sexsomnia

Sexsomnia, also known as sleep sex, is a type of parasomnia in which a person engages in sexual activities while asleep and has little or no memory of the events upon awakening. It is considered a form of sleep-related sexual behavior and is typically categorized within non-rapid eye movement (NREM) parasomnias, though there are reports of occurrences during other sleep stages. The behaviors can involve masturbation, fondling a partner, or more assertive sexual activity; the actions are performed without the person’s conscious awareness and often without the partner’s consent.

The condition is relatively uncommon and likely underreported due to embarrassment or fear of misinterpretation. It frequently co-occurs with other sleep disorders such as sleepwalking, sleep deprivation, or sleep apnea, and may be exacerbated by stress, alcohol or sedative use, irregular sleep schedules, and shift work. Some individuals may have a predisposition to parasomnias or to arousal disorders, and hormonal or neurological factors can influence occurrence.

Diagnosis is based on clinical history reported by the patient and, crucially, a partner or observer. Video polysomnography can be used in selected cases to document events and distinguish sexsomnia from other conditions such as REM sleep behavior disorder, nocturnal seizures, or nocturnal masturbation.

Management focuses on safety and addressing underlying sleep problems. Steps include improving sleep hygiene, treating comorbid sleep disorders (for example, sleep apnea), avoiding alcohol and sedatives, and establishing regular sleep schedules. In some patients, pharmacologic treatment with medications such as benzodiazepines (notably clonazepam) or other agents may reduce episodes. Counseling and open communication with partners are also advised to mitigate relationship or legal concerns. With appropriate management, episodes often decrease in frequency or severity.