Abnormal Sexual Behavior During Sleep: Sexsomnia and More
- 8 Downloads
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.
KeywordsParasomnia 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.
- 3.American Academy of Sleep Medicine. International classification of sleep disorders. 3rd ed. Darien: American Academy of Sleep Medicine; 2014.Google Scholar
- 4.Pandi-Perumal SR, BaHammam AS, Shapiro CM. Parasomnias. In: Stolerman I, Price LH, editors. Encyclopedia of psychopharmacology. 2nd ed. Berlin: Springer; 2015. p. 1210.Google Scholar
- 6.Almeneessier AS, BaHammam AS. A snoring man with an abnormal sexual behavior. J Nat Sci Med. 2018;1(2):85–8.Google Scholar
- 8.Al-Zahrani A. Women’s sexual health care in Saudi Arabia: a focused ethnoaphic study. Sheffield: University of Sheffield; 2011.Google Scholar
- 9.Mohebbi A, Holoyda BJ, Newman WJ. Sexsomnia as a defense in repeated sex crimes. J Am Acad Psychiatry Law. 2018;46(1):78–85.Google Scholar
- 11.Berry RB, Brooks R, Gamaldo CE, Harding SM, Lloyd RM, Marcus CL, et al. The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications, Version 2.1. Darien: American Academy of Sleep Medicine; 2014. http://www.aasmnet.org. Accessed 15 Nov 2018.
- 13.Wong K. Masturbation during sleep—a somnambulistic variant. Singap Med J. 1986;27(6):542–3.Google Scholar
- 19.Chung SA, Yegneswaran B, Natarajan A, Trajanovic N, Shapiro CM. Frequency of sexsomnia in sleep clinic patients. Sleep. 2010;33:A226.Google Scholar
- 21.Alkaabi S, Meyerovich MD, Yakubov B, Shapiro CM. Triggers of parasomnias—what sleep experts think? Disord Psychiatr Neurol J. 2018;1(1):1–8.Google Scholar
- 26.Oudiette D, De Cock VC, Lavault S, Leu S, Vidailhet M, Arnulf I. Nonviolent elaborate behaviors may also occur in REM sleep behavior disorder. Neurology. 2009;72(6):551–7. https://doi.org/10.1212/01.wnl.0000341936.78678.3a.CrossRefGoogle Scholar
- 29.Aurora RN, Zak RS, Maganti RK, Auerbach SH, Casey KR, Chowdhuri S, et al. Best practice guide for the treatment of REM sleep behavior disorder (RBD). J Clin Sleep Med. 2010;6(1):85–95.Google Scholar