Issue publication date: June, 2012
This month’s newsletter is guest-authored by UPLNC Nurse Consultant Sue Baer, MSN, CFNP, RN, LNC. Learn more about Sue in the “About Us” section.
A recent case study involved a man who had molested a child while he was sleeping soundly. The incident was interrupted by a third party who actually noted the man to be snoring while the incident occurred. He had performed similar acts prior to this incident during which he was observed to be asleep. He had no recollection of the events and was extremely confused when awoken. A combination of precipitating factors and witnessed events led me to believe he has a newly recognized disorder called sexsomnia.
Sexsomnia, also known as somnambulistic sexual behavior, is a variant of sleepwalking. The scientific community has performed studies of this disorder for the past 10 years. It was validated as a sleep disorder in 2005 when the International Classification of Sleep Disorders 2nd Edition, 2005, included sexsomnia as a parasomnia (or a sleep disorder) under the category of confusional arousal disorder or sleepwalking.
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Individuals who suffer from sexsomnia have experienced complex sexual behaviors while in deep sleep.Typically the person’s bed partner reports the behaviors as the individual remains completely amnesic regarding the events. In virtually all cases the individual experiences disorientation upon wakening, the presence of factors known to trigger sleepwalking (such as substance use, stress, sleep deprivation), and the acts are completely out of character for the individual. Read Dr. Michael Mangan’s Book [amazon_link id=”1401037666″ target=”_blank” ]Sleepsex: Uncovered[/amazon_link]
Predisposing factors of sexsomnia include a prior history of a sleep disorder and a family history of sleepwalking. Thus, there appears to be a genetic component to this disorder. External factors that influence the deeper stages of sleep or the arousal from sleep have been shown to precipitate sexsomnia episodes. Obstructive sleep apnea is a common comorbidity with sexsomnia.
A person who suffers from sexsomnia will, under certain circumstances, act out involuntarily and unconsciously. Just like the phenomena of sleepwalking the performance of sexual acts while asleep occur without any awareness by the individual and during a state of deep sleep. Most often the shame and embarrassment of this behavior prevents the individual from seeking help. Researchers believe that sexsomnia is extremely underreported due to the psychological consequences of the behaviors. (Video: Sexsomniac Mocked During Sexsomnia Episode)
[amazon_link id=”B000FCW3L2″ target=”_blank” ]Sexsomnia.(a subtype of parasomnia): An article from: FOCUS: Journal for Respiratory Care & Sleep Medicine[/amazon_link]
Fortunately, once sexsomnia has been identified it can also be successfully treated. Medical treatment focuses upon the underlying cause(s) of sexsomnia. There are also medications that have proven helpful. Individuals throughout the research thus far have demonstrated complete resolution of sexsomnia with appropriate treatment(s).
Unfortunately, sexsomnia is typically not recognized until legal complications arise. As the majority of individuals do not realize that they have a treatable disorder they tend to hide their actions out of embarrassment and shame. (Video: Sexsomniac Confronted) Once the actions have infringed upon an unwilling participant or a minor the legal consequences can be horrific. As stated, the actions of sexsomnia are completely out of character for these individuals. Thus, they tend to suffer severe emotional responses upon learning of their behaviors. (Video: Sexsomnia, My Shocking Reality)
[amazon_link id=”0195377729″ target=”_blank” ]A Case a Week: Sleep Disorders from the Cleveland Clinic[/amazon_link]
In order to diagnose sexsomnia a thorough review of all medical records is necessary. Any history of sleep disorders or use of medications which impact the quality of sleep are important considerations. Medical factors that interrupt deep sleep are also precipitating factors to consider. The individual typically has had prior incidents of sexsomnia. Finally, one of the most significant factors in our case was a detailed explanation provided by a third-party witness which included the individual’s behaviors during and just after the incident. As the diagnosis of sexsomnia is newly recognized there is still some much needed research in the area. Most of the research thus far has been case studies rather than experimental. At this time the diagnostic criteria are rather vague. However, the research has devised a small list of criteria which make a diagnosis possible. (Video: How to Talk About Sexsomnia)
Andersen, M. L., Poyares, D., Alves, R. S., Skomro, R., & Tufik, S. (2007). Sexsomnia: Abnormal sexual behavior during sleep. Brain Research Reviews , 56, 271-282.
Bienenfeld, M. D. (2011, January 28). Parasomnias. Retrieved March 18, 2012, from Medscape Reference: http://emedicine.medscape.com/article/291931-overview
Guilleminault, M. B., Moscovitch, M. A., Yuen, M. K., & Poyares, M. N. (2002). Atypical Sexual Behavior During Sleep. Retrieved March 24, 2012, from Psychosomatic Medicine:http://www.psychosomaticmedicine.org/content/64/2/328.full.pdf
Mangan, M. A., & Reips, U. D. (2007, May). Sleep, sex, and the Web: surveying the difficult-to-reach clinical population suffering from sexsomnia. Retrieved March 23, 2012, from PubMed Central:http://www.ncbi.nlm.nih.gov/pubmed/17695349
Mangan, P. M. (2004). A Phenomenology of Problematic Sexual Behavior Occurring In Sleep. Archives of Sexual Behavior , 33 (3), 287-293. Pressman, M. (2007, February 11). Factors that predispose, prime and precipitate NREM parasomnias in adults: clinical and forensic implications. Retrieved March 22, 2012, from PubMed Central: http://www.ncbi.nlm.nih.gov/pubmed/17208473
Schenck, M. C. (2011, September 24). Restless Legs Syndrome & Parasomnias. Retrieved March 26, 2012, from Minnesota Women Physicians:http://mnwphysicians.org/resources/Schenck+MWP+2011+handout.pdf
Schenck, M. C., Arnulf, M. P., & Mahowald, M. M. (2007, June 1). Sleep and Sex: What Can Go Wrong? A Review of the Literature on Sleep Related Disorders and Abnormal Sexual Behaviors and Experiences. Retrieved March 22, 2012, from PubMed Central:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1978350/?tool=pubmed
Zaharna, M. M., Budur, M. K., & Noffsinger, M. ,. (2008, July). Sexual behavior during sleep: Convenient alibi or parasomnia. Retrieved March 24, 2012, from The Journal of Family Practice:http://www.jfponline.com/Pages.asp?AID=6343
Source: Sue Baer. (2012) Case Study: Sexsomnia University Park Legal Nurse Consulting, Inc. http://universityparklnc.com/newsletter/case-study-sexsomnia Retrieved: 26 Jan 2013
Sexsomnia, Sexsomnia Episode, Sexsomnia Treatment, Sleep Disorder
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