Legal defenses attempt to use an arcane disorder, and we have to wonder if it is a valid disorder.

Sleep is usually a time of rest where only dreams may be present, according to popular thinking, but there are disorders of sleep that may be extremely distressing and present legal issues. These disorders are grouped in a specific category known as parasomnia.

Parasomnias are disruptions to regular sleep patterns that can happen during rapid eye movement (REM) sleep as well as other phases of the sleep cycle. Sexsomnia is a kind of sleep parasomnia that does not involve rapid eye movement (REM) sleep; it is a form of sleepwalking that causes amnestic sexual actions and causes great distress to both the person experiencing it and their partner.

It usually happens in the early half of the night and can have medicolegal consequences. Factors that put susceptible people at risk for engaging in this complicated behavior while sleeping include not getting enough sleep, having physical touch with a partner, and certain medications.

People who suffer from sexsomnia often find themselves engaging in sexually explicit actions while they sleep, including masturbation, aggressive sexual activity, and establishing sexual relations with others. They are indeed asleep when they make sexual noises and open their eyes, but they have no idea what they are doing when they are awake.

Estimating the prevalence of sexsomnia is challenging for medical professionals. Unless someone else observes the symptoms, the affected individual may be unaware that they are experiencing the sleep disorder. Symptoms were present in over 8% of patients visiting one sleep clinic.

Both the person experiencing sex insomnia and their partner may go through emotional and psychological pain as a result of it. Nevertheless, there is hope for treatment; depending on the root cause of the parasomnia, and it may involve medication or changes in lifestyle.

Who Is Most at Risk?

Men are three times more likely than women to show signs of sexsomnia, according to a study published in the American Academy of Sleep Medicine. Male behaviors are more obvious and even violent. Masturbation is more common among women.

Experiencing sexsomnia is not the only possible outcome of a disorder that prevents deep sleep. These sleep-sex behaviors may manifest in a person experiencing a sleep-wake state brought on by conditions such as heartburn, restless leg syndrome, or sleep apnea.

Also linked to sexsomnia are conditions such as epilepsy, migraines, head trauma, Crohn’s disease, and colitis. People with this disorder may experience an episode if they drink alcohol or use recreational drugs, according to the evidence. What about the legal consequences of this disorder?

Reports from the United Kingdom detail instances of rape involving sexsomnia. After several high-profile cases where individuals suspected of sexual offenses were either cleared or had their investigations abandoned due to the assertion of sexsomnia, the English and Welsh prosecutions department had previously promised to “robustly challenge” such allegations.

Some people have asserted their innocence by claiming they were sleepwalking when the alleged offense occurred; this includes suspects in cases of serial sexual violence and child abuse. According to sleep specialists, it's challenging to debunk such assertions.

For their failure to adequately contest a defendant’s assertion that he had not sexually assaulted a woman — rather, she had been experiencing sexsomnia and had actively participated while asleep — the Crown Prosecution Service (CPS) issued an apology and paid damages in a prominent case.

Despite the Crown Prosecution Service’s public pledge to better handle sexsomnia claims, a FOIA request has shown that the agency is unaware of the number of cases it has dropped or refused to file charges in during the last five years when sexsomnia was mentioned.

Are Medications Involved and What Treatments Are Used?

Patients should consider stopping using certain drugs, such zolpidem (Ambien), because they might cause NREM parasomnias. The patient should also address comorbid sleep disorders like insomnia.

Researchers explored the two most common interventions in the research, but methodological and design features may have led to questionable outcomes. The researchers examined case reports and 72 other papers covering the years 2009–2023 that dealt with the behavioral and psychological therapy of NREM parasomnias.

Therapists commonly used psychotherapy and hypnosis. Mindfulness activities, education, relaxation techniques, regular wake-up times, planned naps, and improved sleep hygiene were among the additional therapies.

Hypnosis, planned awakenings, sleep hygiene, and multicomponent cognitive behavioral therapy were among the methods that they found to have some evidence of efficacy.

The evidence from sleep center studies has established this disorder's presence. However, it is unclear whether someone may suffer from it. Because of this reason, it is still in legal limbo and leaves questions unanswered about what should be done when a crime of this nature is committed.