As early as 1996, (Shapiro, Fedoroff and Trajanovic, 1996) SBS was identified as a medical condition that may place one at risk of being accused of sexual assault. Thus, if a person is aware of their SBS and takes it seriously, this knowledge may carry with it some accountability for not taking actions to prevent sexual misconduct.
SBS is listed in the most current (revised) edition of the International Classification of Sleep Disorders (ICSD-2), which is the diagnostic manual used by sleep medicine practitioners to make diagnoses. Although it is recognized as a sub-type of parasomnia, “sexsomnia” is not included as a particular type of sleep disorder with its own diagnosis.
SBS is mentioned in the ICSD-2 and recent medical research suggests sexual behavior in sleep is a distinct form of sleep-related behavior in the class “parasomnia” (Shapiro et al, 1996; 2003; Schenck & Mahowald, 2005). Over the past five years information in the popular realm has become available (e.g., articles have appeared in Cosmopolitan, Redbook, Details, Newsweek). A Web search will yield a number of information sources. However, the community of legal and health professionals and the lay public remain largely “in the dark” when it comes to SBS and its clinical and forensic implcations.
In fact, when one discovers their own SBS, usually after being informed about their behavior by a bed partner, they themselves are unlikely to believe that could behave in such a fashion. Often this is a source of conflict in couples as it is embarrassing to accept it as fact. Even when one reports another’s (that is, a person complains he/she has been fondled, etc., by a person who clearly appeared to be asleep), to a friend or health care provider in an attempt to try to get some support and to encourage their partner to treat his/her SBS, these persons cannot expect others to believe that they have experienced unwanted sexual contact initiated by a sleeping individual.
At present most people know that people walk, talk and eat in their sleep. That sexual behavior also occurs in sleep is not, at present, common knowledge. With increasing media and academic interest in this phenomenon, this will likely change.
If you are experiencing problematic sexual behavior in sleep, find a sleep center and speak with a qualified sleep expert.
- Schenck, C.H., Mahowald, M.W. (2005). Rapid eye movement and non-REM sleep parasomnias. Primary Psychiatry, 12(8), 67-74.
- Shapiro, C.M., Fedoroff, J.P., & Trajanovic, N.N. (1996). Sexual behavior in sleep: A newly described parasomnia. Sleep Research, 25, 367.
- Shapiro, C.M., Trajanovic, N.N., & Fedoroff, J.P. (2003) Sexsomnia: A new parasomnia? Canadian Journal of Psychiatry, 48(5), 311-317.
Scientific research on sexsomnia (SBS)
If you have ever experienced SBS, please tell us about it! Your story is important and will contribute to my ongoing research into this disorder. All submissions are entirely anonymous.
1996: Shapiro, Fedoroff and Trajanovic first advanced the notion that sexual behavior during sleep may be a new type of “parasomnia.” Shapiro, C.M., Fedoroff, J.P., & Trajanovic, N.N. (1996). Sexual behavior in sleep: A newly described parasomnia. Sleep Research, 25, 367.
1998: Some experts later suggested that SBS may be a variant of sleepwalking. Rosenfeld, D. S., Elhajjar, A. J. (1998). Sleepsex: A variant of sleepwalking.Archives of Sexual Behavior, 27(3) , 269-278.
1999: Brazilian researchers (Download article PDF) showed that sexual behavior in sleep can be successfully “treated” pharmacologically. Alves R, Aloe F, Tavares S, Vidrio S, Yanez L, Aguilar-Roblero R, Rosenthal L, Villalobos L, Fernandez-Cancino F, Drucker-Colin R, Chagoya De Sanchez V. (1999). Sexual behavior in sleep, sleepwalking and possible REM behavior disorder: a case report. Sleep Res Online, 2(3), 71-2.
2002: Researchers at Stanford University suggested that “violent” or problematic forms of sleepsex are a medically treatable “conditions.” Guilleminault C, Moscovitch A, Yuen K, Poyares D. (2002). Atypical sexual behavior during sleep. Psychosom Med. 64(2), 328-36.
2003: The research suggests sleepsex, or “sexsomnia” can be distinguished from all known parasomnias and thus is likely to be a distinct clinical entity. (Download article PDF) Shapiro, C.M., Trajanovic, N.N., & Fedoroff, J.P. (2003) Sexsomnia: A new parasomnia? Canadian Journal of Psychiatry, 48(5), 311-317.
2004: Paper presents first systematic examination of the phenomenology of problematic sexual behavior occuring in sleep. Mangan, M.A. (2004). A phenomenology of problematic sexual behavior occurring in sleep. Archives of Sexual Behavior, 33(3), 287-93.
2005: Paper describes parasomnias and their importance to psychiatry. The authors indicate sexual behavior, along with other types of automatisms, can be expected to occur in cases of parasomnia. Schenck, C.H., Mahowald, M.W. (2005). Rapid eye movement and non-REM sleep parasomnias. Primary Psychiatry, 12(8), 67-74.
2007: Paper reviews academic literature concerning sexual behavior in sleep. Authors’ conclude: “A broad range of sleep-related disorders associated with abnormal sexual behaviors and experiences exists, with major clinical and forensic consequences.” Schenck, C.H., Arnulf, I., Mahowald, M.W. (2007). Sleep and Sex: What can go wrong? A review of the literature on sleep-related disorders and abnormal sexual behaviors and experiences. Sleep, 30(6), 677-686.
2007: Paper reviews the literature on sexual behavior in sleep comparing samples sizes of clinical versus Web-based research. The advantages and disadvantages of Web-based research on sexsomnia are discussed. Mangan, M., & Reips, U. D. (2007) Sleep, sex, and the Web: Surveying the difficult-to-reach clinical population suffering from sexsomnia. Behavior Research Methods, 39, 233–236.
2007: Paper discusses the results of a Web-based survery of persons with direct experience of sexual behavior in sleep. Among the findings were that bodily contact is a commonly reported trigger for episodes. Trajanovic, N. N.; Mangan M., Shapiro C. M. (2007). Sexual behaviour in sleep: an Internet survey. Social Psychiatry and Psychiatric Epidemiology, 42(12):1024-31.
2023: A possible solution involving penis extenders is being researched now. The first results show a lot of improvement in relationships where the male suffers from sexual behaviors during sleep by wearing a Phallosan Forte penis extender.
Is there a clinical diagnosis for sexsomnia (SBS)?
Sexsomnia is not presently included in the American Academy of Sleep Medicine’s Diagnostic and Coding Manual/International Classification of Sleep Disorders (ICSD) as a specific sleep disorder. Nor is it in the most recent edition of the Diagnostic and Statistical Manual of the American Psychiatric Association (a manual used to clinically diagnose psychiatric conditions).
However, the ICSD, the most widely used classification of sleep disorders, does discuss sexual behavior in sleep as a variant of an existing sleep disorder known a “confusional arousals.” It is recognized by leaders in sleep medicine as something that can and does occur in some people.
Many people for whom sexsomnia has become problematic are too embarrassed to seek help because they think no one will believe them. I have received many reports from individuals who have sought the help of physicians, counselors, and psychologists only to have their complaints dismissed. Why? Because many professionals are uninformed about sexsomnia. If SBS has become problematic for you, I suggest printing copies of the research abstracts (linked above) prior to seeking help. Bring them with you when you seek help from a sleep medicine specialist, physician or other professionals (including clergy).
Free eBook (PDF) Version If you do not have it already, you will need Adobe Reader to read the eBook.
Print Version: US $17.84 Buy it at Xlibris.com
In Sleepsex: Uncovered (2001), Michael Mangan, Ph.D. sheds light on questions about sleepsex such as, “How many people ‘have’ sleepsex?” “What causes it?” “What can be done about it if it is a problem?” “What are the legal implications of sleepsex?” In plain language, the author summarizes what sleep experts have written on sleepsex, and provides a etailed and thoughtful analysis first-hand experiences of sleepsex. Dr. Mangan’s analysis reveals what direct experience with sleepsex is like and how it affects those involved. (Note: As this book was published in 2001, please see links above for most recent research.)
“Your book will be of great value to the general public, patients, sleep medicine professionals, and to the legal profession. Nice job.” Mark Mahowald, M.D., Prof. of Neurology, University of Minnesota Medical School, Director of the Minnesota Regional Sleep Disorders Center.
“Thank you so much for sending your book to me. I have used it already in teaching our residents about the topic of parasomnias. I am delighted to have it as a reference as this is an area on which I frequently get consulted by defense attorneys and have already given one such person your name and how to find a copy of the book. We have had a few of these cases here at Rush. I must admit that on the first one I missed cold and had no help to offer until I realized that this was part of the same picture as the other parasomnias. The book is certainly valuable in filling the niche for the legal profession and for sleep medicine and for sleep clinicians to whom such patients refer themselves for help.” Rosalind Cartwright Ph.D., Prof. of Psychology, Chair of the Department of Psychology, Director of the Sleep Disorder Service and Research Center Rush-Presbyterian-St. Luke’s Medical Center, Rush University
Thank you for sending me a copy of your book. I think it will be quite useful for laypersons suffering from this disorder. Thanks again for sending me a copy. David S. Rosenfeld, M.D., Neurologist and Sleep Medicine Specialist, Los Angeles Kaiser-Permanente Medical Center
“Thanks for sending me your book. I enjoyed reading it, especially because it includes so many first-hand accounts. The use of the Internet to collect data is original. I would interpret all of these accounts as sleep-wake dissociations akin to sleep walking, sleep talking, and nocturnal eating.” J. Allan Hobson, M.D., Prof. of Psychiatry, Harvard Medical School