Tuesday, July 08, 2008

Sexual Behavior during Sleep

Current Psychiatry has an article this month on "sexsomnia":
Sexual behavior during sleep (SBS)—or “sexsomnia” ...is more than a sensational defense for a high-profile court case. Sleep physicians are finding that sexual behaviors during sleep are real and more common than previously thought. Although SBS cases sound psychological in origin, it appears that the problem lies in the brain itself.
SBS can cause great distress to its initiators and recipients but often goes unreported and untreated because of embarrassment about seeking help. Among patients who report their symptoms, many say they experienced SBS 10 to 15 years before seeking help. SBS not only disrupts sleep but can damage relationships and lead to allegations of sexual assault and rape.


I have had only one case of this in my sleep practice- a woman with masturbatory behavior during sleep. She failed all the standard treatments- benzodiazepines, tricyclic antidepressants, and anticonvulsants. Her polysomnogram and EEG were essentially negative. I ended up referring to the local university sleep center for a second opionion. She didn't keep her follow up appt with me and I have no idea what happened to her.

6 comments:

LGP said...

quite an interesting entry.

AlexV said...

That was a good case. Did your patient have any comorbid psychiatric disorders?. I encontered two patients with sexsomnia.

One lady in her 30's who engaged in full sexual activity with her husband and / or masturbation during the first half of night. She was also bipolar on atypical antipsychotics. Negative PSG. She declined treatment.

The second patient was a young man who presented with his girlfriend who was surprisingly very accepting of the patient's behavior. The patient called his behavior "perve sleep" and voiced frustration because he was unable to remember his behavior. He apparently had an axis II disorder. No meds. Negative polysomnogram.

Good luck

Michael Rack, MD said...

alexv: she had no comorbid psychiatric disorders. thanks for sharing your cases.

Anonymous said...

She failed all the standard treatments- benzodiazepines, tricyclic antidepressants, and anticonvulsants

Michael Rack, MD said...

kaicevy- I guess anticonvulsants aren't standard- I was grasping at straws at the point I got to anticonvulsants (neurontin, not sure if I also tried tegretol)

Anonymous said...

I have sexsomnia. I found out I had it in 2001, but I unknowingly had it for over 20 yrs. It caused major problems in my marriage until I did a search online and was dumbfounded that this did exist.

When I first discovered it, I went to a sleep dr. and mentioned it. He basically told me I was crazy that no such disorder existed. It really turned me off to getting medical treatment.

I haven't kept up on the current medical reports so I didn't know there was something to treat it.

I am a female in my 40's.