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Sexsomnia: An embarrassing sleep disorder no one wants to talk about

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A 38-year-old man repeatedly tries to force his wife to have sex in the middle of the night, but has no memory of his actions when he wakes up.

A married woman in her twenties often tears off her clothes and masturbates, but remembers nothing when her partner wakes her.

For a dozen years, a 31-year-old man has been masturbating in his sleep, sometimes injuring his groin. Embarrassed by his unconscious behavior, he avoided relationships for eight years.

These are all clinically documented cases of sex during sleep, or sexsomnia, which are part of a family of sleep disorders called parasomnias that include sleepwalking, sleepwalking, sleepwalking, and night terrors.

Although it may seem like people are experiencing dreams, many parasomnias occur when the brain is not in a dream state, said Dr. Carlos Schenck, professor and senior psychiatrist at Hennepin County Medical Center of the University of Minnesota.

“These are disorders of arousal,” said Schenck, who has studied parasomnias for decades. “They most often occur during the slowest, deepest phase of sleep, called delta sleep. It’s like an alarm or trigger goes off in the central nervous system and you go from your basement to your roof in no time.

“Your cognition is deep asleep and you’re not participating in the program, but your body is activated,” Schenck said. “It’s dangerous because then you start walking and running and doing all kinds of things without your mind being awake.”

Sexsomnia is difficult to study because unless people self-injure, many have no idea about their unconscious sexual activity until a bed partner tells them about it.

A 2010 study surveyed 1,000 randomly selected adults in Norway and found that around 7% had suffered from sexsomnia at least once in their lifetime, while almost 3% were currently living with it. disease.

“Some people engage in sexual activity with their partner, and it doesn’t bother either of them. So it’s possible that it’s consensual for some,” said Jennifer Mundt, assistant professor of sleep medicine, psychiatry and behavioral sciences at the Feinberg School of Medicine at Northwestern University in Chicago.

“There are certainly cases where it is alarming for the partner and for the person doing it once they realize what they have done.”

The episodes began in 2005, according to one woman’s husband. About twice a month, his wife would moan sexually and engage in “foul talk,” words she never used when awake, he told Schenck, who treated the woman and published his anonymous case in 2021.

Sometimes the woman would caress her husband during the night and they would have sex until she regained consciousness and accused her husband of forcing sex on her.

She also masturbated while shouting other men’s names, including that of a co-worker, leading her husband to believe she was cheating on him. However, partners shouldn’t assume that people with sexsomnia are letting a secret slip out of their subconscious, Schenck said.

“The sleeping brain is wired very differently from the waking brain,” he said. “You are not conscious when you sleep, so you cannot draw any valid conclusions about so-called lies or the truth while you sleep.”

The woman refused to believe her husband’s descriptions of her behavior for years, before finally seeking professional treatment in 2015 after her 9-year-old son heard her moaning sexually in her sleep.

“It was terrible, terrible,” Schenck said. “And what’s really disconcerting for these patients is that they have complete amnesia. It’s the bed partner or a family member who says to them, “You did this, why did you do that?” and then the patient says: “I don’t remember anything.” So they are really embarrassed, full of shame, very sorry and totally unhappy.

Yuliya Kirayonak/Cavan Images RF/Getty Images

Unless people are injured, sexsomnia is often unknown unless a partner witnesses the actions during the night.

Sometimes people have even been arrested because of their behavior. “Sexual behavior, especially with minors, as well as aggressive behavior during sleep can certainly have legal consequences,” Schenck said.

“There is a whole field of forensic sleep medicine to treat these issues,” he said. “They do very comprehensive assessments, case histories and interviews with relatives and others to determine whether this is an excuse or reality.”

There is no way to predict that you will develop a parasomnia. Some people who sleep while talking or walking as children develop sexsomnia or another parasomnia as adults, but many others do not, Schenck said.

“We don’t know the ultimate cause, but there is a genetic component,” he said. “If you have at least one first-degree family member with parasomnia, you are more likely to develop one. Then, the more first- or second-degree relatives there are who suffer from parasomnia, the more likely the condition is to persist into adulthood or recur.

Obstructive sleep apnea can also be a trigger. Also called OSA, obstructive sleep apnea is a serious sleep disorder in which breathing stops for 10 seconds to two minutes several times an hour each night. This disease mainly affects men, although more and more women are now developing it.

“It’s breathing apnea or obstructive sleep apnea that triggers arousal, usually in men, which then triggers sexual behaviors during sleep,” Schenck said. “Once you diagnose sleep apnea and treat the patient, the treatment controls not only the sleep apnea, but also the secondary sexsomnia.”

There are medications such as clonazepam, a medication used for epilepsy, restless legs syndrome, and panic disorder, that can successfully control unwanted sexsomnia in many, but not all.

Medication didn’t help the 41-year-old woman Schenck treated after her son heard it, but leaving her high-stress job helped. She began sleeping soundly for six to seven hours without a recurrence of her sexsomnia.

“It’s very interesting, because a lot of people who are stressed become hyposexual and are no longer interested in sex,” Schenck said. “And for others, it’s the opposite. So there is no 100% absolute rule.

Medications for sexsomnia have side effects and can be addictive. People who don’t want to use drugs can try various behavioral approaches to control the disease, said Northwestern’s Mundt, who published a review of these treatments in September 2023.

“From the literature and my own experience, it is absolutely true that we can significantly reduce symptoms and even eliminate them in some people,” she said. “Others may have only partial improvement or no improvement, and that’s where medication may be needed.”

Education comes first, Mundt said, because many people don’t understand the stages of sleep and how sexsomnia is different from nightmares or experiencing vivid dreams.

During the first and second stages of sleep, your body begins to slow down its rhythms. Then comes the third stage: deep, slow sleep in which the body literally regenerates itself at the cellular level. REM sleep, called paradoxical sleep, occurs when dreaming occurs: in this final stage, the body becomes paralyzed, so you cannot act out your dreams and injure yourself.

Since each sleep cycle lasts about 90 minutes, most adults need seven to eight hours of relatively uninterrupted sleep to achieve restful sleep, according to the U.S. Centers for Disease Control and Prevention.

“Education itself is a treatment strategy because it often really helps reduce the person’s anxiety, and if we can reduce stress and anxiety, that helps,” Mundt said.

“Then I’ll target sleep hygiene, such as reducing caffeine or alcohol, maintaining a more consistent sleep schedule, keeping the bedroom cool, and eliminating noise in their environment,” she said. “Relaxation techniques come next, and if we need additional strategies, I might move on to hypnosis.”

Clinical hypnosis has nothing to do with the magician performing his act on audience members, Mundt said. Instead, it encourages a person to voluntarily enter a daydream or trance state.

“It’s like you’re on a bus and you look out the window, and you don’t even see what’s in front of you because you’re so lost in thought,” she said. declared.

A trance state is clinically useful because people are more open to new ideas, suggestions and images, such as seeing themselves sleeping calmly and peacefully through the night, she said.

“In some ways, it feels like a parasomnia episode,” Mundt said. “People vary in how easily they enter this trance state, but it can be very, very effective.”

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