1225 Sexsomnia: A Case of Sleep Masturbation And Sleeping In An Open Work Environment

Abstract

Abstract Introduction Sleep sex or sexsomnia is classified in the International Classification of Sleep Disorders as a non-rapid eye movement (NREM) parasomnia. The overall prevalence is unknown but several conditions such as obstructive sleep apnea (OSA), shift work, and/or insufficient sleep have been reported as factors affecting the frequency of NREM parasomnias. Parasomnias, with sexsomnias in particular, can cause significant emotional distress to patients and their families. We present a case of co-morbid sexsomnia and OSA in a patient serving in the military that had the complicating factor of sleeping in open quarters. Report of Case A 40-year-old male in active duty military without significant past medical history or medication use presented to clinic with a two year history of disruptive sleep masturbation reported by wife. Patient’s wife reported no instances of attempted sexual intercourse. The patient had no recollection of the episodes. The frequency and nature of the episodes were causing personal and marital distress. Patient was also concerned about work responsibilities, since he was periodically required to sleep in open environments. After initial clinic evaluation, patient underwent a video polysomnography (vPSG) with an extended EEG montage. No parasomnia activity was captured on vPSG but patient was diagnosed with moderate OSA. He was started on continuous positive airway pressure (CPAP) therapy, resulting in decreased number of episodes with relapses corresponding to nights without CPAP usage. Conclusion Sexsomnia cases require careful history taking and evaluation. The nature of the episodes and the sleep environment of the patient must be examined for any medico-legal ramification as there are court precedents of sexual assault charges made in sexsomnia-related cases. The military environment is unique with group-sleeping conditions, often in austere environments. If sexsomnia were to be misinterpreted as indecent exposure, under the military code of conduct, this could have significant career implications.