Now available on Amazon Kindle
Sherman's Mistress in Savannah

Sexsomnia (Sleep Sex)

Lawrence Martin, M.D.
Clinical Professor of Medicine
Case Western Reserve University School of Medicine, Cleveland
Board Certified in Pulmonary and Sleep Medicine

Sleep Home Page / Internet Sleep Links / Books about sleep disorders (with links to / Drugs for Sleep & Awake / Index of Dr. Martin's web sites

What is sexsomnia?

It is a parasomnia, similar to sleep walking, where people commit sexual acts while while sleeping or during an arousal from sleep. The perpetrator is not aware of his/her sexual aggression.

The International Classification of Sleep Disorders, 2nd Edition, states that parasomnias are "undesirable physical events or experiences that occur during entry into sleep, within sleep or during arousals from sleep...."basic drive states" can emerge in pathologic forms with the parasomnias, as seen with sleep related aggression and locomotion, sleep related eating disorder, and abnormal sleep related sexual behaviors [sexsomnia]."  Note that "arousals from sleep" in the definition of parasomnia means the subject is still not awake and that the behavior displayed is automatic. 

The ICSD goes on to state that "Parasomnias often involve complex, seemingly purposeful, and goal-directed behaviors, which presumably are performed with some personal meaning to the individual at the time, despite the illogical and unsound nature of the behaviors enacted outside the conscious awareness of the individual...Parasomnias involve sleep related behaviors and experiences over which there is no conscious deliberate control." (Italics added). Sleep walking is the best example of this type of parasomnia; sexsomnia and sleep eating are two other examples, each much less common than sleep walking. Even rarer is the parasomnia where sleep walkers have turned violent and killed other people - sleep murder. All these activities - simple sleep walking, sleep walking with aggression, sleep sex and sleep eating - are well-documented manifestations of abnormal behavior while sleeping.

Does sexsomnia involve just intercourse, or any type of sex?

Any sexual activity. A comprehensive literature review published in 2007 indentified all the different types of sexual activity that have been described while sleeping, including: sexual vocalizations/talking/ shouting, masturbation, fondling another person, sexual intercourse with and without orgasm, and agitated/assaultive behaviors. "Females almost exclusively engaged in masturbation and sexual vocalizations, whereas males commonly engaged in sexual fondling and sexual intercourese with females." The authors identifed 2 cases of sleep related homosexual behavior.

Do people who have "sleep sex" with another person remember the act once they are awake?

No. This is characteristic of the parasomnia. There is no memory of the event by the perpetrator. The victim relates what happened.

How is the diagnosis made?

Like sleep walking, sexsomnia is thought to occur during non-REM "deep sleep." This is the same stage in which sleep walking and sleep eating occur. (The other major stage, REM sleep, is where most dreams occur, but not this type of parasomnia.) However, almost all cases are based on the history provided by the victim of the sexual aggression, and the perpetrator's assertion that he (or she, in some cases) was sleeping and completely unaware of the act. There are a few cases studied in the sleep lab, where brain waves prove the subject was sleeping while becoming sexually aggressive.

Is sexsomnia a new condition?

It is a newly recognized condition, only since the mid 1990s. The first paper was apparently published in 1996 in Canada, by Drs. Colin Shapiro, Nik Trajanovic and Paul Fedoroff. (All references are listed below). A more recent and definitive medical publication is "Sexsomnia: a new parasomnia?" published in Canadian Journal of Psychiatry, June 2003. In 2007 Dr. Carlos Schenck and colleagues published a comprehensive literature review in the journal Sleep.

Is the public aware of this condition?

Not nearly as well as sleep walking, about which everyone is aware to some extent. The perpetrators are also unaware that they could be 'having sex' while asleep. According to information on, "when one discovers their own [sexual aggression], 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...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 [sexsomnia], these persons cannot expect others to believe that they have experienced unwanted sexual contact initiated by a sleeping individual."

Is it a real problem? Don't people who sleep together usually have sex?

For a small number of people and their victims/partners, yes, it can be a major problem. Undoubtedly many cases of sexsomnia are unreported because they occur between husband and wife, and are dealt with internally, ie, without anyone outside the home aware of the situation. But several cases have come forward that show people can be harmed by the activity (see Wikipedia article on Sleep Sex). The review article mentioned above, Sleep and Sex: What can go wrong?, notes that "Forensic consequences were common, occurring in 35.5% (11/31) of parasomnia cases, with most (9/11) involving minors."

Is there treatment?

Yes, the same types of therapy used to treat other parasomnias, like sleep walking and sleep eating. They include drugs and psychotherapy, plus avoiding precipitating factors and ensuring a safe environment. The medication type commonly used for treating parasomnias are benzodiazepines, such as Valium (diazepam) or Ativan (lorazepam). About half of the subjects with sexsomnia have some significant psychological problem (eg, anxiety stress disorder), so treatment of this is essential as well. Precipitating factors could be alcohol or drugs taken for sleep, such as Ambien and Lunesta, so a detailed history is vital to uncover and then exclude what might be causing the problem. As to environment, sleep walkers (who may or may not have sexsomnia) can hurt themselves if there are open bedroom windowns, stairs without gates or nearby bodies of water. Closing off these areas can help ensure a safe environment. Finally, there may be co-existing sleep problems that need treatment. Dr. Carlos Schenck, a pioneer in this field, discusses a case of sexsomnia that coexisted with obstructive sleep apnea (OSA) in a 32 year old man (in Casebook of Sleep Medicine, full reference below). The OSA was causing 'confusional arousals', which led him to sexually molest his wife almost every night, and this was causing her great distress. He had no memory of this activity, and the marriage was otherwise sound, with no problems. Treatment of his OSA with CPAP effectively treated the sexsomnia.

Has sexsomnia appeared in the lay media?

According to the Wikipedia article on sleep sex, over the past several years articles have appeared in Cosmopolitan, Redbook, Details, Newsweek. Wikipedia also mentions the following fictional cases that have been produced:
-- A case of sexsomnia is in the episode "Role Model" of the television series House, Season 1 Episode 17.
-- An episode of Law and Order: Special Victims Unit (season 9, episode 2, aired October 2, 2007) called Avatar featured a suspect with this disorder.
-- In Ralph Ellison's novel Invisible Man, a farmer claims to have had sex with his daughter while asleep (the novel was written in 1953, decades before the condition was described).

Where can I get more information about sexsomnia?


Dr. Michael Mangan, a psychologist, has both a web site ( and a book on the subject. His book is Sleepsex: Uncovered, Xlibris, 2001. From the publisher’s blurb on

Sleepsex: Uncovered is the first book to be published on sexual behavior that occurs during sleep, sheds light on questions such as, "How many people have sleepsex?" What causes it?" What be done about it if it is a problem?""What are the legal implications of sleepsex?" In plain language, Dr. Mangan summarizes what sleep experts have written on sleepsex, and provides a detailed and thoughtful analysis of over 60 persons´ first-hand experiences with sleepsex.

The following two books are comprehensive reviews of all of sleep medicine, and discuss sexsomnia only briefly. The ICSD 2nd edition includes sexsomnia in the section on parasomnias, portions of which are quoted above. The Casebook presents a single case, discussed in detail (and mentioned above), by Dr. Carlos Schenck at the University of Minn. Dr. Schenck is a psychiatrist who has perhaps done the most research on this diagnosis (see especially his 2007 review article, below).

The International Classification of Sleep Disorders, 2nd Edition. American Academy of Sleep Medicine, Westchester, IL, 2005.

Casebook of Sleep Medicine. A learning companion to the ICSD. American Academy of Sleep Medicine, Westchester, IL, 2008.

Web sites
Wikipedia article on sleep sex
Live Science: Have Sex While You Sleep
Discussion of treatment
Australian woman reported sleepwalking and having sex with strangers

Medical articles (in order of publication)

Shapiro CM, Fedoroff JP, Trajanovic N. Sexual behavior in sleep: A newly described parasomnia. Sleep Research 1996;25:367.

Rosenfeld DS, Elhajjar AJ. Sleepsex: A variant of sleepwalking. Archives of Sexual Behavior, 1998;27(3), 269-278.

Guilleminault C, Moscovitch A, Yuen K, Poyares D. Atypical sexual behavior during sleep. Psychosom Med 2002;64:328-36.

Shapiro, CM, Trajanovic N, Fedoroff JP.  Sexsomnia: A new parasomnia? Canadian Journal of Psychiatry 2003;48:311-317.

Mangan MA. A phenomenology of problematic sexual behavior occurring in sleep. Archives of Sexual Behavior, 2004;33(3), 287-93.

Schenck CH, Mahowald MW. Rapid eye movement and non-REM sleep parasomnias. Primary Psychiatry, 2005;12(8), 67-74.

Schenck CH.  Uncontrolled intimacy: sexual sleep disorders [case report].  Sleep Review 2007;8:24-28.

Mangan MA, Reips UD. Sleep, sex and the Web. Behav Res Methods 2007;39:233-36.

Schenck CH, Arnulf I, Mahowald MW. Sleep and sex: what can go wrong? A review of the literature on sleep related disorders and abnormal sexual behaviors and experiences. Sleep 2007;30:683-702.

Sleep Home Page / Internet Sleep Links / Books about sleep disorders (with links to / Drugs for Sleep & Awake / Index of Dr. Martin's web sites
Forward any comments to:

Copyright © 2008-2012, Lawrence Martin, M.D.