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Coming to Terms With Sexsomnia

Things are getting better. For my wife and I, at least.
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In September 2014, the author of this piece wrote a feature for Motherboard about living with sexsomnia, an obscure, albeit real diagnosis for sexualized sleep behavior. We thought we'd check in with him to see how he's doing.

I'd never heard of it before. I never even knew it was a thing, let alone an official medical diagnosis. I only knew that occasionally I got frisky with my wife while I was dead asleep. It's definitely not normal. But nothing about my sleep ever was.

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This was merely a recent development in a long list of issues I've dealt with most of my life. Before this, there were episodes of sleepwalking, night terrors, and insomnia. But unlike my other bedtime problems, what getting handsy in my sleep lacked in distress, it made up for in complexity.

My wife knows my sleep troubles well. She would usually welcome my clumsy seduction, most of the time half asleep herself, and we'd go with it. Other times she'd be amused, maybe slightly annoyed, and decline with the encounter ending there. It even became something we'd laugh about the next morning. Eventually, we'd share in the absurdity with our friends who'd laugh as well. One friend actually recognized the behavior and casually threw out the term "sexsomnia."

"Sexsomnia." It sounded too much like a passing trend. It was a little too perfect, a little too catchy. However, despite how it sounds, it's a very real medical diagnosis for sexualized behavior during sleep. And it can include anything from light touching to full-on intercourse, sometimes straining relationships to the point of divorce or even resulting in charges of sexual assault.

Concerning? It wasn't even a question.

I've felt something new after having an episode: shame

So I went to see a doctor who recommended a sleep study. It's the weird world we live in where you mine your personal life for interesting material. But I used the doctor visits and the sleep study as an opportunity to research sexsomnia in greater detail—both for my own understanding and the understanding of others. And with the research underway, I documented what I found.

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At its most basic level, a sexsomnia episode is the result of faulty electrical signals in the brain. While you're asleep, your pre-frontal cortex is offline. This is the part of the brain that handles decision-making and deeming actions right or wrong. Elsewhere, much deeper in the brain, you have central pattern generators that handle primal behaviors necessary for survival: fight or flight, eating, and of course, sex.

Interestingly, these central pattern generators are located very close to the part of the brain that controls sleep and wake functions. As you might suspect, this is where the trouble comes in. For someone who experiences sexsomnia, all it takes is being abruptly disturbed in a deep sleep, and an electrical signal that's supposed to tell you to wake up is telling you to procreate instead.

Knowing how this happens is one thing. But knowing what exactly causes it is something else entirely. That's where science comes up short. Further study is necessary to prove that sexsomnia is the result of genetics or, say, gender. Outside of that, we're simply left with what we know to trigger episodes.

In addition to having a history of sleepwalking, night terrors, or other parasomnias, three other factors make sexsomnia episodes more likely. Sleep deprivation is one. You have a greater chance to fall into a very deep sleep, and be abruptly awakened from it, when you haven't gotten enough. Another is alcohol. It's among the top causes for fragmented, troubled sleep. And the last big one is stress, admittedly a harder one to avoid altogether. But I found if I could manage these factors, I could essentially manage my sexsomnia, getting the number of episodes I continued to experience as close to zero as possible.

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After the sleep study, my doctor also prescribed a trial of Klonopin. Klonopin is an anti-anxiety sedative shown to be effective in treating sexsomnia over 70 percent of the time. But I didn't take it. For one, I'm always hesitant to take prescription medication, especially something like a sedative, on a daily basis with no end in sight. I also happened to Google search Klonopin right before I was about to try it. (A wealth of information is not always necessary or helpful when it comes to prescription drugs.) Plenty of people have positive experiences with these types of medications and genuinely do get better. Clearly, I went a different route.

Instead, I made time for meditation and exercise to manage stress. I limited my daily alcohol intake, reserving drinks for social occasions. I also did my best to get that golden seven to eight hours of sleep every night, not easy for someone like me. And then I assessed my sleep hygiene. This is a fancy term to describe how peaceful and free from technology your sleeping arrangement is. Having your phone by your bed or a TV in the room are some of the biggest offenders. I've since banished my phone, but haven't been able to part with the TV just yet. Much like sexsomnia research, my progress is slow. But it's progress nonetheless.

It's officially been one year and four months since I wrote about participating in a sleep study and being diagnosed with sexsomnia. Since then, I can count on one hand the number of sexsomnia episodes I've had. And while I got a lot better at preventing it, the way I reacted to the infrequent episodes took a different turn.

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Maybe it was that I learned so much researching sexsomnia when I initially wrote about it, but since then I've felt something new after having an episode: shame. Even though I know it's only a switching error where the electrical signals in my brain take a wrong turn. Even though I know the difference between appropriate and inappropriate while I'm awake. Even though I know I will never be able to prevent it 100 percent of the time. Even though I know none of my sexsomnia episodes have ever been violent or aggressive. There was still something deeply disconcerting about being immersed in it, in all the court cases and painful sexual assault allegations brought forth by victims, that made it feel like it should be happening to someone else.

Because while I might've laughed about it with my wife and my friends, there are many people dealing with sexsomnia claims who have not. There are ongoing court cases involving rape and appeals being granted, all raising extremely complicated questions and setting potentially dangerous precedents.

Sadly, people will most likely hear about sexsomnia in this context, until there's something newer to hear about first.

You'll Sleep When You're Dead is Motherboard's exploration of the future of sleep. Read more stories.

Listen to the Radio Motherboard episode about sleep hacking your room. The podcast is available on iTunes and on your favorite podcast app.