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Sexsomnia: A Medicolegal Case-Based Approach in Analyzing Potential Sleep-Related Abnormal Sexual Behaviors

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Parasomnias

Abstract

Sexual behaviors in sleep have gained wide recognition and can take on many expressions. These behaviors have been given many popular terms including “sexsomnia” and “sleep sex” but the most common primary pathway through the platform of sleep is as a disorder of arousal from NREM sleep. The public’s fascination with “sexsomnia” may equate this condition with unrestrained libidinous sexual intercourse between strangers but the most common expression of this condition may be an inappropriate and unwanted emerging intimacy between individuals who by tacit agreement have chosen to sleep in close proximity. Major influences for which there is clinical-based evidence that may promote sleep-related abnormal sexual behaviors include sleep deprivation and obstructive sleep apnea (OSA). Alcohol has long been erroneously cited in the past as a priming influence for disorders of arousal from NREM sleep, including sleep-related abnormal sexual behaviors. The sleep forensics experience in the United States has revealed an alarming increase in the number of cases of sexual assaults purported to be attributed to “sexsomnia”. If such legal cases are indeed a bellwether, a proposal could be made for more rigorous controlled epidemiologic studies into this condition to better define its prevalence and characteristics as part of public policy to ensure personal and public safety—especially in those who cosleep with children. Despite its increasing recognition, there also remains significant skepticism, if not disdain, related to “sexsomnia” as witnessed by published reports served by the National District Attorneys Association’s National Center for Prosecution of Child Abuse. To counteract media driven bias and the general skepticism emanating from an adversarial-driven court system, this chapter presents a progressive medicolegal case-based approach in analyzing potential sleep-related abnormal sexual behaviors to equip the sleep medicine professional with a combination of cognitive neuroscience constructs and salient clinical features to navigate the topology of sexual behavior in sleep in order to provide the most appropriate patient-centered care with the potential to be a resource to the legal community when indicated.

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  1. HealthEast Care Systems of Minnesota, Saint Paul, Minnesota, USA

    Michel A. Cramer Bornemann MD DABSM FAASM

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Correspondence to Michel A. Cramer Bornemann MD DABSM FAASM .

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Editors and Affiliations

  1. Harvard Medical School, Associate Professor, Department of Neuro, Boston Children's Hospital, Longwood Avenue 300, Boston, 02115, Massachusetts, USA

    Sanjeev V. Kothare

  2. Feinberg School of Medicine, Alexian Brothers Medical Center, Northwestern University, Biesterfield Road 800, Elk Grove Village, 60007, Illinois, USA

    Anna Ivanenko

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Cramer Bornemann, M. (2013). Sexsomnia: A Medicolegal Case-Based Approach in Analyzing Potential Sleep-Related Abnormal Sexual Behaviors. In: Kothare, S., Ivanenko, A. (eds) Parasomnias. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7627-6_30

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  • DOI: https://doi.org/10.1007/978-1-4614-7627-6_30

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