Abnormal Sexual Behavior During Sleep: Sexsomnia and More

Abstract

The purpose of the paper was to describe cases of abnormal sexual behavior during sleep in Saudi Arabian patients and classify them under the pertinent subtype. Patients diagnosed with abnormal sexual behavior during sleep received a clinical interview and underwent video-polysomnography recordings at the University Sleep Disorders Center, King Saud University Medical City, Riyadh. Three men and one woman between 27 and 46 years of age reported abnormal sexual behaviors during sleep, with duration of symptoms ranging from 4 months to 3 years. Episodes consisted of masturbation without seeking the participation of a sleeping partner (case no. 1), attempts at sexual intercourse with inappropriate and uncharacteristic vocalizations and behaviors (cases no. 2 and 3), and rapid eye movement (REM) behavior disorder (RBD) presenting with abnormal sexual behavior (case no. 4). The frequency of the episodes ranged from 1–3 per week to 2–3 per night. Cases 1, 2, and 3 were amnestic of these events and expressed surprise to their partners’ account of their behavior. However, case no. 4 had a full recall of the event. Sexsomnia (a non-REM parasomnia) is characterized by abnormal sexual behavior during sleep ranging from masturbation to inappropriate attempts at achieving sexual intercourse followed by total amnesia of the event. Nevertheless, REM behavioral disorder can, at times, present as abnormal sexual behavior during sleep, like sexual dream enactments, which may mimic sexsomnia. Therefore, the condition warrants diagnostic consideration as abnormal sleep-related sexual behavior.