Sex Sleep Homemade

Sex Sleep Homemade

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Sleep

v.30(6); 2007 Jun 1

PMC1978350

Minnesota Regional Sleep Disorders Center, Hennepin County Medical Center, University of Minnesota Medical School, Departments of Psychiatry
1 and
2 Center for Narcolepsy, Stanford University School of Medicine, Palo Alto, CA
Address correspondence to: Carlos H. Schenck, MD,
Minnesota Regional Sleep Disorders Center, Hennepin County Medical Center (Psychiatry R7), 701 Park Avenue South, Minneapolis, MN 55415Phone: (612) 873-6288Fax: (612) 904-4207, ude.nmu@010nehcs
Received 2006 Oct; Accepted 2007 Feb.
Copyright © 2007 Associated Professional Sleep Societies, LLC.
Keywords: Sleep, sleep disorders, sexual behavior/experience, parasomnias, sleep related/nocturnal seizures, NREM sleep parasomnias, confusional arousals, Kleine-Levin Syndrome, polysomnography/sleep EEG, forensic medicine
Parasomnias with abnormal sleep related sexual behaviors (sexual vocalizations/talking/shouting, masturbation, fondling another person, sexual intercourse with or without orgasm, agitated/assaultive sexual behaviors):
Confusional arousals (with or without obstructive sleep apnea)
REM sleep behavior disorder (RBD) (?) 1
Sleep related sexual seizures (sexual vocalizations/moaning/ shouting, masturbation, libidinal hyperarousal, genital arousal, ictal orgasm, sexual automatisms, agitated/assaultive sexual behaviors)
Sleep disorders with abnormal sexual behaviors during wakefulness and wake-sleep transitions:
Kleine-Levin syndrome (broad range of hypersexual and deviant sexual arousal and behaviors)
Severe chronic insomnia (increased libido, genital arousal, compulsive sexual behaviors)
Restless legs syndrome (masturbation, rhythmic pelvic/ coital-like movements)
Narcolepsy (compelling sexual hypnagogic/hypnopompic hallucinations and REM-onset dream attacks, cataplectic orgasm)
Sleep exacerbation of persistent sexual arousal syndrome (genital-sensory sexual arousal without increased libidinal arousal; sexual behaviors)
Sleep related painful erections and increased sexual activity (increased sexual behaviors—masturbation and intercourse)
Sleep related dissociative disorders (pelvic movements and other sexualized behaviors, attempted reenactments of past sexual/physical abuse scenarios)
Nocturnal psychotic disorders (sexual delusions/hallucinations after awakenings)
Hypersexuality after nocturnal awakenings
Miscellaneous (naps; [REM] sleep erections and sexual vulnerability; medication-induced states) (masturbation, sexual intercourse, sexual hypnagogic/ hypnopompic hallucinations with or without sleep paralysis)
1 Three patients with histories of abnormal sleepsex were diagnosed with RBD, but polysomnographic (PSG) monitoring did not document any sexual or nonsexual behaviors during REM sleep; only REM sleep without atonia was documented by PSG monitoring.
2 Age of sleepsex onset was known in 54.8% (17/31) of patients, and was unknown or not reported in 45.2% (14/31) of patients.
3 Duration of sleepsex reported on n=8 patients; n=8 had only one reported episode of sleepsex and n=1 had two reported episodes within 1 month, so duration is not applicable; n=14, duration not known.
4 Adult males assaulted 9 girls (8–15 years old [n=8], and a “teenage girl” [n=1]).
5 Confusional arousals [CAs] (n=24); Sleepwalking [SW] (n=21); Sleeptalking and vocalizations, sexual & nonsexual (n=15); Sleep terrors (n=7); REM sleep behavior disorder [RBD] (n=3); sleep related eating disorder (n=1). [A history of enuresis was not included in these data].
6 In all 3 patients with RBD, no behaviors (sexual or nonsexual) were documented in REM sleep. OSA=obstructive sleep apnea).
7 An additional patient with a DOA responded to clonazepam, but with remission maintained after clonazepam was discontinued. Another patient with a DOA did not respond to limited therapy consisting of low-dose (25 mg) clomipramine at bedtime. Therefore, these two cases were kept separate from the treatment outcome data. For the remaining n=17, treatment was not mentioned. [CPAP: continuous positive airway pressure].
8 Control of nocturnal seizures was achieved with anticonvulsant medications. N=2, treatment outcome was not mentioned.
A 34-year-old married man would spontaneously masturbate to ejaculation every night after he had been asleep 2–3 hours, and was not arousable. Nightly sleep masturbation occurred while he continued to engage in sexual intercourse with his wife every night before falling asleep. 20
A 27-year-old man “usually ‘awoke’ with an ejaculation between 02:00 and 06:00 during the preceding 5 years. He broke 2 fingers when he tore off the restraints he used to avoid moving in bed. He also slept in a different bed or on the floor in futile attempts to avoid the undesired masturbation. 3
A 26-year-old married woman had a history of abruptly tearing off her clothing and masturbating violently during the first half of the night. Her masturbation was associated with soft to loud vocalization and occasional vaginal discharge. If her husband interrupted the episode of masturbation, it might recur a second or a third time during the night. Any attempt to initiate intercourse after she was awakened was rejected, and she denied the behavior. 3
A 38-year-old woman “asked for professional help after her husband, to whom she was married for 2 months, had awoken repeatedly at night only to find his wife apparently masturbating in her sleep.” 4
A 26-year-old woman had soft to loud vocalizations during sleep masturbation. 3
A 27-year-old woman had sexual moaning during sleep at least three nights weekly for 15 years that would emerge within 15–20 minutes of sleep onset. 3
A 28-year-old woman had nightly sexual moaning and sexual fondling during sleep for 16 years that would appear within 20 minutes of falling asleep and disturb the sleep of her husband and children. 3
A 26-year-old woman would initiate foreplay with her bed partner while they were both asleep between 02:00 and 05:00 and would utter sexually provocative phrases while fondling him. Whenever he responded positively to her involuntary sexual overtures during sleep, she would then awaken and accuse him of forcing sex on her while she slept. 3
A 23-year-old man would attempt to remove his girlfriend's clothing and fondle her, without ejaculating, during the first part of the night. When he was awakened, he would be confused and disoriented. 3
An 18-year-old male was accused of putting his finger into the vagina of a nearby teenager at 6 a.m. while he was asleep with recent sleep deprivation. 3
A man would grab his wife's buttocks during sleep while “grinding her from behind” with rhythmic pelvic movements. 22
A 22-year-old man on two occasions within a month, while presumably asleep, fondled the breasts of one woman (before initiating intercourse), and inserted his fingers into the vagina of another woman (and when she asked him to stop, “he did so and left the room without incident”). 25
A 27-year-old man would frequently engage in cunnilingus on his wife while they both were asleep. 4
“During the episodes, the [27-year-old] patient typically procured his wife, achieving complete sexual intercourse with total amnesia…His wife remained in bed with him after the episodes.” 24
A 43-year-old man engaged in nightly episodes of amnestic sleepsex along with amnestic eating in his sleep. His current and previous girlfriends had sexual intercourse with him every night while he would be snoring and sound asleep for up to 30 minutes before ejaculation. Furthermore, “the repertoire of unconscious sexual activity by the patient was varied and included intercourse in different body positions, as well as oral sex, both given and received.” 2
A 38-year-old man for 12 years had sexually assaulted his spouse during sleep between 03:00 and 05:00 at irregular intervals, but at least once every 15 days. He would tear off his wife's clothes, fondle her, and initiate sexual intercourse. His wife observed that he was “not present” and “unresponsive” while acting violently, and one time attempted to choke her. 3
A 33-year-old man one night grabbed his wife in his sleep, tore off her bed clothes, and forced intercourse. Despite her active resistance, she could not “reach” him. He seemed “far away” and appeared “glassy-eyed.” 3
A woman whose husband would initiate and consummate sexual intercourse with her while asleep also described his total disregard for her menstrual status while engaging in sexsomnia; they never had engaged in sex during wakefulness while she was menstruating. 4
A woman described her husband as being more amorous and more aggressive during episodes of sexsomnia than during his wakeful sexual activity. On some nights “there is no stopping him.” Once when he grabbed her around the neck, she slapped him hard, which awakened him, and he immediately let go. 4
A man had his two current girlfriends independently confirm that he frequently engaged in sexsomnia. One girlfriend commented that he was a “different person” during sexsomnia, being a more amorous and gentle lover, and more oriented in sexually satisfying her. 2
A 29-year-old man for at least six years had sexually assaulted his bed partner and uttered profanities between 03:00 and 06:00 while he was asleep. He also moved his arms and legs excessively in sleep when he dreamt of fighting against “intruders.” 4
A 22-year-old man “after a night out drinking” fell asleep on the sofa in a separate room from a female (platonic) friend who an hour later “was woken suddenly feeling a hand fondling her breasts and then, in rapid succession, she felt his erect penis penetrating her anally, vaginally, and then being forced orally.” 25
A 41-year-old woman developed frequent, brief episodes of sleep related somatosensory seizures that responded to phenobarbital therapy for 2 years. One night 5 months after discontinuing phenobarbital she “was awakened by the electrical [seizure] discharge, now with paresthesia in the right lateral abdominal and pubic regions and about her genitalia. 28 A sensation of vaginal dilatation ensued immediately afterward, which inevitably brought about an orgasm, either pleasant or painful. During these episodes there was no confusion or memory loss…Normal marital sexual behavior was reported.” PSG with extensive sleep EEG documented 8 clinical seizures, with the first 4 emerging from slow wave sleep, and the remainder emerging from stages 1 and 2 sleep. The central-parietal regions exhibited sharp wave and spike paroxysmal activity followed by the patient awakening, with electrical sensations. Orgasm immediately ensued, with persistence of generalized paroxysmal EEG activity. Resumption of phenobarbital therapy immediately conrolled her seizures.
A 55-year-old woman had a 12-year history of “paroxysmal nymphomania” arising from sleep, when she awakened with “a feeling of being hot all over as if she were having coitus.” 29 She also had left somatosensory seizures and developed left hemiplegia.
A 31-year-old man with temporal lobe epilepsy had nocturnal attacks in which he would awaken with a stereotyped sequence of motor, sensory, and experiential symptoms that began with twitching of the forehead and face which progressed down to the neck and left arm, followed by the sensation of “being just like an orgasm” and “sexual and intensely pleasurable,” but never associated with ejaculation. 30 There was a dramatic response to diphenylhydantoin therapy, with total cessation of nocturnal attacks and orgasmic sensations.
A 45-year-old man with lifelong sleepwalking was awakened one night around 02:00 by the screaming of his 14-year-old daughter's girlfriend who was sleeping over at their home. She accused him of sexually fondling her while she was asleep. He was arrested that night, and claimed to be entirely amnestic for the episode. 2
An 18-year-old male with longstanding sleep terrors and sleepwalking was accused of placing his finger into the vagina of a female teenager who was sleeping in the vicinity. 4
A 39-year-old married man was charged with sexually touching his 9-year-old daughter while she was sleeping one night in bed with her parents, after leaving her own bed because of a nightmare. He claimed to have been sleeping at the time. He and his wife would often initiate sex with each other during sleep. 4
A 32-year-old man was accused of inserting a finger into the vagina of a 10-year-old girl, after falling asleep in bed with her (and another child) subsequent to drinking alcohol excessively and smoking marijuana. He had a history of sleeptalking, had one known episode of sleepwalking, and had a family history of parasomnia. 4
A man was accused by his 15-year-old daughter of kissing her breasts and penetrating her vagina with his finger while he was asleep, which his wife and ex-wife also reported his doing to them while he was asleep. 23
A 35-year-old man was accused by his 11- and 8-year-old daughters of touching their genitalia (without penetration) while they were all apparently asleep. 21
One woman commented that her boyfriend's sleepsex was more “aggressive and dominant” than his waking sexual behavior, and she “found some aspects of the sleepsex pleasurable…and a little kinky,” such as “forceful albeit playful biting and ‘talking dirty,‘ but “nonetheless she requested that the patient incorporate some of the nighttime sexual practices...into their conscious daytime lovemaking.” 2
Another woman “reported infrequent and hurried sex with her husband, whom she described as distant and reluctant during wakefulness. Nocturnal sex was more satisfactory to her, even if associated with bruises at times.” 3
A woman who slept with a sexsomniac boyfriend commented on how he was a “different person during these activities—apparently, he is a more amorous and gentle lover and more oriented toward satisfying his partner when he is asleep.” 4
A wife reported that her husband would initiate sex in his sleep about once monthly, during which times he would be “more aggressive and more amorous… than when he is awake.” 4
A 41-year-old woman with nocturnal somatosensory seizures would experience pleasurable (or painful) orgasms together with vaginal dilatation during her seizures. 28
A 31-year-old man with temporal lobe epilepsy would experience a sleep related “sensory phenomenon along with the twitching [that] was described as ‘being just like an orgasm…sexual and intensely pleasurable,” but without ejaculation being achieved. 30
A 32-year-old woman with an 18-year history of complex partial seizures developed sleep related hypersexuality arising from sleep that began 3 weeks after surgery. “She would wake in the middle of the night with intense sexual desire and rouse her husband. She stated a wish for her husband to have the same operation.” 27
A “wife had started to look forward to this happening,” referring to her husband's post-ictal (psychomotor attacks) hypersexuality that occasionally emerged from sleep. 31
disorientation upon awakening from sleep, as determined by the arresting police officers. (However, this could have been lingering intoxication after sharing 36 beers with his friend)
amnesia for the event (this also could have been due to intoxication)
presence of factors known to trigger sleepwalking—alcohol; fatigue; stress
no apparent attempt to conceal the crime
the crime was out of character for this person.
1 Covers the range of abnormal sleep related and sleep disorder-related sexual behaviors.
2 ICSD-2: International classification of sleep disorders, 2nd edition, 2005.
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