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18 June 2007
Asleep On The Job - Sexsomnia
by Paul Aitken

The vast majority of us go to bed every night, fall asleep and stay there until we wake up, either in the morning or when we have to go pee. We may toss and turn and mumble nonsense like "those damned elephants," but for the most part we stay in the bed we fell asleep in. But a subset of humanity has a physically active nocturnal life. They regularly get up, make sandwiches, watch TV and go for drives, all while fast asleep. They're referred to as parasomniacs or somnambulists by the experts. Sleep-walkers by everyone else.

Most people have probably had at least some somnambulatory experience, even if it's only sitting up in bed typing on an imaginary keyboard. To my knowledge I've sleep-walked only once in my life. I was nine years old and I woke up as I was feeling my way along the bedroom wall trying to find the door. Not much of a story I'll admit. Other people have had more interesting experiences. My wife once woke up nude on the fire escape of her apartment building locked out! My father woke up on a speeding motorcycle negotiating a curve at high velocity on black ice. Now that's an experience.

A couple of experiences sleep-walking does not necessarily make one a sleep-walker per se. To achieve that distinction one has to make a habit of it. Three percent of children and adolescents are regular sleep-walkers. By adulthood the instance is below 1 percent. For the most part the activity involves nothing more extraordinary than eating a bowl of Cheerios at two in the morning. But a subset of that parasomniac subset has a very active sex life while asleep. These people are referred to collectively as sexsomniacs.

Sexsomnia is an umbrella term for any sexual behavior (masturbation, intercourse, fondling, taking dirty etc.) that manifests itself while the perpetrator is unconscious. It can occur during both REM and slow wave (deep) sleep. It also includes sexual behavior that occurs during seizures, a condition known as Kleine-Levin syndrome.

The incidence of sexsomnia appears to be on the rise. Most experts attribute this to growing public awareness of the problem rather that an upsurge in actual incidence. There have been several widely reported incidents of sexual assault conducted while the perpetrator was allegedly asleep. It's also found its way onto television. In a memorable episode of Everybody Loves Raymond, Ray has sex with Debra while asleep and it was the best sex they ever had!

The exact number of sexsomniacs is difficult to determine because it's usually not enough of a problem to seek treatment for, let alone report. They bump up against their loved ones while asleep, snuggle up and one thing leads to another. Satisfying sex is enjoyed by both parties and the only thing that is unusual about it is that one of the parties was never awake to enjoy it.

But as anyone who has ever had a nightmare knows, the subconscious is at times a dark, convoluted netherworld, capable of producing very disturbing thoughts and images. And given that conscious sexual fantasies can sometimes be more aggressive and indulgent than we would consider in reality, it isn't surprising that sleep sex isn't always so warm and cuddly.

Sexsomniacs have been the victims of violent, injurious masturbation and are themselves victimizers in broad range of sexual assaults. Most often these assaults are visited upon the sexsomniac's partner, either in the form of non-consensual sex, or consensual sex that becomes disturbing or violent. In such cases, the couple usually seeks medical help in an effort to sort it out.

It's when the sleep-sex episodes involve someone other than an understanding partner that things get messy. Episodes that are predatory in nature typically end up involving the law, which has not shown itself to be particularly adept at recognizing or dealing with the problem. Other episodes are simply strange.

In one case, a female sexsomniac from Sydney, Australia, would leave her husband's bed and house where she would engage in random sex with willing strangers. Her "problem" was only discovered when her husband decided to follow her one night and caught her in the act.

The main issue in the above case and all those that involve the law is of course, credulity. How convenient when caught il flagrante delicto by your lover, or in the midst of a sexual assault, to suddenly exclaim, "Hzzaa! Wha... Where am I? Who are you? Oh my God, I'm naked!" Yeah, sure. Likely story.

And therein lays the dilemma. Obviously we don't want to imprison people for what they do while they're asleep, even if they do terrible things. I've done some terrible things in my dreams and I'd hate to have to defend them before a jury. Given that mens rea (a guilty mind) is the sine qua nons of criminal law, what is to be done when someone claims to have committed a sexual assault while asleep?

Well, one evidential indicator is a history of sleep-walking, both in the accused and/or his family. It helps if the incidents were officially documented as anybody can make up a "case history" after the fact. It is especially helpful if the accused has a documented history of sexsomnia. As well, the accused may be subject to sleep testing where his/her brain activity while sleeping can be measured and analyzed for parasomniac patterns.

When confronted with such evidence, most people charged with the responsibility of weighing it, be they mates or jurors, tend to give the accused the benefit of the doubt. Better a guilty man go free etc. But even after jurors have acquitted a sexsomniac of assault, the prosecutors more often than not will appeal. One man in Norway was acquitted by one jury only to be convicted by another. Another man in Toronto, Canada looks set to meet the same fate.

So, if determining guilt after the fact is a nightmare, what can be done to prevent the unwanted behavior in the first place? Much depends on the underlying psychosis. Sexsomniac episodes are associated with and may be triggered by stress or depression. Treating these conditions with drugs, therapy or a combination thereof has been shown to decrease the incidence of sleep sex.

The drug Clonazepam, a benzodiazepine which is normally used to treat anxiety, has long been known to be effective in treating REM stage parasomnia but it may also work for those behaviors generated during slow wave sleep. Research is ongoing. The difficulty in determining the effectiveness of any particular treatment is that even for habitual sexsomniacs the behavior is intermittent, arising only in periods of stress or sleep deprivation. Counter-intuitively, the amount of sex a sexsomniac gets while awake appears to be unrelated to how much sex they seek while asleep.

So it would seem that the best treatment for sexsomniacs is to chill out and get lots of sleep. A good prescription for just about everybody, I'd guess.

Related articles:
Violent 'Sleep Sex' Condition Examined
The Unpredictable Erection




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