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Sexsomnia: A Rare Parasomnia With Important Medicolegal Aspects

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Abstract

Sexsomnia, also known as sleep sex, is a non-rapid eye movement (NREM) sleep parasomnia characterized by sexual behavior during sleep. This term is rather loose in literature, often used to describe a variety of abnormal sexual behaviors and experiences occurring during sleep or sleep–wake states. One hundred and sixteen clinical cases of sexsomnia have been reported so far. The overall prevalence of parasomnias for adults is estimated around 2–6%; however, the prevalence of sexsomnia still remains unknown. The majority of reported cases of sexsomnia refer to male patients. Although it is considered as a NREM sleep parasomnia, it can present with episodes in both rapid eye movement and NREM sleep. Clinical manifestations of sexsomnia are variable, with sexual intercourse/attempted intercourse being the most frequent and masturbation the main presentation in women. Other presentations include sexual vocalizations, pelvic thrusting, fondling and groping the bed partner. Violence, aggression, and spontaneous sleep orgasms have also been reported. Useful diagnostic tools for sexsomnia are the interview of both the patient and the bed partner, physical, neurological and psychiatric evaluation. The video-polysomnography study can aid diagnosis of unusual cases and recognition of possible precipitating factors, as well as help to differentiate parasomnias from epilepsy. Its treatment includes medical and mostly non-medical interventions. Sexsomnia, even though it is rare, has major relational, clinical, and medicolegal aspects. As our comprehension of sexsomnia improves, so will our capacity to make the correct analysis in clinical practice and in a forensic context.

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Correspondence to Efstratios-Stylianos Pyrgelis.

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Pyrgelis, ES., Mavridis, I.N., Wimalachandra, W.S.B. et al. Sexsomnia: A Rare Parasomnia With Important Medicolegal Aspects. Sleep Vigilance 5, 29–34 (2021). https://doi.org/10.1007/s41782-021-00139-3

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