Masturbating in my sleep

Question

I’m male, age 26. My partner tells me that quite frequently she wakes up to see me asleep but masturbatiing or simply touching my genitals in my sleep.

I have no recollection of this, nor of any erotic dreams that might accompany this phenomenon.

She is very upset and disturbed by all of this.

Answer

David writes:

She needs to be realise that for many men it is normal to touch or grasp their genitals in their sleep.

Indeed, virtually all men get erections during the night. And because the hand is so near the penis, it would be surprising if the fingers didn’t sometimes grasp the organ.

So there is nothing wrong with you – and you do not have a ‘problem’.

Christine adds:

Your partner might be happier if she understood that the vast majority of men have a very loving relationship with their penises.

It sounds as if she thinks this is abnormal in some way – and maybe also resents it because she has some idea that her body should provide you with all the sexual comfort and relief that you need.

I hope she does provide a lot, but she can’t be on duty 24 hours a day!

Many men in very happy relationships also masturbate from time to time. As for when they are asleep, well, this just happens.

Plenty of women caress themselves in their sleep too. And masturbate when they’re awake as well. This is nothing to get upset about. It’s just normal behaviour.

I do hope our answer will help you to reassure her.

Yours sincerely

Dr David Delvin, GP, and Christine Webber, sex and relationships expert

Last updated 08.05.2012

What Is Sexsomnia?

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.

I Have Sexsomnia—And Can’t Be Cured

It happened in the dark. It always did. Around three years ago, I started having dreams about a strange woman. You could say we had a physical connection. Any time this woman and I were in the same place, things instantly got hot and heavy, without words, or so much as a glance, exchanged. But these weren’t just ordinary dreams: these dreams seeped into reality. I soon realized this strange woman was actually my girlfriend, lying next to me in bed.

The feeling is that of a bizarre wet dream that blends with reality just enough to make it real, but not enough to abandon the surreal—like something out of a Murakami novel. My girlfriend, to whom I’m now married, began affectionately referring to my nocturnal advances as the “Midnight Sex Pest,” even though it typically happened around 1 AM. But these encounters also go by another name gaining in popularity: sexsomnia.

Early in his career, Dr. Colin Shapiro, PhD, was working as a researcher at a sleep laboratory in South Africa. It was then, around 1984, when he first stumbled across the woman that would lead him to coin the term “sexsomnia.”

“I did an interview with a female reporter. And at the end of the interview she asked me if she could discuss something personal,” Shapiro said.

This reporter opened up to Shapiro, recounting nights where her husband woke to find her masturbating in her sleep. The couple, at the time, had recently married. Her unrecognized sexsomnia symptoms put a strain on their relationship, leading to feelings of inadequacy for the husband and confusion for the wife.

“I have to say, when I heard this I didn’t understand,” Shapiro told me. “It took seeing a few cases to realize that there was a pattern. So, eventually, when you start asking the right questions, you get an answer.”

Over the next twelve years, Shapiro collected other sexsomnia cases and wrote an article about them—the first of its kind—published in 1996 and called “Sexual behaviour in sleep—a newly described parasomnia.” Parasomnia, both then and now, is a broad categorization of abnormal behavior like sleepwalking, night terrors and paralysis, and most recently, sexsomnia. In 2003, Shapiro and his colleagues published an evolution of that initial report under the heading “Sexsomnia—A new parasomnia?” that presented and described the 11 cases he’d since collected in more detail.

One of the more eye-opening pieces of sexsomnia research, however, came out of an effort coordinated between the Minnesota Regional Sleep Disorders Center, the University of Minnesota, and Stanford University. Published in 2007 by Dr. Carlos Schenck, MD, Dr. Mark Mahowald, MD, and Dr. Isabelle Arnulf, MD, PhD, “Sleep and Sex: What Can Go Wrong?” shed more light on how sexsomnia is experienced differently from person to person. The study showed that sexsomnia in women typically manifests itself as self-stimulation, while men tend to incorporate the person lying next to them into their sexual behavior.

The latest study—another Shapiro was involved with, released in 2010—found that almost eight percent of patients at a sleep disorder center in Toronto had reported sexsomnia. The same study also revealed the condition is more common in men than women.

Despite Shapiro’s history with the condition, sexsomnia itself is still in its clinical infancy. It was only officially published as a recognized condition in the International Classification of Sleep Disorders III (ICSD-3) in May of 2014. There’s still much we don’t know about it. We do know, however, that the full spectrum of sexsomniac behavior includes moaning, shouting profanity, masturbation, inappropriately touching the person lying next to you, pelvic thrusting, or even intercourse.

It became a pleasant surprise for us, if not a source of humor. But not all sexsomnia is that innocent.

In my case, it involved me putting the moves, with some heavy petting, on my wife. Most of the time she responded positively, albeit half-asleep, to my unconscious come-ons. There was something weirdly heightened about the experience, as though we were both different people somehow. It became a pleasant surprise for us, if not a source of humor. But not all sexsomnia is that innocent.

A quick Google search on the subject led to enough alleged cases of rape and sexual assault for me to realize I had to see a doctor. You see, along with my sexsomniac symptoms, I also have a long history of sleepwalking and night terrors, which have produced their fair share of stories: During the latest episode, I flipped over our bedroom dresser that doubles as a TV stand in my sleep. As if I didn’t need more to worry about, I became increasingly fearful about what else I might do in the Land of Nod—sexually or otherwise.

My general practitioner referred me to the Weill Center for Sleep Medicine at Cornell, located on Manhattan’s Upper East Side. I met with co-director Dr. Arthur J. Spielman, PhD, who had a field day with my initial consultation. There was little doubt he’d order me an overnight sleep study. It was just a matter of which conditions to investigate.

Parasomnias, including sexsomnia, can be triggered by any number of things. What brings on this behavior in people like me is an abrupt awakening from a deep sleep. In some cases it could be an external factor, something as simple as a noise in the middle of the night, that rouses you. Other times, it could be a medical condition like sleep apnea where snorers are partially waken after they’ve stopped breathing—another type of disturbance that can fragment sleep and, the thinking goes, trigger sexsomnia. Alcohol, another major sleep disrupter, plays a key role as well.

Given the variety of parasomnias I reported to Dr. Spielman, and the fact that I sometimes snore, my sleep study order included observation for sleep apnea and non-REM parasomnias, which includes sexsomnia, along with the classic sleepwalking and night terror behaviors. For good measure, Dr. Spielman also threw in nocturnal seizures (a subset of epilepsy) and REM-behavior disorder, involving punching and kicking in your sleep.

By the time I got fully wired up by my sleep technician on the night of the study, I was wearing 33 pieces of technology, monitoring every relevant behavior possible. This colorful assortment of instruments relied heavily on electroencephalography (EEG), measuring everything from my brain’s activity to what the rest of my body was up to during sleep.

I had 15 EEG electrodes on my head to monitor my brain waves, ultimately showing what stage of sleep I was in. Normally there are nine, but in my case, the tech applied an extra six EEG electrodes to check for nocturnal seizures. Each of these electrodes on my head was applied with a conductive paste, smeared between my hair and the electrode, to help facilitate the electrical reading. The tech then applied one EEG electrode by each eye to measure optical movements and help gauge REM sleep, and three on my jaw to monitor teeth grinding. Two EEG electrodes were placed on each of my arms and legs to measure for muscle tone and limb movement associated with REM behavior disorder.

There were also two electrocardiogram (EKG) electrodes applied to my torso, one on my rib cage and the other on my upper chest, to get a reading on my heart rate. Two respiratory bands looped around my chest to determine how much my chest was rising and falling. One thermistor, a set of plastic tubing perched in front of my mouth, measured my breathing and circadian rhythms.

We were almost done. The most annoying part, however, was yet to come.

Wired for sleep. Photo courtesy the author

That would be the p-flow cannula, another set of plastic tubing, this time inserted into my nostrils to measure snoring. It tickled at first, but became easily the most aggravating part of the whole prep process. The finishing touch was the finger pulse oximeter, attached to my right index finger to measure the oxygen levels in my blood. Even with all of these pieces of hardware clinging to my body, I felt oddly comfortable after ten minutes or so. Then I was ready to sleep.

Because parasomnias like sexsomnia are triggered by an abrupt awakening from deep sleep, sleep deprivation in the days prior to an event is typically a factor in these sorts of episodes. I agreed to get two hours less sleep than I normally would the night before my study. The goal was to make the conditions as similar as possible to the nights when my episodes occur. So with that in mind, I did what I normally do during my bedtime routine: watched some TV and read afterwards until my eyes got heavy.

Falling asleep was much easier than I thought it would be, but I stirred throughout the night. At one point I woke up agitated, thrashing in bed. I couldn’t understand what I was doing. But then I figured it out: I was trying to rip the pulse oximeter off my index finger. I didn’t know why, but I was doing everything I could to tear the damn thing off.

Once I fully woke up and calmed down, I alerted the technician through the intercom system. He came in and tried to reattach the oximeter to no avail. Apparently, I broke it. So he reattached a new one. These types of episodes are uncommon under the clinical observation of a sleep study, and I felt a strange sense of pride as I fell back asleep.

Later, I learned that I may have had a little help. While it’s still unclear if this is practiced at the Weill Cornell Center for Sleep Medicine, Dr. Andrew Westwood, MD, a neurologist at the Columbia University Medical Center, shared a trade secret.

“We look to see if they’re in a deep sleep. And then any kind of noises through the intercom can be used to try to provoke one of these episodes,” Westwood told me.

I was unable to confirm if this was a regular practice of Dr. Spielman, who wished not to be directly quoted during my study and follow-up, or his staff. But it might explain why I felt so groggy the next morning as I washed my hair for the third time, trying to remove the last bits of conductive paste. I was glad I did the overnight study, but I couldn’t imagine doing it again any time soon.

“Usually, people come to the sleep clinic because of someone else,” said Westwood. “It’s usually not their own motivation that gets them to go, it’s when other people are concerned about them, or they’ve injured themselves and they’re starting to worry that there could be something seriously wrong.”

But even in the city that never sleeps, these studies are becoming more common. For his part, Westwood said they’re becoming more popular.

“You see now and again, people want to come in to have a sleep study not because anything in particular is wrong, but just to make sure everything’s okay,” he said.

People want to come in to have a sleep study not because anything in particular is wrong, but just to make sure everything’s okay.

A week after my overnight study, I had my follow-up with Dr. Spielman to go over the findings. There was good news: With what was observed, he was able to rule out sleep apnea, nocturnal seizures, and REM-behavior disorder.

The study showed I had large amounts of slow wave non-REM 3 sleep, or N3. During this slow wave N3 sleep, I had several abrupt awakenings paired with a rapid heart rate—the signature of non-REM parasomnia. Dr. Spielman was thus able to confirm that my sexsomnia, sleepwalking, and night terrors—even my attempt to rip off the pulse oximeter—could be linked to these patterns.

As Dr. Spielman closed out my file in his computer system, he entered in “sexsomnia” as one of the diagnoses. It’s something he might not have been able to do four months ago, but now can, thanks in part to the recently published version of the ICSD-3, revised to include the condition. And while my diagnosis of sexsomnia was straightforward, what actually happens in the brain during an episode of sexsomnia is anything but.

“In sleep, the pre-frontal cortex is essentially offline,” explained Dr. Michel Cramer Bornemann, MD, lead investigator at Sleep Forensics Associates, a leading group of medical and legal experts on parasomnias.

“The pre-frontal cortex is the part of the brain that legislates motivation, executive function and goal-driven behaviors,” he told me. “Deep seated in the brain you have central pattern generators. And these central pattern generators handle behaviors that are necessary for survival.”

These survival behaviors, regulated with programmed loops of electric current, include primal urges like our fight or flight response, eating, and of course sexual activity, said Bornemann, who added that the central pattern generators of those urges are located “very close” to parts of the brain that control sleep and waking life.

“So if you have anything that fragments sleep,” like a noise in the night or a partner nudging you, “it takes just a little electrical switching error from the sleep/wake generating centers to trigger a central pattern generator,” he explained. “And one of the results could be sexualized behavior.”

In other words, when a switching error like this occurs, your pre-frontal cortex isn’t on the job to make sure you don’t do anything in your sleep you might regret, or otherwise would never do. This also helps explain people who eat or become violent during their sleepwalking episodes.

The neurological mechanics of sexsomnia, it seems, can be explained. The treatment, however, is still hard to decipher.

Photo courtesy the author

The treatment plan Dr. Spielman and I agreed on was a trial of Klonopin (generic Clonazepam), a benzodiazepine anti-anxiety sedative. Klonopin is known to be effective in treating non-REM parasomnias like sexsomnia over 70 percent of the time. What’s unknown is how exactly.

Klonopin essentially functions by activating gamma amino butyric acid (GABA)—your brain’s neurotransmitter in charge of calming you down. The drug locks onto the GABA-A receptor site of the brain, increasing sedation and hypnosis. The theory is that with a higher level of sedation you’re less likely to be disturbed by things that go bump in the night, and less likely to have an abrupt awakening that triggers a sexsomnia episode.

Whether Klonopin actually alters the pathways in the brain where these late night switching errors occur has yet to be seen. But even if the neurological specifics aren’t fully clear, doctors have seen positive results.

“Needless to say, I think we accept that Klonopin is pretty effective across the board,” Bornemann said.

According to him, Klonopin is currently the most widely prescribed treatment for sexsomnia and other non-REM parasomnias. And although the way we medicate sexsomnia is so seemingly single-minded, the way the condition affects different relationships is quite varied.

“Whether it’s severe or mild may not relate as much to your behavior,” said Dr. Bornemann, “but to how your partner reacts to it. Let’s say it happens once a month. For someone who’s sensitive to it, that once a month could be really problematic.”

I’m fortunate in the sense that my sexsomnia episodes are mild and non-threatening. My wife understands my condition, and accepts it. But then, there is the other end of the spectrum. As you might imagine, sexsomnia can lead to relationship problems, including divorce. Even worse, it can lead to—or at least be blamed for—incidents of sexual assault.

In neuroscience, we recognize that consciousness is on a spectrum. The legal community doesn’t really account for that.

Along with medication, lifestyle adjustments can also help prevent such unfortunate events. Managing one’s sleep deprivation and stress, and likewise who one chooses to share a bed with, are at the top of the list.

Even though the condition is completely unrelated to pedophilia, I’m told parents with sexsomnia would be well advised to forgo sharing beds with their kids. (I, for one, do not have children.) Tragically, some people discover this advice too late.

In the recent case of an Ottawa man accused of molesting his daughter, the defendant testified that he had a history of sexsomnia, but didn’t seek a formal diagnosis until after the alleged episode that brought about criminal charges. Every case is different in its complexity, but this one had two sleep experts—one of them being Dr. Shapiro—giving conflicting testimonies on the role alcohol plays as a trigger. A verdict is expected on November 12.

According to Dr. Bornemann, many of the criminal cases he participates in with claims of alleged sexsomnia involve parents and their children. He and his colleagues at Sleep Forensics Associates were the first group to offer sleep disorder expertise in legal cases. Even before their group was formed, Bornemann, Dr. Carlos Schenck, MD, and Dr. Mark Mahowald, MD were all sought out by the legal and law enforcement community in criminal allegations that potentially involved parasomnia.

“An attorney might go to the legal assistant and say, ‘Find anything you can in medical literature related to violence and sleep.’ And inevitably, it always pointed in our direction,” Bornemann said.

As the lead investigator at Sleep Forensics Associates, Bornemann has investigated over 300 sleep-related criminal cases, 40 percent of which are associated with sexual assault. If you account for the cases involving both Ambien side effects and sexual assault, that percentage creeps higher.

“Now that’s not to say that I’m always working with the defense. It’s not uncommon for the prosecution to hire me because they’re concerned that the opposing counsel is attempting to use a ‘Twinkie defense,'” Bornemann said, referring to a label for flimsy legal claims coined by reporters covering the trial of Dan White, who was tried for murdering Harvey Milk and San Francisco Mayor George Moscone in 1979. (White’s lawyers argued that his consumption of Twinkies was a symptom of his depression and “diminished capacity” at the time of the killings. White was convicted of voluntary manslaughter, instead of first-degree murder, and spent five years in prison before being paroled in 1985.)

In his work, Bornemann does everything from looking at past medical history and screening for other sleep conditions, to examining police and eyewitness reports. He even goes so far as to reconstruct the events in 3D video.

“So based upon that we can start to construct the behavioral processes and the complexity of the behavior,” he explained. “Was it a several step process? This is particularly important. Then we can begin to piece it together.”

From there, Bornemann assesses the sleep forensics and whether or not it tracks with the signature of sexsomnia. After thorough investigation and analysis, he recommends to the courtroom whether sexsomnia behavior was “very likely, likely or not likely.” The jury is ultimately left to make the decision.

The biggest obstacles to his work in these types of cases, Bornemann told me, are interlinked. The court’s skepticism of sexsomnia is part and parcel of pervading beliefs that oppose neurological science. With any legal case, there are two important components for a conviction to be made: mens rea, Latin legalese for motivation or intent, demonstrated by consciousness; and actus rea, which deals with the physical actions that took place.

A legal defense of sexsomnia is based on the assumption that the perpetrator could not have motivation or intent at the time of the crime due to a lack of consciousness. It’s this crucial point where law and science differ.

“Simply put, the legal community sees consciousness as a dichotomy. Either you’re fully conscious or you’re not conscious,” Bornemann said. “It’s the same thing with sleep. Either you’re fully asleep or you’re awake. It’s one or the other. But in neuroscience, we recognize that consciousness is on a spectrum. And the legal community doesn’t really account for that.”

One thing that has furthered sexsomnia’s case in the courtroom is its recent addition in the ICSD-3 as an official condition, a revision that, as chair of the parasomnias section of the ICSD-3, Bornemann was able to make himself. Before this classification, the sexsomnia defense could get thrown out entirely if the judge deemed it “novel.”

This new development was not just an advancement in how sexsomnia episodes are viewed in the courtroom. Moving forward, it will help promote research and awareness. With the advent of electronic medical records, being able to code for a relatively uncharted condition like sexsomnia goes a long way in collecting data and developing a broader understanding of the condition.

Still, even with this hopeful step forward, there’s much progress to be made. For my part, I can report only one night terror episode since my overnight study. No sexsomnia. I plan to start my Klonopin trial soon. Given my hesitancy to use prescription medication on a long-term basis, I’m hoping it’s just that—a trial. But the medication itself is only treatment, not a cure. Regardless of what we learn about sexsomnia in the future, when I turn off the lights at night, I won’t expect to see everything clearly in the darkness.

@KlinckStephen

Dear Dr. Kate,

*Sometimes I wake up to my boyfriend masturbating in his sleep but when I confront him he has no idea—and totally denies it. Is it really possible to masturbate in your sleep?*Definitely. Masturbating during sleep is a form of sleep-sex, a catchall term for anything from touching to actual intercourse, all while unconscious. It’s considered a form of sleepwalking, or a “sleep arousal disorder.” And it’s very likely that your boyfriend has no awareness that he’s masturbating (until he finds the evidence in the morning). Usually, this behavior isn’t harmful to him or to you—unless he’s putting any unwanted moves on you while he’s out cold. Certain factors can precipitate sleep disorders, like alcohol, fatigue, stress and drug use. If his nighttime masturbation bothers him or you, he should avoid these triggers, and can try masturbating before he goes to bed, to see if that reduces the chance of nighttime activity. He can also consider counseling or medication therapy. But if he’s not troubled, then you should try not to worry, too (as long as he’s not moaning so loud that he consistently wakes you up).

Have any of you readers caught your guy doing this? What about seen any other sleep-sex symptoms? Have you done it yourself?

Have a sex health question of your own? Ask Dr. Kate here, and keep checking back to see if she’s answered it.

Plus, other readers who have had similar encounters

  • True Dating Confession: “I Have Orgasms in My Sleep”

  • True Dating Confession: “I’m a Sexomniac and Have Sex While Sleeping”

  • A Guy’s Perspective: “What I Think About When I Masturbate”

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Everything you need to know about wet dreams

There are many myths about wet dreams, which can make them confusing or cause anxiety if a person does not know what to expect.

1. Wet dreams do not reduce sperm count

Some people believe that wet dreams will reduce a man’s sperm count. However, wet dreams are a way for the testicles to remove older sperm and help with the natural formation of new, healthy sperm in the body.

2. Women can have wet dreams

Many people associate wet dreams with men or, more specifically, adolescent boys, but women can also have wet dreams.

A female wet dream may result in orgasm as well as additional vaginal secretions from arousal.

Men may be more prone to wet dreams because they naturally produce several erections a night.

3. Wet dreams do not reduce a person’s immunity

Some people believe that wet dreams can cause a person to have lower immunity to things such as a cold or infection. This is a myth and has no basis in fact.

However, wet dreams can help reduce excess sperm in the testicles, which is a healthy function for a male’s reproductive system.

4. Wet dreams only happen during puberty

Share on PinterestWet dreams are more common in puberty due to hormonal changes, but they can also happen during adulthood.

While wet dreams are most common during puberty, they can also happen during adulthood.

Wet dreams tend to occur more often in puberty due to hormonal changes. Hormone levels in adults are much more consistent, making it less likely that they will have a wet dream.

Wet dreams may also be more frequent during adolescence because younger boys may not frequently be masturbating or having sex, so the older sperm is released during sleep instead.

5. Wet dreams are not a sign of illness

It is a myth that wet dreams are a result of an underlying illness or medical condition. In fact, the opposite is true.

Wet dreams are a normal occurrence and may be a sign of healthy sexual functioning.

6. Masturbation probably cannot prevent wet dreams

While masturbation may reduce the number of wet dreams a person experiences, it does not guarantee a person will never experience them.

Evidence linking masturbation and wet dreams is lacking, but a person can experiment to see if it helps in their situation.

Try masturbating before bed for a week or more, followed by the same length of time without masturbating, to see if there is a difference in the frequency of wet dreams.

7. Wet dreams will not shrink a penis

Some people believe that wet dreams reduce the size of the person’s penis. However, there is no scientific evidence for this.

There are no illnesses, conditions, or natural occurrences that will cause the male reproductive organ to shrink.

8. Some people never have wet dreams

Wet dreams are a natural occurrence for both men and women. They cannot be controlled or stopped, and a person should not feel ashamed to have them.

How often wet dreams occur varies between individuals. People may have:

  • no wet dreams ever
  • only a few, sporadic wet dreams during adolescence
  • several, frequent wet dreams throughout adolescence but none in adulthood
  • regular or sporadic wet dreams throughout their life

9. Wet dreams are not always erotic dreams

Wet dreams are often associated with sexual or erotic dreams. However, this is not always the case.

A person can have a wet dream without dreaming about sexual activity and may become aroused due to stimulation from friction with the bedding or other factors.

10. Sleeping on the stomach may induce a wet dream

One study suggests that sleeping on the stomach makes it more likely the person will experience a sexual dream.

The evidence is limited, however, and more studies need to be done to determine if sleep position plays any role in whether a person experiences wet dreams.

Introduction

Parasomnias are abnormal sensory or motor phenomena that occur during sleep, while falling asleep, and upon waking.1 The International Classification of Sleep Disorders groups parasomnias as REM sleep parasomnias (REM sleep behaviour disorder, nightmares, and sleep paralysis), non-REM sleep parasomnias (sleepwalking, confusional arousals, and night terrors), and a third group of ‘other parasomnias’ that includes, for example, enuresis, sleep-related eating disorder, and sleep-related groaning.1

Recent studies have described sexsomnia or sleep sex, a new parasomnia in which specific motor activation produces inappropriate and involuntary sexual behaviour.2–7 After falling asleep, patients with sexsomnia engage or attempt to engage in sexual intercourse or sexual behaviour in inappropriate and inhabitual ways. They are not conscious of this behaviour and cannot recall what happened the next day. Behaviour may include masturbation, attempting sexual activity with a partner sleeping in the same bed, or even attempting sex with a non-partner with whom the patient does not share a bed or a room. Sexsomnia may lead to marital repercussions, or even legal repercussions in very serious cases or those involving minor children.2,3 Prevalence of the syndrome is unknown since it is rare and probably underdiagnosed due to patients’ and doctors’ lack of awareness and reluctance to describe it.7 Medical literature on sexsomnia is very scarce. Fewer than 50 cases had been described prior to October 2012,2–6 and clinical symptoms may be mistaken for those of other entities such as epilepsy. Here, we present 4 cases studied in our sleep disorders unit that may contribute to our understanding of this parasomnia.

Patients, methods, and results

The 4 cases we describe below were identified in the multidisciplinary sleep disorders unit in Hospital Clínic, Barcelona, between November 2007 and March 2012. None of these 4 patients had a history of psychiatric or sexual disorders. In these 4 cases, researchers completed a detailed medical history and a nocturnal polysomnography with synchronised audio-visual recording.

Case 1

The first case was a 38-year-old man, accompanied by his wife, who consulted due to a 7-year history of abnormal behaviour during sleep. He had no family or personal history of relevant medical or surgical episodes except for nasal septoplasty performed 5 years earlier. The patient had no history of traumatic sexual experiences. He reported isolated incidents of sleep talking as a child. The patient presented no other abnormal sleep behaviours, such as confusional arousal, sleepwalking, night terrors, or other types of parasomnia.

He had been in a stable relationship for 17 years and the couple had a daughter. They engaged in conventional and satisfactory sexual intercourse with a frequency of 2-3 times weekly. The patient’s wife reported that in the past 7 years, her husband would sleep for 2-3hours at night before presenting abrupt 10- to 30-minute episodes in which he would attempt to achieve coitus. He experienced such an episode approximately once a week. In contrast to his behaviour when awake, he used vigorous movements and lewd language while attempting to persuade and penetrate his partner. During one episode, he immobilised her by placing his arm around her neck like a yoke. The patient’s wife reported that the patient’s penis was erect during every episode. Although he attempted penetration, she never permitted it because she believed that the episodes were not normal sexual behaviour and that her husband’s actions were involuntary. The patient had awakened in a confused state during some of these episodes and was surprised by his wife’s account of his behaviour. The patient and his partner were unable to link these episodes to any trigger factors such as stress or prior sexual stimuli. He never recalled what had happened the following morning. Likewise, he could not recall having dreamed on the nights on which this behaviour occurred. The patient did not typically remember his dreams, but he did occasionally experience erotic dreams accompanied by spontaneous ejaculation (‘wet dream’). However, these dreams never coincided with the episodes he described in the consultation.

In addition to episodes of sexsomnia, he had a 20-year history of snoring, apnoeic episodes observed by his wife, and excessive daytime drowsiness while eating, reading, driving, and helping his daughter with her homework. Due to the possibility of obstructive sleep apnoea he had undergone nasal septoplasty 5 years before, without having had a prior polysomnography. This procedure did not improve snoring or drowsiness or modify his sexual behaviour during sleep. The patient presented an Epworth Sleepiness Scale score of 14 and a body mass index of 25.

Our hospital performed a daytime EEG, which yielded normal results, as well as nocturnal polysomnography with synchronised audio-visual recording. The latter was indicative of obstructive apnoea episodes associated with oxyhaemoglobin desaturation and micro-arousals causing broken sleep. The global apnoea/hypopnoea index for obstructive episodes was 13/hour, reaching 40/hour when the patient was supine. The study detected no other abnormalities, such as epileptiform activity or abnormal sleep behaviours such as those described during episodes of sexsomnia or other types of parasomnia. The patient refused treatment for sleep apnoea as well as clonazepam treatment for sexsomnia.

Case 2

Case 2 was a 41-year-old woman who made an appointment due to a 1-year history of atypical sexual behaviour. She had presented childhood sleepwalking until the age of 14. The patient had a 1-year history of metrorrhagia of unknown origin which caused iron deficiency anaemia; she was periodically treated with oral iron supplements. The patient had no relevant sexual history.

Her husband explained that in the past year, she had been masturbating about 3 times per week without seeking to involve him although they slept in the same bed. She did not remember these episodes upon waking up the next morning. They occurred around 5.00 and sometimes resulted in orgasm, to the surprise of her husband, who never participated in his wife’s episodes. When her husband described these episodes, she felt ashamed and stated that she was unable to remember them. She reported that they had regular, satisfactory, and pleasant sexual intercourse, with no sexual problems when awake.

In addition, her husband also indicated that she displayed repetitive and periodic non-sexual limb movements while sleeping, especially when in the lateral decubitus position. The patient explained that when she was awake she occasionally presented a sensation of restless legs when resting, especially at night, which did not interfere with her ability to fall asleep when she went to bed. She did not snore and no apnoeic episodes were detected during sleep. Likewise, she presented no excessive daytime drowsiness or insomnia.

A polysomnography study with audio-visual recording identified periodic leg movements during sleep. The study showed an index of 24 movements per hour, occurring throughout the night. An index of 7 periodic leg movements per hour was associated with microarousals resulting in partially broken sleep. Apart from affecting the patient’s feet, the characteristic feature of these movements was their association with sudden abduction of the lower limbs. On 2 occasions, these movements were more prolonged, accompanied by repetitive arm movements. She also placed her hand on her genitals for a few seconds but did not masturbate. No apnoeic episodes, epileptiform activity or other abnormalities were recorded during sleep.

She began treatment with 0.18mg pramipexole administered at bedtime and oral iron therapy, which improved restless legs syndrome. However, her atypical sexual behaviour remained unchanged 90 days after treatment onset and the patient stopped attending follow-up visits.

Case 3

The third case was a 43-year-old man examined due to abnormal behaviour during sleep. Since childhood, he presented frequent episodes of nocturnal talking and shouting. These episodes were occasionally associated with distressing nightmares (impossible tasks, fights with animals, failure to comply with family responsibilities, etc.). In the preceding year, he had been working rotating shifts (morning, afternoon, and night). The patient presented no sexual disorders and practices satisfactory conventional sexual intercourse.

He has been living with his partner for a year. The partner relates that the patient, 2hours after falling asleep, occasionally sits up abruptly and shows signs of confusion and fear. He may also be able to have a partially coherent conversation with her for a few minutes. During these episodes, his eyes are always open; he is able to move and may swat at the air. His partner believes him to be asleep at these times and the patient never recalls the episodes in the morning.

His partner also reported 4 similar episodes involving exclusively sexual behaviour. During each episode, the patient, after sleeping 2-4hours, attempted to initiate sex with his partner by touching her body and genitals. His partner rejected these advances due to finding them inappropriate and probably involuntary; each time, the patient showed no aggression or insistence, but merely moved to the other side of the bed, expressing his frustration and annoyance in such terms as ‘no fun’. Upon being informed of the episode the next morning, the patient was unable to remember it. These 4 sexual episodes were described as not posing problems for the couple and they always occurred on a day when the patient changed shifts. The patient also explained that similar sexual behaviour had also manifested with a former partner, who had on occasions permitted his advances resulting in both parties achieving orgasm. These episodes had been described to him by the previous partner; the patient only had a vague recall of the end of the sex act.

A nocturnal polysomnography study with audio-visual recording was performed during 2 nights without detecting any abnormal behaviour. Both recordings did show snoring and obstructive sleep apnoea. The apnoea–hypopnoea index during sleep was 16/hour and 7/hour on both nights. Apnoeic episodes were more common when the patient was supine, especially during REM sleep; the episode index was recorded at 37/hour and 40/hour for this sleep phase and the supine posture. No periodic leg movements, epileptiform activity, or other abnormalities were recorded during sleep. The polysomnogram showed muscle atony in REM phase, which was sufficient to rule out REM sleep behaviour disorder. The patient refused treatment for sexsomnia and sleep apnoea.

Case 4

Case 4 was a 28-year-old man who made an appointment due to abnormal behaviour during sleep. Medical history revealed use of anodyne, with no history of drug abuse and no current medications. Regarding family history, he reported that his brother had experienced probable sleepwalking as a child: “he would get up at night and go to the balcony to urinate”.

His partner, with whom he had been living for 9 months, reported that between 3 and 6 nights per week, while the couple was sleeping, the patient would abruptly sit up in bed or turn towards her and shake her before uttering incoherent fragments like “look at that house” or “the devil”. According to his partner, they were even able to hold conversations. On some occasions, the patient would cry out or laugh. He also displayed abnormal movements and gestures that appeared to mime driving, holding a conversation, or searching for something in the bed. In doing so, he seemed to be acting out a dream. During these episodes, the patient’s eyes remain open and he appears restless and worried. His partner is generally able to soothe him by telling him to go back to sleep. The patient has never managed to get out of bed during an episode.

The partner also reported that the patient suffers episodes that are similar, but exclusively sexual, some 2 or 3 times a month. During these episodes, the patient begins to masturbate or turns to his partner and touches her in an attempt to initiate sex. His partner reported that the patient is neither aggressive nor violent during these times, but states “it isn’t him”, describing the behaviour as more lewd and vulgar. During the episodes, the patient’s penis is erect. His partner consistently refuses sex at these times, and the patient obediently stops the behaviour without insisting or complaining. His partner believes that if she allowed it, he would be able to engage in coitus.

All his episodes of abnormal sleeping behaviour, whether sexual or non-sexual, tend to occur only once per night, between 3.00 and 4.00, when the patient has been asleep for 2-3hours. The patient does not recall any abnormal behaviour, although he feels more tired on the days after an episode is reported. Likewise, the patient reports no nightmares or erotic dreams. The couple engage in regular sex during waking hours, and both consider it satisfactory.

As a child, the patient presented episodes of sleep talking and sleepwalking. In the past, the patient’s former partners with whom he did not cohabitate had also mentioned occasions on which he talked in his sleep or displayed unusual behaviour, including sexual behaviour, resembling that described by his current partner.

A nocturnal polysomnography study with audio-visual recording did not register abnormal conduct. No apnoeic episodes, periodic leg movements, epileptiform activity, or other abnormalities were recorded during sleep. Following diagnosis of non-REM sleep parasomnia with confusional arousals and sexsomnia, we recommended improving sleeping habits (regular cycles and 8hours of sleep per night) and clonazepam 0.5mg before bed. Due to better sleeping habits and clonazepam, the patient’s confusional arousal frequency dropped to 1 or 2 nights per week, and sexsomnia frequency decreased to 1 or 2 episodes every 3 months.

Discussion

In 2005, the International Classification of Sleep Disorders defined and classified sexsomnia as a variant of the confusional arousals typical of non-REM sleep parasomnia.1 The clinical spectrum of sexsomnia is illustrated by the 4 cases we described here; a summary is also included below (Table 1).

Table 1.

Clinical characteristics and polysomnography findings.

Case 1 Case 2 Case 3 Case 4
Sex Male Female Male Male
Age at onset (years) 29 40 42 25
Duration (years) 7 years 1 year 1 year 9 months
Sexual activity Coitus Masturbation Coitus Coitus and masturbation
Episode frequency 15 episodes 2-3 per week 4 episodes 2-3 per month
Recall of episode None None None None
Medical history Sleep talking Sleepwalking Confusional arousals Confusional arousals
Video-polysomnography Mild obstructive apnoea Periodic leg movements Mild obstructive apnoea Normal
  • 1.

    Predominant in males (3 men, 1 woman).

  • 2.

    Affects younger adults (patients’ ages at time of examination ranged from 28 to 43 years).

  • 3.

    History of isolated sleep talking (1 case) or non-REM sleep parasomnia (3 cases).

  • 4.

    No history of neurological diseases such as epilepsy.

  • 5.

    No psychiatric disorders and no history of sex-related diagnoses such as paraphilias. While our patients did not complete specific psychiatric or neuropsychological evaluations, our clinical opinion is that no such disorders were present.

  • 6.

    Sexual activity with intention to complete coitus (in all 3 men) or masturbate (the woman and one of the men).

  • 7.

    Inappropriate or atypical attitude to sex compared to waking sexual behaviour, characterised by lewdness and vulgarity, or more rarely, forcefulness or aggressiveness.

  • 8.

    Variable frequency (from 4 single episodes to 2-3 episodes weekly).

  • 9.

    Not associated with dreams.

  • 10.

    Total amnesia of the episodes.

  • 11.

    Polysomnography recordings do not typically detect episodes of sexsomnia, but they may identify other sleep disorders, including apnoea or periodic leg movements.

  • 12.

    Sexsomnia episodes may possibly be triggered by circumstances leading to broken sleep, such as apnoea (cases 1 and 3), periodic leg movements (case 2), or changes in the sleep-wake cycle (changing shifts in case 3). It is possible that treating these trigger factors may decrease the frequency and intensity of sexsomnia episodes. Two of our patients refused apnoea treatment. The patient with periodic leg movements (case 2) underwent short-term treatment with low doses of pramipexole, with no beneficial effects on sexsomnia. Research suggests that masturbation may be a strategy for treating restless legs syndrome8 and that it may also be a complication of pramipexole treatment.9 However, the patient in case 2 only engaged in masturbation when ‘asleep’, and sexsomnia symptoms began a year before she started treatment with pramipexole.

  • 13.

    Research shows that treatment with clonazepam may reduce the frequency of sexual behaviours during sleep.2 In the only patient in our series to accept treatment, clonazepam did decrease the frequency of sexsomnia and confusional arousals.

  • 14.

    Sexsomnia had not led to any significant marital or legal repercussions in these 4 cases.

As of October 2012, fewer than 50 cases of sexsomnia had been described in the literature.2–7 Most (80%) of the published cases are of men; average age at initial consultation is between 30 and 32 years, with about a 10-year history of symptoms. Average age at onset in women is 14 years, compared to 27 years in men. All patients experienced total amnesia of the episodes, which were described by the people who witnessed them masturbating or with whom they attempted intercourse. Sexsomnia is not associated with erotic dreams; this being the case, the subject does not seem to be acting out a dream, as we see in other types of parasomnia such as sleepwalking, confusional arousal, and REM sleep behaviour disorder. Masturbation and sexual vocalisations are the most typical sexsomnia behaviours in women, whereas men more commonly touch and fondle a bed partner’s breasts and genitals or attempt to complete coitus. The latency between sexual arousal and sexual readiness is short; patients easily achieve erection or vaginal lubrication. Sexual interests during sexsomnia episodes do not reflect the patient’s waking preferences. Cases of homosexual sexsomnia have been described in subjects who are heterosexual when awake; there are also cases of fathers touching the genitals of their daughters or daughters’ friends. Sexual behaviour during sexsomnia episodes also differs from waking behaviour. Some patients are more gentle and affectionate with their partners, whereas others are more direct and abrupt, or even aggressive and violent. They may strike or insult their partners or even attempt sex acts not contemplated in their normal practice, such as anal penetration. A few partners prefer the patient’s sexual approach during sexsomnia episodes to the waking approach; the patient may be either more gentle or more direct than normal. However, most partners refuse to engage in sex play and coitus after realising that the patient’s actions are not voluntary. In other cases, sexsomnia episodes have erroneously been considered rape due to being interpreted as non-consensual sex acts committed by a person in an alert and conscious state.2–6

Sexsomnia episodes are especially common during the first half of the night. Frequencies vary between patients, ranging from one-time occurrences to several episodes weekly. Trigger factors tend to be physical contact with the bed partner, sleep deprivation, periods of stress, fatigue, and abuse of such substances as alcohol and marijuana on the night of the episode. Sleep masturbation may be violent; the literature includes a case of vaginal tearing and a fractured digit. Typically, the bed partner is surprised upon waking up to find the patient masturbating and uttering moans and sexual vocalisations. Such vocalisations may present as moaning, provocative remarks intended to initiate sex, lewd and sexual remarks, or sexual insults. Sex play includes attempts at removing the partner’s clothes, touching his or her genitals, and initiating fellatio or cunnilingus. Sexsomniacs may attempt vaginal, or more rarely anal, penetration; if coitus is completed, it may or may not be followed by ejaculation or orgasm. Various postures are possible if permitted by the patient’s partner.2–6

Sexsomnia is often associated with a history of isolated sleepwalking and sleep talking incidents. It has also been described in 4 patients with REM sleep behaviour disorder. Patients with waking sexsomnia have a normal sex life with no history of sexual abuse, sexual trauma, paraphilia, or psychiatric alterations. Some cases have been associated with obstructive sleep apnoea syndrome and the use of zolpidem and selective serotonin reuptake inhibitor antidepressants.2,3

Sexsomnias must be distinguished from other involuntary sexual behaviours, which include wet dreams (a normal phenomenon consisting of spontaneous ejaculation during sleep, typically associated with erotic dreams) and pathological conditions such as painful erections. It must also be differentiated from the hypersexuality occurring in Kleine-Levin syndrome and cases of epileptic seizures with sexual behaviour.2

Very few episodes of sexsomnia have been described using polysomnography with audio-visual recording. Three patients were heard to utter sexual moans during deep N3 stage sleep.10 One patient with sexsomnia completed coitus with his partner (who provoked him sexually while they were sleeping together in the laboratory). He was between wakefulness and light N1 stage sleep, and was unable to recall the episode later.11 A video-polysomnography study of a 60-year-old woman revealed a masturbation episode lasting a few minutes and beginning in deep N3-stage sleep. During the episode, the EEG trace showed a mixture of alpha activity and persistent delta waves indicating deep N3 sleep. When the technicians roused the patient, she could not recall touching herself or having been dreaming.2

As with all other types of non-REM sleep parasomnia, the pathophysiology of sexsomnia is unknown, but it is likely related to disordered sleep-wake regulation mechanisms. We should also mention another type of parasomnia, sleep eating, in which motor activity consists of consuming foods in unusual ways instead of presenting as the sexual behaviour seen in sexsomnia.12

The potential consequences of sexsomnia are quite predictable. Patients are surprised and ashamed by their sexual behaviours, which they may consider anomalous and humiliating. They are unable to recall the behaviour, which is therefore involuntary. This is also a topic for legal medicine since several patients with sexsomnia have been tried for child molestation and rape.

Clonazepam is effective for reducing sexsomnia episode frequency and intensity in most patients.2 Antidepressants may be of use,6 although there is a published case in which citalopram caused sexsomnia episodes.13 The patient should achieve uninterrupted sleep with no arousals or microarousals. Shift changes, apnoea, and periodic leg movements may fragment sleep, and this can lead to episodes of sexsomnia in predisposed individuals.2 On this basis, fostering good sleeping habits and treating apnoea and periodic limb movements may reduce the frequency of sexsomnia episodes.

In summary, sexsomnia is a type of parasomnia that manifests in young adults and consists of masturbation or inappropriate attempts at coitus in a sleeping patient who cannot recall the event. It is important that the entity be recognised so that patients and their partners will receive the appropriate information on their doctor’s visit; sexsomnia is potentially treatable, it may present with other parasomnias, and it can result in marital and legal problems in extreme cases.

Conflicts of interest

The authors have no conflicts of interest to declare.

Sexsomnia, sometimes called “sleep sex” is a sleep disorder. A person with sexsomnia acts out sexually while sleeping. He or she might masturbate, fondle a bed partner, give oral sex, engage in intercourse, or reach orgasm while asleep and have no recollection of this activity the next morning.

The condition is a type of parasomnia – a behavior that would not normally occur during sleep. One of the most common examples of a parasomnia is sleepwalking, but people have also been known to eat, drive, and be aggressive while sleeping.

Sexsomnia episodes usually happen within the first few hours of sleep. They may happen several times during the night.

Scientists are not sure what causes sexsomnia, but they have identified some risk factors. Obstructive sleep apnea and sleep deprivation are common in sexsomnia patients. Drug and alcohol abuse can also trigger episodes. For some, sexsomnia and other parasomnias are genetic. The behavior might also be a side effect of certain medications.

Sexsomnia is more common in men than in women.

In severe cases, a person with sexsomnia may commit sexual assault or rape. The diagnosis is sometimes considered in legal proceedings.

PMC

REPORT OF CASE

A 37-year-old male presented with complaints of loud snoring at night for 13 years. His wife reported witnessed apneas. Epworth Sleepiness Scale score was 12 of 24. Examination revealed body mass index 26 kg/m2, neck girth 16.5 inches, and Mallampati class I designation.

During the first clinic visit, his wife shared that they had had sexual relations during sleep on a nightly basis for many years, though the patient had no recollection of this, even though he had invariably initiated the sexual activity. This appeared to surprise him and he recalled her telling him of this many times, when he would dismiss it in disbelief.

Video polysomnography (vPSG) showed moderately severe sleep apnea with an apnea-hypopnea index (AHI) of 15 events/h and oxygen saturation nadir of 91%. CPAP at 6 cm H2O pressure was effective in treating OSA. Subsequently, the patient opted for a MAD as an alternative therapy. After 5 months of nightly MAD, he began experiencing pain in his jaw and wanted to switch to CPAP.

The patient had come to realize that he was actually having nocturnal sex outside of awareness for 13 years, when he would protest to his wife about lack of sex in their relationship, and she would dismiss it, saying “you don’t remember it.” She explained to him that they would have sex in the middle of the night once or twice a week, but within a 6-month period, this frequency began increasing to every night. His snoring was first noted around the time when these episodes began.

He would typically initiate sex between midnight and 2:00 AM after they had fallen asleep by 9:00 PM. Per his wife, the sex during these episodes was “wild,” but never violent. He would perform oral sex, though never when sexually active while awake, in spite of his wife’s request. After washing himself, he would return to bed and resume sleep, and have no recall of the sexual event. When he would request sex during wakefulness, his wife would refuse, citing their sexual activity the night before. He assumed that she was “making an excuse.”

Once he realized that he was sexually active with her without recall, he expressed embarrassment. He then understood her reluctance and was remorseful about his concern that she may have been unfaithful.

The patient’s medical history included sleepwalking between the ages of 6 and 13 years. There was no history of psychiatric illness/substance abuse. Medication included only calcium 500 mg q.d. Physical examination was unremarkable.

We hypothesized that arousals related to OSA were the triggers for his sexsomnia, though there was no NREM parasomnia recorded during the vPSG. The patient began use of the MAD after his sleep study, and the sexsomnia ceased immediately. After the occurrence of jaw pain 5 months later, he reverted to nasal CPAP therapy, 6 cm H2O pressure, and the sexsomnia remained absent over 6 months of follow-up care.

6 Ways To Deal With Your Partner’s Sexsomnia, aka Sleep Sex

Sleep: a time for dreaming, relaxation, restoration, and, for some, sex. According to a recent study, one in 10 British people engage in sleep sex, aka sexsomnia, which basically entails getting it on (or trying to) while you’re dead asleep.

Sexsomnia is a parasomnia, which refers to a host of abnormal behaviors exhibited while sleeping, including sleepwalking, nightmares, and sleep eating. The causes vary from individual to individual, but research points to stress and brain disorders as common triggers.

While laying waste to your fridge or waking up in your closet are embarrassing, sexsomnia can have far more disturbing consequences, ranging from general awkwardness to sexual assault to rape. I know, because I dated a guy with sexsomnia, and it was no laughing matter. At first, I thought it was a cute middle-of-the-night ploy for some play, but, just like the woman in this Cosmopolitan article, when my partner would repeatedly not remember his actions, I started to get worried. This all led to Google searches, a lot of long talks, and a few decisions on my part as to how to handle the surprise onslaught of sleep sex. Here are six ways I coped with my partner’s sexsomnia, and how you can do the same:

1. Do Your Research

Giphy

Saying “sexsomnia” to your friends will probably invoke some giggles, because the representations in pop culture can be pretty absurd. However, don’t let that deter you from getting the real scientific facts, because the more you know, the more you can prepare yourself for dealing with this frustrating disorder.

2. Communicate

Your partner will probably feel a certain level of guilt for trying to touch you while you’re trying to get some Zs. Open lines of communication are vital to negotiating both your feelings and theirs.

3. Figure Out Your Partner’s Triggers

Giphy

My significant other’s trigger was usually a consistent lack of sleep mixed with stress and alcohol. This lethal cocktail would create aggressive levels of sexsomnia, and knowing this, I tried to steer our activities in more healthy directions when I could.

4. Set Your Boundaries

Sometimes I would laugh off midnight attempts at sleep sex, and other times I felt extremely violated. If unwarranted advances are triggering for you (as they are for many of us), your relationship might need to accommodate that, whether it means breaking up or changing how you sleep. Although it’s not your partner’s fault they have this disorder, it doesn’t mean you should just “deal with it.”

5. Update Your Sleeping Arrangements

Giphy

Part of setting your boundaries might be sleeping in different beds, at least some of the time. That’s totally OK, and can actually relieve a lot of stress on your relationship.

6. Get Professional Help

At a certain point, you can talk and negotiate and switch beds all you want, but it can’t substitute for professional help. There are sleep centers in most major cities, and you can get your partner the help they need by encouraging them to see a doctor.

Want more of Bustle’s Sex and Relationships coverage? Check out our new podcast, I Want It That Way, which delves into the difficult and downright dirty parts of a relationship, and find more on our Soundcloud page.

Images: Photographee.eu/Fotolia; Giphy (3)

Imagine falling asleep, having sex, and not remembering a thing. You have no clue that you have sexually expressed yourself. You can’t recall any pleasurable effects. You don’t know that you suffer from this sleep oddity until a partner says something — until you’re awakened with a good slap. Or, in the worst-case scenario, somebody presses charges against you.

Misunderstood and under-recognized, it is only recently that sleep disorders involving sex have received proper attention. These conditions cause the sleeper — and any partner — distress, and they can have legal ramifications. Forensic consequences are common.

There are at least 11 different sex-related sleep disorders that are classified as “sexsomnia,” “sleep sex,” or “atypical sexual behavior during sleep.” People with sexsomnia unknowingly engage in a variety of sexual activities while they sleep. Reported behaviors include fondling, masturbation, initiating sex with a partner, sexual vocalizations, sexual assault and/or rape (including of one’s spouse), sleep exacerbation of persistent sexual arousal syndrome, ictal sexual hyperarousal and ictal orgasm. (“Ictal” is a physiological state like that of a seizure or stroke.)

In a review of studies regarding behavioral sleep disorders that were published between 1950 and 2006, psychiatrist Carl Schenck and colleagues found that having another sleep disorder, like sleep terrors or sleepwalking, puts one at increased risk for sleep sex. Those with a history of sleep apnea, bedwetting and seizure disorders appear to be at greater risk for experiencing sexsomnia. Documented sleep sex clinical cases include:

— A 34-year-old man who masturbated every night, after sleeping for two to three hours, despite having sex nightly with his wife before bedtime;

— A 26-year-old woman who would talk erotically to her husband between the hours of 2 and 5 a.m. When he would respond positively, she would awaken and accuse him of forcing sex on her while she slept;

— A husband who would grab his wife’s butt and grind up against her from behind while sleeping.

Whether married, coupled or single, any case of sexsomnia involves the “no consent” issue of sex. Sleep invites the opportunity for the emergence of a person’s basic instincts — and ones that are released inappropriately at that. The court system, couples, and victims alike are all grappling with the issues of accountability and consequences for one’s actions while asleep.

In February, the Ontario Court of Appeal upheld an acquittal on sexual assault charges brought against a 35-year-old Toronto landscaper who tried to have sex with a woman at a party. Both had fallen asleep before the man attempted intercourse while in a state of sexsomnia (he had been drinking heavily that evening).

While the Supreme Court of Canada had previously dealt with sleep-walking defenses, this was the first time the high court handled a sexsomnia defense. The court upheld the man’s acquittal on the basis of “non-insane automatism.” Since his actions were without conscious control, like the beating of his heart, the court ruled that there was a lack of criminal intent, and therefore he couldn’t be proven guilty of sexual assault.

What makes sleep sex disorders even more perplexing and difficult to sort through is that they do not indicate psychological problems. The people who suffer from these disorders are otherwise psychologically healthy. However, if left untreated, these conditions increase an individual’s risk of developing a psychological problem, like depression.

Sexsomnia itself can also take quite a toll on the sufferer, his or her partner and relationship(s). Partners may experience lesions and lacerations from more aggressive or forced sex. The sexsomniac may awaken with a bruised penis or fractured fingers. Both parties report feelings of bewilderment, embarrassment, shame, guilt, despair, shock, denial, annoyance, confusion, worry and fear.

Other problems include feelings of:

— A lack of emotional intimacy;

— A sense of repulsion and sexual abandonment;

— Self-incrimination in sexually expressing one’s self.

Some partners of sexsomniacs do, however, report having more satisfying sex during these nightly romps, whether this involves a lover being:

— More aggressive and dominant;

— Kinkier;

— More amorous;

— Gentler;

— More into satisfying his or her partner.

Regardless, it is important for people with sexsomnia and their lovers to recognize sleep sex triggers. These tend to be physical contact with another person in bed, sleep deprivation, stress, and alcohol. As researchers learn more about these disorders, they are also finding that they can be treated with medication.

In the Know Sex News . . .

— Namibian Military to Give Condoms to Troops. In combating HIV and STDs among its forces, Namibia’s Ministry of Defense has announced that no-cost condoms will be made available to troops free of charge. The condom, which goes by the name “Protector,” is covered in camouflage. An informational leaflet on how and why to use condoms accompanies it.

— HIV, Mental Illness Links Often Overlooked. A study on 900 HIV-positive persons, conducted by South Africa’s Human Sciences Research Council, found that 44 percent were suffering from a mental disorder. Mental healthcare professionals in South Africa often find themselves struggling to figure out what’s causing a patient’s psychosis or dementia, not realizing that the person has a late-stage HIV infection. A one-stop shop to treat HIV and mental illness is in the works.

Dr. Yvonne Kristín Fulbright is a sex educator, relationship expert, columnist and founder of Sexuality Source Inc. She is the author of several books including, “Touch Me There! A Hands-On Guide to Your Orgasmic Hot Spots.”

What is a Sleep Disorder?

Sleeping is a key function of life. Especially since, we spend about a third of our life in bed. It plays a crucial role in a person’s physical health and emotional well being. A person is considered to have a sleep disorder (somnipathy) when they have trouble with their sleep patterns. There are a multiple variations of sleep disorders and there are even more causes that help create a sleep disorder. There are three categories of sleep disorders. One category is intrinsic, which occurs from within the body, the second is extrinsic, which is caused by environmental elements or pathological circumstances, and the third category is disturbances of circadian rhythm, which is a person’s internal body clock. Some of the more common sleep disorders include:

  • Insomnia
  • Narcolepsy
  • Sleep apnea
  • Snoring
  • Restless leg syndrome
  • Sleepwalking
  • Sleep terror
  • Tooth-grinding (Bruxism)
  • Bedwetting
  • Sleep talking
  • Sleep sex (sexsomnia)

The people struggling with these disorders have trouble falling asleep and remaining asleep. A sleep disorder can be caused by uncontrollable body movements (teeth grinding, leg movements), mental disorders (anxiety, depression), and alcohol and substance abuse. In some cases, certain sleep disorders will cause the sufferer to sleep too much or suddenly fall asleep (narcolepsy, sleep apnea). Regardless of the cause, a person is considered to have a sleep disorder when they have had difficulties with their sleep patterns for approximately one month. However, help is available in learning how to manage a sleep disorder. Assistance can be found through loved ones and professional care such as a sleep disorder treatment center.

Statistics on Sleep Disorders

A Behavioral Risk Factor Surveillance System (BRFSS) survey determined that, among 74,571 adult respondents in 12 states, 35.3% reported <7 hours of sleep during a typical 24-hour period, 48.0% reported snoring, 37.9% reported unintentionally falling asleep during the day at least once in the preceding month, and 4.7% reported nodding off or falling asleep while driving at least once in the preceding month . Other statistics follow:

  • Five million Europeans suffering from sleep apnea syndrome can fall asleep while driving .
  • In many cases, a disturbance of sleep is one of the symptoms of another disorder, either mental or physical. Even when a specific sleep disorder appears to be clinically independent, a number of associated psychiatric and/or physical factors may contribute to its occurrence .
  • Lack of sleep is creating a major public safety problem as well—drowsy driving. The 2009 poll finds that more than one-half of adults (54%) – potentially 110 million licensed drivers– have driven when drowsy at least once in the past year. Nearly one-third of drivers polled (28%) say that they have nodded off or fallen asleep while driving a vehicle .

Causes of Sleep Disorder

There is no single element that causes a sleep disorder. However, a sleep disorder can be generated by alcohol and substance abuse, or it can be developed by a mood or mental disorder. A physical or environmental factor such as jet lag or working late shifts may be catalyst for creating a sleep disorder. These various causes aid in the difficulty of analyzing and treating sleep disorders. Due to the complexities of sleep disorder causes, the treatments can be just as complicated.

Signs and Symptoms of Sleep Disorder

Dealing with a sleep disorder can be extremely frustrating. It can take a heavy toll on the sufferer’s health and mental acuity. The most obvious sign of a sleep disorder is realizing that a person has trouble going to sleep and maintaining sleep. However, there are some signs and symptoms that can indicate a sleep disorder. Some of these indications include:

  • Having trouble falling asleep for four weeks
  • Fear of falling asleep
  • Difficulty remaining asleep for four weeks
  • Snoring
  • Stop breathing throughout the night

Sleep Disorder Effects

The effects of a sleep disorder can present some grueling consequences. People spend a substantial portion of their lives sleeping. Sleeping is a key element in maintaining one’s health, it is crucial to a body’s healing, and it is important to sustaining a person’s mental health. A sleep disorder can have a serious impact on someone’s life. Some of the emotional results include:

  • Depression
  • Anxiety
  • Stress
  • Irritable
  • Frustrated

Some of the physical results are:

  • Bodily injuries
  • Death
  • Dependency on sleeping pills
  • Declining health
  • Continuously tired
  • Lack of energy

A few of the social consequences are:

  • Loss of career
  • Strained family relations
  • Drain on resources
  • Become reclusive

Sleep Disorder Treatment

Treatment for a sleep disorder is as unique as the individual that is suffering from one. There is no general cure for overcoming a sleep disorder. Relief may be as simple as changing the habits of one’s sleep routine, or as complicated as working through personal trauma, drug addiction, and a mental disorder. The treatment depends on the circumstances of the person medical history, the diagnosis, expertise of the counselor, the patient’s presences, and their psychiatric history. Once all of the factors are understood and evaluated, a sleep disorder treatment program can be developed.

: http://www.cdc.gov/features/dssleep/

: http://www.who.int/formerstaff/publications/qnt_76.pdf

: http://www.who.int/classifications/icd/en/bluebook.pdf

: http://www.sleepfoundation.org/sites/default/files/2009%20NSF%20POLL%20PRESS%20RELEASE.pdf

Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on April 15th, 2013
Published on AddictionHope.com, Addiction Info

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