy­per­som­nia (in­a­bil­i­ty to stay awake): Broad range of hypersex­u­al and de­vi­ant sex­u­al arous­al and be­hav­iors
B. Se­vere chron­ic in­som­ni­a: In­creased li­bi­do, gen­i­tal arous­al, com­pul­sive sex­u­al be­hav­iors
C. Rest­less legs syn­drome: Mas­tur­ba­tion, rhyth­mic pelvic/coital-like move­ments

IV. Spe­cial Clin­i­cal Con­sid­er­a­tions:

A. Nar­co­lep­sy: Com­pel­ling sex­u­al hal­lu­ci­na­tions in the sleep-wake in­ter­me­di­ate (hyp­no­pom­pic) stage; REM-onset dream at­tacks, cat­a­plec­tic or­gasm
B. Sleep ex­ac­er­ba­tion of per­sist­ent sex­u­al arous­al syn­drome: Genital-sensory sex­u­al arous­al with­out in­creased li­bid­i­nal arous­al; sex­u­al be­hav­iors
C. Sleep-related pain­ful erec­tions and in­creased sex­u­al ac­tiv­i­ty: In­creased sex­u­al be­hav­iors – mas­tur­ba­tion and in­ter­course
D. Sleep-related dis­so­ci­a­tive dis­or­ders: Pel­vic move­ments and oth­er sex­u­alized be­hav­iors, at­tempted reen­act­ments of past sex­u­al/physical abuse sce­nar­i­os
E. Noc­tur­nal psy­chot­ic dis­or­ders: Sex­u­al delusions/hal­lu­ci­na­tions af­ter awak­en­ings
F. Mis­cel­la­ne­ous sleep and sex as­so­ci­a­tion: Mas­tur­ba­tion, sex­u­al in­ter­course, sex­u­al hal­lu­ci­na­tions in the sleep-wake in­ter­me­di­ate (hyp­no­pom­pic) stage asso­ci­ated with sleep pa­ral­y­sis

“It seems that more and more re­ports are sur­fac­ing of ab­nor­mal sex­u­al be­hav­iors emerg­ing dur­ing sleep,” said Car­los Schenck, a psy­chi­a­trist at the Min­ne­so­ta Re­gion­al Sleep Dis­or­ders Cen­ter in Min­ne­ap­o­lis and the lead au­thor of the pa­per. The re­search ap­pears in the June 1 is­sue of the re­search jour­nal Sleep. 

Sci­en­tists call these be­hav­iors, which emerge dur­ing slum­ber, sleep­sex or sex­som­nia.

“While peo­ple may think this type of be­hav­ior is hu­mor­ous, in real­ity it can be dis­turb­ing, an­noy­ing, em­bar­rass­ing and a po­ten­tially se­ri­ous prob­lem for some in­di­vid­u­als and cou­ples,” Schenk said.

“De­spite their aware­ness of the con­di­tion, many suf­fer­ers of­ten de­lay seek­ing help, ei­ther be­cause they don’t know that it’s a med­i­cal dis­or­der or for fear that oth­ers will in­stead judge it as will­ful be­hav­ior,” he con­tin­ued.

“This pa­per high­lights the ex­pand­ing set of sleep dis­or­ders and oth­er noc­tur­nal dis­or­ders known to be as­so­ci­at­ed with ab­nor­mal sex­u­al be­hav­iors and ex­pe­ri­ences, or the mis­per­cep­tion of sex­u­al events. The le­gal con­se­quenc­es are al­so de­scribed and dis­cussed.”

Schenck and his col­leagues stud­ied past lit­er­a­ture on sex­u­al ac­ti­vity dur­ing sleep, and sex­u­al be­hav­iors as­so­ci­at­ed with sleep dis­or­ders. 

Find­ings of sleep-related sex­u­al be­hav­iors range from mas­turba­t­ion to in­ter­course, to re-enactments of past sex­u­al or phys­i­cal abuse, they wrote.

Those who think they might have a sleep dis­or­der of any kind should dis­cuss their prob­lem with their pri­ma­ry care doc­tor, who will is­sue a re­fer­ral to a sleep spe­cial­ist, Schenk and col­leagues said.

* * *

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Abnormal sexual behaviors during sleep may be more common than was once thought, researchers say. A new report provides what the authors say is the first systematic review and classification of sleep-related disorders associated with abnormal sexual activities and experiences. “It seems that more and more reports are surfacing of abnormal sexual behaviors emerging during sleep,” said Carlos Schenck, psychiatrist at the Minnesota Regional Sleep Disorders Center in Minneapolis and the lead author of the paper in the June 1 issue of the research journal Sleep. Scientists call these behaviors, which emerge during slumber, “sleepsex” or “sexsomnia.” “While people may think this type of behavior is humorous, in reality it can be disturbing, annoying, embarrassing and a potentially serious problem for some individuals and couples,” Schenk said. “Despite their awareness of the condition, many sufferers often delay seeking help, either because they don’t know that it’s a medical disorder or for fear that others will instead judge it as willful behavior. This paper highlights the expanding set of sleep disorders and other nocturnal disorders known to be associated with abnormal sexual behaviors and experiences, or the misperception of sexual events. The legal consequences are also described and discussed.” Schenck and his colleagues studied past literature on sexual activity during sleep or sexual behaviors associated with sleep disorders. Findings of sleep-related sexual behaviors range from masturbation to intercourse, to re-enactments of past sexual or physical abuse, they wrote. Those who think they might have a sleep disorder of any kind should discuss their problem with their primary care doctor, who will issue a referral to a sleep specialist, Schenk and colleagues said.