Sleep and Vigilance

, Volume 3, Issue 1, pp 81–89 | Cite as

Abnormal Sexual Behavior During Sleep: Sexsomnia and More

  • AbdulRouf Pirzada
  • Aljohara S. AlmeneessierEmail author
  • Ahmed S. BaHammam
Case Series



The purpose of the paper was to describe cases of abnormal sexual behavior during sleep in Saudi Arabian patients and classify them under the pertinent subtype.


Patients diagnosed with abnormal sexual behavior during sleep received a clinical interview and underwent video-polysomnography recordings at the University Sleep Disorders Center, King Saud University Medical City, Riyadh.


Three men and one woman between 27 and 46 years of age reported abnormal sexual behaviors during sleep, with duration of symptoms ranging from 4 months to 3 years. Episodes consisted of masturbation without seeking the participation of a sleeping partner (case no. 1), attempts at sexual intercourse with inappropriate and uncharacteristic vocalizations and behaviors (cases no. 2 and 3), and rapid eye movement (REM) behavior disorder (RBD) presenting with abnormal sexual behavior (case no. 4). The frequency of the episodes ranged from 1–3 per week to 2–3 per night. Cases 1, 2, and 3 were amnestic of these events and expressed surprise to their partners’ account of their behavior. However, case no. 4 had a full recall of the event.


Sexsomnia (a non-REM parasomnia) is characterized by abnormal sexual behavior during sleep ranging from masturbation to inappropriate attempts at achieving sexual intercourse followed by total amnesia of the event. Nevertheless, REM behavioral disorder can, at times, present as abnormal sexual behavior during sleep, like sexual dream enactments, which may mimic sexsomnia. Therefore, the condition warrants diagnostic consideration as abnormal sleep-related sexual behavior.


Parasomnia Obstructive sleep apnea REM sleep behavior disorder NREM sleep Sex 



This work was supported by the Strategic Technologies Program of the National Plan for Sciences and Technology and Innovation in the Kingdom of Saudi Arabia (MED511-02-08). The study sponsors played no role in the study design, the collection, analysis or interpretation of data, writing the manuscript, or the decision to submit the manuscript.

Compliance with Ethical Standards

Conflict of interest

The authors have conflict of interest to declare.

Research involving human participants and/or animals

The study was approved by the Institutional Review Board, King Saud University and informed consent was obtained from the participants.


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Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  1. 1.Department of Medicine, College of MedicineThe University Sleep Disorders Center, King Saud UniversityRiyadhSaudi Arabia
  2. 2.Family and Community Medicine Department, College of MedicineKing Saud UniversityRiyadhSaudi Arabia

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