Sexsomnia: Clinical Analysis of an Underdiagnosed Parasomnia

Scott G. Williams, MD; Christopher J. Lettieri, MD


May 04, 2012

In This Article


Sexsomnia, also known as sleep sex or somnambulistic sexual behavior, refers to unintentional sexual behaviors or activities during sleep. Sexsomnia is a relatively new diagnosis. The term was coined by Shapiro and colleagues in 2003,[1] but cases of this condition have been reported in the literature for the past 3 decades.[2,3]

Sexual behavior during sleep automatism can range from explicit vocalizations to touching or sexual intercourse, and in some cases even sexual assault or rape. It is non-rapid eye movement (NREM) parasomnia characterized by abnormal transitions between sleep and wake states. The second edition of the International Classification of Sleep Disorders (ICSD-2) discusses somnambulistic sexual activity in the context of disorders of arousal from NREM sleep.[4]

Most commonly, NREM parasomnias arise from slow-wave sleep (SWS). Because of a relative lack of cortical control, partial arousals from this deep state of sleep can lead to uninhibited manifestations of primal drives. In this way, sexsomnia is linked to other primal drives. For example, fear and anger may manifest as night terrors, whereas hunger and thirst manifest as nocturnal eating or drinking.


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