Sexsomnia - Types, Signs and Symptoms, Causes, Diagnosis, and Treatment

Introduction:

Sleeping disorders often go unnoticed or even neglected, mostly when the patient is asleep. Most people do not realize they are actually victims of sleeping disorders unless they have been told to by their partners, family members, and close friends. One such sleeping disorder is sexsomnia.

A recent study was conducted in a sleeping disorder center, where patients with sleeping disorders were closely monitored for their sleeping patterns under constant supervision. The study reported that around 7.6 percent of people with sleeping disorders indulged in sexual activities during their sleep (sexsomnia). Results showed sexsomnia was nearly three times higher in men than in women.

What Is Sexsomnia?

Sexsomnia, or ‘ sleep sex’ is a disorder involving sexual behaviors when the person is asleep. Studies show sexsomnia mostly occurs in males than in women. Sexsomnia is a sleeping disorder like parasomnias (parasomnias occur between sleep stages when a person indulges in different awake-like activities while sleeping ).

Sexsomnia is a rare sleeping disorder in which the person indulges in sexual activities while they are asleep. After the event, the person may experience amnesia and fall back to sleep.

The person may or may not be in the senses to understand what is happening and may not remember indulging in these activities after they wake up from sleep.

What Are the Types of Sexsomnia?

Sexsomnia is a disorder characterized by the occurrence of sexual behavior during sleep. This can occur at any time in a sleeper's life but is most often reported in the teens and early twenties. It is an umbrella term for multiple subtypes, including-

1. Non-REM Sleep Behavior Disorder (NREMSBD): When a person engages in sexual behavior while asleep but does not wake up.

2. REM Sleep Behavior Disorder (RBD): When a person engages in sexual behavior while sleeping and wakes up.

3. Mixed NREMSBD and RBD: When someone engages in both non-REM sex and REM sex (such as waking up multiple times during the night).

What Are the Signs and Symptoms of Sexsomnia?

Sleep sex or sexsomnia symptoms may manifest differently in different individuals. Some common symptoms and behaviors include:

• Talking dirty during sleep.

• Masturbating during sleep.

• Making sex sounds and moaning.

• Initiating sexual activities.

• Sexual fondling with their partners.

• Indulging in foreplay.

• Participating in sexual intercourse.

• Having sexual orgasms.

• Unusual body movements, including pelvic thrusting.

• Watery eyes on waking up.

• Sleep-related violence or sexual aggression.

• Genital lacerations.

• Bruises on various body parts.

These unusual sexual behaviors may also occur during confusional arousals, which can happen when a sleeping person is suddenly aroused out of deep sleep.

Though sleep-related disorders can prove to be a problem not only for the person suffering from it but also for their partners, family members may seem quite troubled by the behavior. It can prove harmful to the family's close members and may be an alarming sign to seek immediate professional help.

What Are the Causes of Sexsomnia?

Causes of sexsomnia are more often multifactorial, and most of the people suffering from it are due to mental health disorders and increased stress levels. Let’s find out the other causes of sexsomnia in detail-

• Overconsumption of Sleeping Pills and Sleeping Medications- Studies show over usage of sleeping pills in patients with insomnia, who have trouble sleeping, the patient may exhibit unusual behaviors like sexsomnia while asleep.

• Parasomnias- People with a history of parasomnia (such as sleepwalking and sleep talking) are more prone to sexsomnia. This can also be because of an underlying medical condition, increased stress levels, or mental health disorders.

• Overconsumption of Hard Drugs- Various hard drugs like Cocaine, Lysergic acid diethylamide (LSD), and 3-4 Methylenedioxymethamphetamine (MDMA) are known to cause various psychological disorders and mental illnesses, which may make people more prone to develop sleep disorders, including sexsomnia.

• Stress and Anxiety- Stress and anxiety are one of the main causes of people experiencing sexsomnia.

• Depression and Mental Illness- Mental illnesses and depression can cause sexsomnia and vice versa. In such cases treating depression can reduce the symptoms of sexsomnia.

• Sleep Deprivation- Unusual work shifts and night shift working hours can cause sleep deprivation or even fragmented sleep. This somehow may induce unusual sexual behaviors like sexsomnia in individuals.

• Underlying Medical Conditions - History of certain medical conditions like irritable bowel syndrome (IBS), Alzheimer's disease, gastroesophageal reflux disease (GERD), migraines, Parkinson's disease, etc., are linked with sexsomnia.

Other causes of sexsomnia:

• Other parasomnias, such as sleepwalking and REM sleep behavior disorder.

• Obstructive sleep apnea.

• Sleep-associated seizures.

• Kleine-Levin syndrome (excessive sleep syndrome).

• Chronic insomnia (lack of sleep).

• Restless legs syndrome (excessive leg movements during sleep).

• Narcolepsy (daytime drowsiness and sudden episodes of excess sleep).

• Persistent sexual arousal syndrome (sexual arousal without any stimulation or sexual activities).

• Nocturnal psychotic disorders (psychotic activities during nighttime).

• Night bruxism (teeth grinding).

What Are the Factors That Trigger Sexsomnia?

• Drinking alcohol.

• Past or current recreational drug use.

• Stress or anxiety.

• Sleep deprivation.

• Depression.

• Poor sleep hygiene.

• Shift work.

How Is Sexsomnia Diagnosed?

Since sexsomnia is a condition that occurs during sleep and the person does not recollect the events, a professional diagnosis is required apart from the sleep descriptions given by their partners. Diagnosis includes a sleep study done overnight under the supervision of the doctor or a general physician. Additional studies and investigations may be required in case the episodes or incidents of sexsomnia do not occur overnight. EEG (electroencephalogram) and polysomnography investigations are done to rule out other medical conditions like epileptic disorders and seizures.

What Is the Treatment for Sexsomnia?

As sexsomnia may occur along with underlying medical conditions, treating the medical conditions first may reduce the symptoms of sexsomnia to some extent. However, further measures need to be taken to cure sexsomnia as well.

• Treating Sleep Apnea - Patients with obstructive sleep apnea are treated with oral appliances to have more space and open their airways to improve breathing patterns.

• Antidepressant Medications - Patients with mental disorders or illnesses are prescribed antidepressant medications like Selective serotonin reuptake inhibitor (SSRI) to improve the signs and symptoms of sexsomnia. Medications like Carbamazepine and Clonazepam may be given to patients who exhibit sexsomnia and sleepwalking and talking.

• Reducing Drug and Alcohol Consumption- Reducing or complete cessation of drug and alcohol consumption reduces sexsomnia behaviors.

• Trying Relaxation Therapies - Meditation, relaxation therapies, or even yoga is known to reduce stress levels which improves the current condition and prevents the condition from becoming worse.

• Adapt to Healthy Sleeping Habits- Healthy sleeping habits that improve sleep hygiene prove to improve the quality of sleep. Poor sleeping conditions and poor sleep quality provoke sexsomnia. Habits like warm water showers, following a night skincare routine, reading a book, and writing a bedtime journal help in improving the quality of sleep.

• Wearing a Night Guard - Night bruxism (teeth grinding while asleep) may harm and cause the teeth to weaken and cause teeth sensitivity. Night guards fabricated by dentists protect the teeth from tooth attrition (flattening of teeth due to constant friction between two opposite teeth)and teeth sensitivity.

• Talking to a Psychologist- Seeking help at the right time may prevent the signs and symptoms from getting worse. Psychologists and therapists also help to deal with anxiety and help manage stress which is the key cause of sexsomnia.

Conclusion

Sexsomnia may be a rare phenomenon, but it is important to look out for its complications in patients with other sleep disorders or mental illnesses. While it is not entirely understood by the person suffering from it, early diagnosis and intervention can prevent the symptoms from worsening. People should watch out for signs and symptoms of sexsomnia and try to understand their sleep behaviors. Consequences of sexsomnia may occur to the extent that may affect the mental status of the patient, lower confidence, and self-esteem. That being said, it is important to seek help from qualified doctors and therapists and also to make sure not to neglect any other medical conditions one may have.