Sexsomnia Is Real, Sexy Sleepwalking Not So Much

Also called sleep sex, sexsomnia is a parasomnia, which puts it in the same category as sleepwalking, sleep talking, and sleep-related eating.

A man and a woman couple in bed cuddling. The man is leaned over pressing a kiss to the woman's neck.
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Sleep sex, or sexsomnia, is a rare sleep disorder that causes individuals to engage in sexual behavior during sleep without conscious control. Sexsomnia is a parasomnia, which puts it in the same category as sleepwalking, sleep talking, and night terrors. Those who experience sexsomnia often have no recollection of the behavior when they wake up.

Like other parasomnias, sexsomnia can be distressing not just for those suffering from the condition but for the person’s romantic partner and family.

If you suspect you or someone you know may experience sleep sex, you will want to speak to a doctor about how to get a diagnosis, plus available treatment options.

Recognize the symptoms of sleep sex

One common misconception about sleep sex is that it has to involve intercourse, but that is not the case. Other behaviors can indicate sexsomnia, so recognizing the symptoms of sexsomnia is the first step in understanding the parasomnia. Clinical psychologist and sleep medicine specialist Britney Blair says while cases of sexsomnia are rare, they occur when a form of sexual behavior happens while asleep with little or no recollection upon waking. “Sexsomnia symptoms include sexual behavior, so it could be anything from masturbating to fondling your bed partner,” says Blair.

Identify the root causes of sexsomnia

When it comes to risk factors for sexsomnia, Dr. Chris Winter, a neurologist, sleep medicine specialist, and host of the “Sleep Unplugged” podcast, notes there could be non-sexual warning signs that might help put someone in a higher-risk category. “Other parasomnias like sleepwalking, sleep talking, or sleep-related eating might be tip-offs that an individual could be at risk for sexsomnia,” he says.

Gender can also play a factor: A study presented at a meeting of the American Academy of Sleep Medicine found the prevalence of sexsomnia was almost three times higher in men than in women.

As with many sleep disorders, stress and mental health can exacerbate parasomnias, including increasing the risk of sleep sex. “It happens more often when people are stressed, depressed, anxious, or in general when something's off,” Blair says. “It can also occur more often with really bad sleep hygiene.”

Winter adds that the root of sexsomnia is often something that disrupts sleep. While this could be due to stress or depression, Winter says other causes may be another sleep disorder like sleep apnea, restless leg syndrome, or narcolepsy. Sexsomnia could also be triggered by alcohol use, shift work, a sudden change in sleep schedule, or mood disturbances, according to Winter.

Improve sleep hygiene to help manage sexsomnia

Sleep hygiene often plays a role in how well we sleep each night. This includes elements like keeping your bedroom cool, dark, and quiet, but sleep hygiene also incorporates our nighttime habits like a soothing wind-down routine and maintaining a consistent bedtime and wake-up time.

“For all of us, sleep hygiene is really important,” Blair says. “Trying to have a stable bedtime ritual that happens before bed, getting up at the same time every day, trying to avoid things like alcohol before bedtime. Basically, spending nine hours out of every 24 hours in a sacred resting space can improve sleep hygiene and sleep quality.”

She mentions that consistently getting poor sleep or insufficient sleep can increase the risk for any parasomnia, including sleep sex.

How therapy or medication can help manage sexsomnia and other parasomnias

According to Blair, some forms of therapy could be effective management tools, including cognitive-behavioral therapy (CBT). This form of therapy works to identify and address psychological or emotional factors that could be contributing to engaging in sexual activity while asleep. “It helps with figuring out what are the triggers and what can you do to mitigate those triggers,” Blair explains.

If sleep sex becomes a consistent, debilitating issue, it may be time to talk with your doctor. While behavioral changes like improved sleep hygiene can help, they may not be enough. “While we try to avoid meds, they can be necessary,” Winter explains. But he also points out that in some cases, common sleep medications can even be the cause of parasomnias like sexsomnia. In 2019, the FDA required some sleep-aid medications to include a warning of possible serious injury from experiencing parasomnias that involve engaging in activities while not fully awake.

When to seek out help for sleep disorders

Both Winter and Blair recommend seeking help from a sleep specialist for any sleep disorder or parasomnia, including sexsomnia. “You want to get someone board-certified in sleep medicine or behavioral sleep medicine,” Blair says. The process of managing sexsomnia involves identifying and managing triggers, which she says is best done with a sleep medicine specialist.

Blair also adds that seeking a diagnosis and treatment plan from a sleep specialist is important since not all medical doctors are trained in parasomnias. For sexsomnia, in particular, Winter recommends flagging any sexual behavior while sleeping with your doctor as soon as you’re aware of it, as any episodes with another person while asleep cannot be considered consensual sexual encounters.

Most asked sleep sex disorder questions and answers

What causes sleep sex or sexsomnia?

Parasomnias like sleep sex are often caused by sleep disruptors. This can include sleep disorders like sleepwalking, restless leg syndrome, or obstructive sleep apnea. Other factors like stress, depression, poor sleep hygiene, and alcohol or drug use could also increase the risk of developing sexsomnia.

How is sleep sex or sexsomnia diagnosed?

A diagnosis of sexsomnia comes from a clinical evaluation that could include a sleep study, reviewing the individual's sleep habits, and looking into the patient's medical history.

What are the symptoms of sleep sex or sexsomnia?

Sexsomnia is a parasomnia that presents itself with sexual behavior or sexual acts during sleep. Often the sleeper has little or no recollection of the behavior upon waking.

Can sleep sex or sexsomnia be treated?

Sexsomnia can be treated with lifestyle changes, medication, therapy, or a combination of any of these components. A sleep medicine specialist is the best option to determine which treatment method will be the most effective.

Is sleep sex dangerous?

Similar to how other parasomnias can be dangerous, it’s possible that an episode of sexsomnia could be detrimental, especially with non-consensual behavior. It’s important to seek treatment for sleep sex to prevent potential harm to oneself or others. Some instances of sexual assault are linked to cases of sexsomnia disorder.

How can someone manage sexsomnia?

How an individual can manage sexsomnia is best decided with a sleep medicine specialist. It’s possible that management will include medication, therapy, or lifestyle changes like improving sleep hygiene. Other solutions could be avoiding drugs and alcohol, stress management, and practicing relaxation techniques.