Definition: what is sexsomnia?

"Sexsomnia is a parasomnia, a set of abnormal motor behaviors during deep sleep that is characterized by maladaptive sexual behaviors" defines Dr. José Haba-Rubio, neurologist and specialist in sleep disorders. THE night terrors and sleepwalking are also parasomnias during deep sleep. The prevalence of sexsomnia is not known (the studies on the subject relate to small series of patients) but it is a very rare parasomnia, which seems to affect more men than women. "We do not know, however, if it is really more common in men or less reported by women." emphasizes Dr. Haba-Rubio.

What causes sexsomnia?

"It would be a cerebral mechanism during deep slow sleepspecifically dissociated arousal, i.e. part of the brain wakes up while most of the brain remains in deep sleep" informs Dr. Haba-Rubio. It exists a strong genetic component for this type of deep slow sleep parasomnias.

What are the symptoms of sexsomnia?

Sexsomnia is sometimes used as a defense by sex offenders

The person who suffers from sexsomnia has no or very vague recollection of his behavior. It is the person who sleeps towards her who is the witness of this inappropriate sexual behavior. Sexual parasomnia is manifested by variable symptoms depending on the individual: masturbation, ejaculation, movements of the pelvis imitating the sexual act, moaning, full intercourse with the partner. There is also a risk of violent behavior and sexual assault during sleep. "Sexsomnia can pose a medico-legal problem" says our specialist who emphasizes the importance of protecting others if you suffer from sexsomnia. Note that sexsomnia is sometimes used as a defense by genuine sex offenders "just like the sleepwalking for some as an alibi for crimes like an assassination" says Dr. Haba-Rabio. "This is where the specialist can be called to make an expertise, he will have to analyze all the aspects: history of sexsomnia or other parasomnias, the existence of contributing factors, the behavior during the episode or after, once awake (because at that time he should recover normal consciousness and stop the maladaptive behavior), rely on sleep recordings…but c I am sure that these are often complex cases" he points out.

Who to consult?

It is recommended see a doctor when a loved one reports inappropriate sexual behavior that took place during sleep. "Ideally, you should go in a sleep center" informs Dr. Haba-Rubio.

How is sexsomnia diagnosed?

The diagnosis of sexsomnia is made with an interrogation and a sleep recording (polysomnography) to see the structure of sleep. The sleep recording also looks for any sleep disturbances (sleep apnea syndrome, restless legs syndrome) which are factors favoring access to sexsomnia because they can cause dissociated awakenings.

What is the treatment for sexsomnia?

The first treatment consists in acting on the hygiene of life. "The objective is avoid anything that causes dissociated awakenings and who what increases slow-wave sleep, for example an irregular sleep pattern or sleep deprivation". The sleeping environment should be as quiet as possible. The environment must also be secure to protect the sexsomniac and his relatives by ensuring to close doors and shutters. If that’s not enough, pharmacological treatments can be prescribed to reduce or even eliminate this type of behavior by avoiding dissociated awakening during deep slow sleep. "The most commonly used drug is clonazepam which is part of the benzodiazepine family" informs Dr. José Haba-Rubio. This medication is also prescribed for other slow-wave sleep parasomnias such as sleepwalking.

Thanks to Dr. José Haba-Rubio, neurologist and specialist in sleep disorders, Co-medical director of the sleep center of Florimont (Switzerland).

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