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Cited by 235Sleep and related disordersSleep and Wakefulness ResearchSexuality, Behavior, and Technology

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Sleep and Sex: What Can Go Wrong? A Review of the Literature on Sleep Related Disorders and Abnormal Sexual Behaviors and Experiences

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Schenck, Carlos H., Arnulf, Isabelle, Mahowald, Mark W.·2007·Sleep
DOI 10.1093/sleep/30.6.683PMC PMC1978350
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Abstract

STUDY OBJECTIVES: To formulate the first classification of sleep related disorders and abnormal sexual behaviors and experiences. DESIGN: A computerized literature search was conducted, and other sources, such as textbooks, were searched. RESULTS: Many categories of sleep related disorders were represented in the classification: parasomnias (confusional arousals/sleepwalking, with or without obstructive sleep apnea; REM sleep behavior disorder); sleep related seizures; Kleine-Levin syndrome (KLS); severe chronic insomnia; restless legs syndrome; narcolepsy; sleep exacerbation of persistent sexual arousal syndrome; sleep related painful erections; sleep related dissociative disorders; nocturnal psychotic disorders; miscellaneous states. Kleine-Levin syndrome (78 cases) and parasomnias (31 cases) were most frequently reported. Parasomnias and sleep related seizures had overlapping and divergent clinical features. Thirty-one cases of parasomnias (25 males; mean age, 32 years) and 7 cases of sleep related seizures (4 males; mean age, 38 years) were identified. A full range of sleep related sexual behaviors with self and/or bed partners or others were reported, including masturbation, sexual vocalizations, fondling, sexual intercourse with climax, sexual assault/rape, ictal sexual hyperarousal, ictal orgasm, and ictal automatism. Adverse physical and/or psychosocial effects from the sleepsex were present in all parasomnia and sleep related seizure cases, but pleasurable effects were reported by 5 bed partners and by 3 patients with sleep related seizures. Forensic consequences were common, occurring in 35.5% (11/31) of parasomnia cases, with most (9/11) involving minors. All parasomnias cases reported amnesia for the sleep-sex, in contrast to 28.6% (2/7) of sleep related seizure cases. Polysomnography (without penile tumescence monitoring), performed in 26 of 31 parasomnia cases, documented sexual moaning from slow wave sleep in 3 cases and sexual intercourse during stage 1 sleep/wakefulness in one case (with sex provoked by the bed partner). Confusional arousals (CAs) were diagnosed as the cause of "sleepsex" ("sexsomnia") in 26 cases (with obstructive sleep apnea [OSA] comorbidity in 4 cases), and sleepwalking in 2 cases, totaling 90.3% (28/31) of cases being NREM sleep parasomnias. REM behavior disorder was the presumed cause in the other 3 cases. Bedtime clonazepam therapy was effective in 90% (9/10) of treated parasomnia cases; nasal continuous positive airway pressure therapy was effective in controlling comorbid OSA and CAs in both treated cases. All five treated patients with sleep related sexual seizures responded to anticonvulsant therapy. The hypersexuality in KLS, which was twice as common in males compared to females, had no reported effective therapy. CONCLUSIONS: A broad range of sleep related disorders associated with abnormal sexual behaviors and experiences exists, with major clinical and forensic consequences.

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Cites

Research works printed but not linked: 15

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Metadata

Authors
Schenck, C. H., Arnulf, I., & Mahowald, M. W.
Affiliations
  • Hennepin County Medical Center (US)
  • Stanford Medicine (US)
  • University of Minnesota (US)
Corresponding author
Schenck, Carlos H.
ORCID
Venue
Sleep
Publisher
Oxford University Press (OUP)
Published
2007-06
Volume
30
Issue
6
Pages
683-702
ISSN
  • 0161-8105 (ISSN-L)
  • 1550-9109
DOI
10.1093/sleep/30.6.683
PMC
PMC1978350
OpenAlex
W136232406
Cited by
235
References
100
Citations by year
2026: 5 · 2025: 5 · 2024: 3 · 2023: 8 · 2022: 18 · 2021: 12 · 2020: 11 · 2019: 10 · 2018: 14 · 2017: 8 · 2016: 13 · 2015: 13 · 2014: 17 · 2013: 20 · 2012: 12
FWCI
2.20
Type
journal article
Language
en
Open access
Locations
  • SLEEP (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
  • Social Sciences › Psychology › Clinical Psychology › Sexuality, Behavior, and Technology
Keywords
sleep disorders, abnormal sexual behavior, sexsomnia, parasomnias, confusional arousals, sleepwalking, REM sleep behavior disorder, sleep-related seizures, Kleine-Levin syndrome, polysomnography, obstructive sleep apnea
MeSH terms
Adult, Affect, Female, Humans, Male, Masturbation, Middle Aged, Orgasm, Seizures, Sexual Behavior, Sex Offenses, Sleep Apnea Syndromes, Sleep, REM, Verbal Behavior, Polysomnography, Parasomnias

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