Sex dreams can be very hot or very awkward, but for the most part they're nothing more than entertaining because they live in your subconscious. Best-case scenario, you wake up a little bit horny and find your partner also wants morning sex. But some people will actually engage in sexual activity while they're asleep, which it turns out is a medical condition that deserves to be taken seriously.
It's very aptly called "sleep sex" or "sexsomnia," says Raj Dasgupta, MD, FAASM assistant professor of clinical medicine at Keck School of Medicine at the University of Southern California. Technically, sexsomnia actually belongs to a category of disorders known as parasomnia, which includes sleepwalking, nightmares, or sleep-eating, Dr. Dasgupta says. "These are unwanted behaviors, thoughts, and emotions that occur as you're transitioning between the different states of sleep, meaning that you're having inappropriate arousal," he says. Note that he's using "arousal" to mean waking up, not horniness.
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Similar to sleepwalking or sleep talking, sexsomnia occurs during the non-REM stage of sleep, during episodes called "confusion arousals," Dr. Dasgupta says. Someone with sexsomnia might grope, fondle, masturbate, or even have intercourse during this stage. Sexsomnia is more common in men than women, and it may be genetic, according to the International Society for Sexual Medicine. But there's a big difference between consciously wanting to have sex in the middle of the night, and uncontrollably doing it while you are asleep.
If someone can't remember the sex episodes when they wake up, that's a huge red flag that they might have sexsomnia, Dr. Dasgupta says. "If you remember that you did it, it's not parasomnia to begin with," he says. Unfortunately, sexsomnia is a "spicy topic," because people have claimed they have sexsomnia as a defense for sexual assault, while they may not have been diagnosed with sexsomnia by a doctor, he says.
The disorder can be tough to diagnose — because a big part of it includes not remembering that it happened. If someone has sexsomnia, they won't be able to remember their symptoms, so their sleeping partners tend to notice these behaviors first.
"Parasomnia in general is very under-diagnosed," Dr. Dasgupta says. "I'm sure there's a big degree of embarrassment, not because they're good people or bad people, but it isn't a thing you tell your doctor." (It probably doesn't come up at family dinners, either, which would preclude people from knowing if they're genetically pre-disposed.) Many individuals may have an isolated case of parasomnia, but if you have recurrent episodes, then you should see a doctor and figure out the underlying cause, he says.
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Doctors aren't exactly sure why people experience sexsomnia, but there are a few sleep disorders that are associated with confusion arousals, such as sleep apnea, Dr. Dasgupta says. "When you have these episodes, your body is consistently arousing because it's not getting air," he says. Drinking alcohol can also trigger an episode because it contributes to poorer sleep. In fact, being sleep-deprived in general can cause sexsomnia. "Everyone unfortunately is somewhat sleep-deprived nowadays, which means that we are definitely at risk for it." Certain medications, such as Ambien, can also be associated with sleepwalking or sexsomnia in some cases, he says.
Depending on the underlying cause, sexsomnia is treatable, Dr. Dasgupta says. Your doctor might examine the list of medications you take, and tell you to stop certain ones that could be causing it, he says. And if you have a bed partner, then it's important to protect them as well. For example, you may have to sleep in different rooms until it's treated. "The minute I suspect there's something that could hurt someone or affect someone emotionally or physically, it needs to be addressed," he says.
While it sounds erotic or funny to have "sleep sex," if you're not aware that it happened, and thus not totally in control of your actions, it's worth discussing with your doctor. Then, you'll be able to rest easy.
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